Zhou Xiangyu, Zhou Shuxi
Department of Rehabilitation Medicine, Second Affiliated Hospital of Chengdu Medical College and 416 Hospital of Nuclear Industry, Chengdu, Sichuan, China.
Medicine (Baltimore). 2025 Aug 8;104(32):e43662. doi: 10.1097/MD.0000000000043662.
The incidence of alcoholic liver disease (ALD) in China has been increasing in recent years, causing serious socioeconomic and public health burden. However, the treatment of ALD lacks a clear, unified, and effective plan. However, there is still lack of systematic analysis and evaluation of the efficacy and safety of probiotic in the treatment of ALD.
A computerized search was performed to identify randomized controlled trials of probiotic and combined probiotic therapy in alcohol-induced liver injury. The control group received placebo or conventional treatment. Retrieval period from database creation to January7, 2022. Both investigators independently searched literature, extracted data, and assessed risk of bias using RevMan 5.4 software and rated the quality of the level of evidence for the outcome indicators according to the GRADE criteria evaluation.
Altogether 10 studies with 835 patients were included. Meta-analysis showed significantly better liver function in test group than control group. The inflammatory level in the experimental group was significantly lower than that in the control group. The intestinal flora of the experimental group was effectively improved. But only Bifidobacteria and Lactobacilli were indigenous; meta-analysis showed that the adverse reactions in the experimental group were slightly higher than those in the control group, but the results were insignificant. Current evidence shows that compared with conventional therapy, probiotic or probiotic combination therapy can effectively improve liver function, modulate the gut microbiota environment, and reduce inflammation in alcoholic liver by modulating the gut microbiota, but the safety needs further investigation. There are limitations in the quantity and quality of the included trials.
This study shows that the use of probiotics therapy has a good regulating effect on liver function, intestinal flora, inflammatory level, and blood lipid level in ALD patients.
近年来，中国酒精性肝病（ALD）的发病率不断上升，造成了严重的社会经济和公共卫生负担。然而，ALD的治疗缺乏明确、统一且有效的方案。此外，对于益生菌治疗ALD的疗效和安全性仍缺乏系统的分析和评估。
通过计算机检索，识别益生菌及联合益生菌疗法治疗酒精性肝损伤的随机对照试验。对照组接受安慰剂或常规治疗。检索时间段为从数据库建立至2022年1月7日。两位研究者独立检索文献、提取数据，并使用RevMan 5.4软件评估偏倚风险，根据GRADE标准评估对结局指标的证据水平质量进行评级。
共纳入10项研究，835例患者。荟萃分析显示，试验组肝功能显著优于对照组。试验组炎症水平显著低于对照组。试验组肠道菌群得到有效改善。但仅双歧杆菌和乳酸杆菌为本土菌；荟萃分析显示，试验组不良反应略高于对照组，但结果无统计学意义。现有证据表明，与传统疗法相比，益生菌或益生菌联合疗法可通过调节肠道菌群有效改善肝功能、调节肠道微生物群环境并减轻酒精性肝病中的炎症，但安全性有待进一步研究。纳入试验的数量和质量存在局限性。
本研究表明，益生菌疗法对ALD患者的肝功能、肠道菌群、炎症水平和血脂水平具有良好的调节作用。
