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益生菌在肠易激综合征管理中的疗效:一项系统评价与荟萃分析。

Efficacy of Probiotics in the Management of Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis.

作者信息

Almabruk Bandar A, Bajafar Ali A, Mohamed Ahmed N, Al-Zahrani Saleh A, Albishi Naif M, Aljarwan Rafeef, Aljaser Rola A, Alghamdi Lama I, Almutairi Turki S, Alsolami Almas S, Alghamdi Joud K

机构信息

Internal Medicine, King Salman Hospital, Riyadh, SAU.

General Practice, King Abdullah Medical Complex, Jeddah, SAU.

出版信息

Cureus. 2024 Dec 18;16(12):e75954. doi: 10.7759/cureus.75954. eCollection 2024 Dec.

Abstract

Irritable bowel syndrome (IBS) significantly impacts quality of life. Probiotics offer relief by modulating gut microbiota, but variability in outcomes necessitates a systematic evaluation of their efficacy. This study aims to evaluate the efficacy of probiotics in improving symptoms of IBS through a systematic review and meta-analysis. A comprehensive search of PubMed and Google Scholar identified studies published between 2014 and 2018. Inclusion criteria focused on randomized controlled trials evaluating probiotics in adult IBS patients diagnosed using standardized criteria. Statistical analysis utilized random effects models to account for heterogeneity, with subgroup analysis performed for IBS subtypes. This review included 23 studies involving 3,288 participants. Probiotics significantly reduced abdominal pain (mean difference = -1.66, 95% CI = -2.39 to -0.93, p < 0.0001) and bloating (mean difference = -2.13, 95% CI = -3.96 to -0.30, p = 0.0224). Improvement in stool habits was significant (mean difference = -1.52, 95% CI = -2.15 to -0.88, p < 0.0001), particularly in diarrhea-predominant IBS. Quality of life improved significantly, with a mean increase of 8.77 points (95% CI = 0.91 to 16.64, p = 0.028). Adverse events were mild and infrequent. However, heterogeneity was high (I² > 90%), reflecting variability in study protocols. Probiotics are effective in reducing IBS symptoms and improving quality of life, mainly in diarrhea-predominant IBS. More research should be conducted that focuses on standardized, long-term trials to refine treatment strategies.

摘要

肠易激综合征(IBS)对生活质量有显著影响。益生菌通过调节肠道微生物群提供缓解,但结果的变异性需要对其疗效进行系统评估。本研究旨在通过系统评价和荟萃分析评估益生菌改善IBS症状的疗效。对PubMed和谷歌学术进行全面检索,确定了2014年至2018年发表的研究。纳入标准侧重于评估使用标准化标准诊断的成年IBS患者中益生菌的随机对照试验。统计分析采用随机效应模型来考虑异质性,并对IBS亚型进行亚组分析。本综述纳入了23项研究,涉及3288名参与者。益生菌显著减轻腹痛(平均差值=-1.66,95%置信区间=-2.39至-0.93,p<0.0001)和腹胀(平均差值=-2.13,95%置信区间=-3.96至-0.30,p=0.0224)。排便习惯改善显著(平均差值=-1.52,95%置信区间=-2.15至-0.88,p<0.0001),尤其是在以腹泻为主的IBS中。生活质量显著改善,平均提高8.77分(95%置信区间=0.91至16.64,p=0.028)。不良事件轻微且不常见。然而,异质性较高(I²>90%),反映了研究方案的变异性。益生菌在减轻IBS症状和改善生活质量方面有效,主要是在以腹泻为主的IBS中。应开展更多侧重于标准化长期试验的研究,以完善治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2571/11741147/c1da417f7d63/cureus-0016-00000075954-i01.jpg

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