酪酸梭菌治疗肠易激综合征疗效的Meta分析  

The clinical efficacy of Clostridium butyricum in treatment of irritable bowel syndrome: a Meta-analysis

作　　者：余思芸 何平[1] 任宁川 房殿亮 YU Siyun;HE Ping;REN Ningchuan;FANG Dianliang(Department of Gastroenterology,Yongchuan Hospital of Chongqing Medical University»Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院消化内科

出　　处：《中国微生态学杂志》2019年第12期1402-1408,共7页Chinese Journal of Microecology

基　　金：重庆市教委科学技术研究项目(KJ1600215)

摘　　要：目的系统评价酪酸梭菌治疗肠易激综合征(irritable bowel syndrome,IBS)的临床疗效。方法计算机检索PubMed、Embase、the Cochrane Library,维普、万方、中国知网和中国生物医学文献数据库,收集建库至2019年5月1日前国内外公开发表的关于酪酸梭菌治疗IBS的随机对照试验。由两位研究员独立进行筛选、资料提取及质量评价,采用RevMan 5.3软件进行Meta分析。结果最终纳人19篇随机对照试验,共2194例患者。Meta分析结果显示:酪酸梭菌辅助治疗IBS时.联合治疗组的总有效率明显高于对照组(93.4%as 77.1%,OR=4.32,95%CI 3.09-6.04,P<0.05);而单用酪酸梭菌治疗IBS疗效并不优于常规药物(7&8%as 68.9%,OR=2.05,95¼CI 0.96-4.38,P=0.06);且联合用药短期复发率显著降低(14.6%as 29.2%,OR=0.41,95%CI 0.20~0.85,P=0.02)。纳入的所有研究均无严重不良反应发生。结论单用酪酸梭菌与常规药物治疗IBS相比,酪酸梭菌并未显示出更好的疗效。而采用口服酪酸梭菌辅助治疗IBS可显著提高患者的临床疗效、降低复发率•且安全性好。Objective To systematically evaluate the clinical efficacy of Clostridium butyricum in the treatment of irritable bowel syndrome(IBS). Methods Relevant randomized controlled trials(RCTs) published before May 1, 2019 were collected by searching PubMed, Embase, the Cochrane Library, VIP, Wan Fang Data, CNKI and CBM. Two independent researchers used RevMan 5.3 to perform statistical analysis on the basis of literature screening, data extraction and quality evaluation. Results Nineteen RCTs consisting of 2,194 patients were included. The result of the analysis indicated that when Clostridium butyricum was used as an adjuvant therapy for IBS, the total efficacy rate of the treatment group was significantly higher than that of the control group(93.4% vs 77.1%, OR=4.32, 95% CI 3.09-6.04, P<0.05). However, there was no statistically significant difference in the total efficacy rate between the treatment group with Clostridium butyricum alone and the control group(78.8% vs 68.9%, OR=2.05, 95% CI 0.96-4.38, P=0.06). The short-term recurrence rate of the combined drugs significantly reduced(14.6% vs 29.2%, OR=0.41, 95% CI 0.20-0.85, P=0.02). No serious adverse reactions occurred in all the included studies. Conclusion Clostridium butyricum alone did not show better efficacy compared with conventional drug treatment for IBS. However, Clostridium butyricum as an adjuvant treatment for IBS can significantly improve the clinical efficacy and reduce the recurrence rate. It is safe and worthy of clinical application.

关 键 词：酪酸梭菌 肠易激综合征 META分析 

分 类 号：R574.4[医药卫生—消化系统]