益生菌制剂治疗肠易激综合征的Meta分析  

A meta-analysis of probiotics for the treatment of irritable bowel syndrome

作　　者：胡玥[1] 陶丽媛[1] 吕宾[1] 

机构地区：[1]浙江中医药大学附属第一医院消化科,杭州310006

出　　处：《中华内科杂志》2015年第5期445-451,共7页Chinese Journal of Internal Medicine

摘　　要：目的 采用Meta分析评价益生菌制剂对肠易激综合征（IBS）的临床疗效.方法 计算机检索PubMed、Cochrane Library、Embase、中国期刊全文数据库、中国生物医学文献数据库、万方数据库中关于益生菌制剂治疗IBS的RCT研究报道.文献检索时限均从建库至2014年8月31日.由两名评价人员按照Cochrane系统评价手册5.1.0标准独立筛选文献、提取资料和评价纳入的文献质量并交叉核对后,使用RevMan5.20软件对数据进行Meta分析.结果 共纳入17项RCT,1 700例患者.Meta分析结果显示：益生菌与安慰剂相比,在改善IBS总体症状（SMD=-0.20,95％ CI-0.33～-0.07,P=0.002）、腹痛/腹部不适（SMD=-0.19,95％ CI-0.29～-0.09,P＜0.001）、腹胀（SMD=-0.16,95％ CI-0.28～-0.03,P=0.020）、排便不适（SMD=-0.22,95％CI-0.42～-0.02,P=0.030）方面,两组差异均有统计学意义.但在总体生命质量评价（SMD=-0.08,95％ CI-0.07～0.23,P=0.290）及不良反应（RR =1.08,95％ CI0.79～1.49,P=0.630）方面,两组间差异无统计学意义.结论 益生菌制剂能改善患者IBS症状,具有一定临床疗效,且不良反应小,安全性好,但由于存在偏倚,仍需更多大规模、多中心、统一结局指标的临床RCT研究,进一步明确有效菌株,规范其用法、用量及疗程.Objective To evaluate the efficacy of probiotics to treat irritable bowel syndrome （IBS）.Methods Publications from database including PubMed,the Cochrane Library,Embase,CNKI,CBM and WanFang Data were searched up to August 31,2014.The randomized controlled trials （RCTs） on probiotics to treat IBS were eligible.The related articles were extracted and cross-checked independently by two reviewers.Methodological quality of trials was evaluated according to Cochrane Handbook 5.1.0 criteria.Meta-analysis was conducted using RevMan 5.2 software.Results A total of 17 RCTs involving 1 700 patients were included.Results of meta-analyses showed that compared with the placebo,probiotics was statistically better in improving the overall symptoms integral （SMD =-0.20,95% CI-0.33--0.07,P =0.002）,alleviating abdominal pain/discomfort （SMD =-0.19,95% CI-0.29--0.09,P 〈 0.001）,relieving abdominal distention （SMD =-0.16,95% CI-0.28--0.03,P =0.020）,and defecation discomfort （SMD =-0.22,95% CI-0.42--0.02,P =0.030）.There was no statistical significance in the overall quality of life （SMD =-0.08,95% CI-0.07-0.23,P =0.290） and adverse effect ratio （RR =1.08,95%CI0.79-1.49,P=0.630）.Conclusion Probiotics have beneficial effects on IBS,which can improve the patients＇ symptoms and with less adverse reaction.Due to the bias,further large-scale,multicenter and high-quality RCTs are required to unify outcome indicators,further define sensitive strain,and standardize its usage,dosage and course of treatment.

关 键 词：肠易激综合征 META分析 益生菌制剂 

分 类 号：R574.4[医药卫生—消化系统]