益生菌预防和治疗支气管哮喘的系统评价  

Probiotics for Prevention and Treatment of Bronchial Asthma: A Systematic Review

作　　者：何敏[1] 王婷[1] 张红萍[2] 贾春娥[2] 熊星宇[1] 王刚[2] 姬郁林[1] 

机构地区：[1]四川大学华西医院呼吸内科,成都610041 [2]四川大学华西医院中西医结合科呼吸组,成都610041

出　　处：《中国循证医学杂志》2012年第4期460-469,共10页Chinese Journal of Evidence-based Medicine

基　　金：国家自然科学基金资助项目(项目编号30971326;81171320)

摘　　要：目的系统评价益生菌(合生元)对预防和治疗支气管哮喘(简称哮喘)的疗效和安全性。方法计算机检索PubMed、EMbase、Web of Science、OVID和Cochrane图书馆等电子数据库,检索时限从建库至2011年8月,查找益生菌预防或治疗哮喘患者的随机对照试验(RCT)。对符合条件的RCT,由两位评价员独立进行资料提取、质量评价并交叉核对后,采用RevMan 5.1软件进行Meta分析。结果共纳入益生菌预防哮喘的RCT 11个(n=3 656),益生菌治疗哮喘的RCT 5个(n=430)。预防性研究Meta分析结果显示,与安慰剂比较,益生菌在预防哮喘[RR=0.76,95%CI(0.47,1.22),P=0.25]和喘息发生[RR=0.92,95%CI(0.62,1.39),P=0.71]方面,差异无统计学意义。治疗性研究Meta分析结果显示,与安慰剂比较,益生菌能延长哮喘无症状持续时间[RR=1.48,95%CI(1.20,1.76),P<0.000 1]。所有的RCT均无严重不良事件报道。结论现有证据尚不足以支持益生菌对哮喘的发生有预防作用,但益生菌治疗可能延长儿童哮喘无症状持续时间,在一定程度可能具有改善肺功能的作用,但不能减少哮喘的急性发作,且亦未在改善免疫功能方面显示优势。Objective To systematically assess the efficacy and safety of probiotics in prevention and treatment of bronchial asthma.Methods Randomized controlled trials（RCTs） of probiotics in prevention/treatment of asthma compared with placebo were searched in PubMed,EMbase,Web of Science,OVID and The Cochrane Library published before August 2011.The quality of the included RCTs was evaluated and the data were extracted by two assessors independently.Meta-analyses were performed with RevMan 5.1 software.Results Eleven RCTs on probiotics preventing asthma（n=3 656） and 5 RCTs on probiotics treating asthma（n=430） were identified.The Meta-analyses on preventing asthma showed that probiotics didn＇t statistically decease the incidence of asthma（RR=0.76,95%CI 0.47 to 1.22,P=0.25） and asthma-like wheezing（RR=0.92,95%CI 0.62 to 1.39,P=0.71） compared with placebo.The Meta-analyses on treating asthma indicated that probiotics could prolong free episodes of asthma（RR=1.48,95%CI 1.20 to 1.76,P0.000 1） in comparison with placebo.No severe adverse events were found in all included studies.Conclusion The present evidence is not strong enough to prove that probiotics is effective to prevent asthma,but it may prolong free episodes of asthma.Although it seems to have the effect on improving lung function,it fails to reduce the acute onset of asthma and has no have the advantage of improving immune function.

关 键 词：益生菌 预防 治疗 支气管哮喘 系统评价 META分析 

分 类 号：R562.25[医药卫生—呼吸系统]