双歧杆菌预防龋病有效性和安全性的系统评价与Meta分析  

Efficacy and safety of Bifidobacteria in preventing caries:a systematic review and meta⁃analysis

作　　者：郝思远 王甲河 张晓奇 邹静[2] 王艳[2] HAO Siyuan;WANG Jiahe;ZHANG Xiaoqi;ZOU Jing;WANG Yan(State Key Laboratory of Oral Diseases,National Clinical Research for Oral Diseases,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China;State Key Laboratory of Oral Diseases,National Clinical Research Center for Oral Diseases,Department of Pediatric Dentistry,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病研究国家重点实验室,国家口腔疾病临床研究中心,四川大学华西口腔医院,四川成都610041 [2]口腔疾病研究国家重点实验室,国家口腔疾病临床研究中心,四川大学华西口腔医院儿童口腔科,四川成都610041

出　　处：《口腔疾病防治》2021年第4期241-248,共8页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金项目(81600864)。

摘　　要：目的系统评价双歧杆菌预防龋病的有效性和安全性。方法计算机检索PubMed、Embase、The Cochrane Library、Web of Science、Scopus、Clinicaltrials、CNKI、WanFang Data和VIP数据库,时限均为从建库至2020年4月,并通过手工检索进行补充。使用RevMan 5.4软件进行Meta分析。结果最终纳入10个随机对照试验(randomized controlled trial,RCT)研究,518例受试者,其中干预组262例,对照组256例。系统评价和Meta分析结果显示:双歧杆菌组唾液中的变异链球菌计数与对照组相比差异无统计学意义[SMD=⁃0.31,95%CI(⁃0.66,0.04),P=0.08][RR=0.53,95%CI(0.17,1.66),P=0.28];两组唾液中的乳酸杆菌计数差异无统计学意义[SMD=⁃0.07,95%CI(⁃0.39,0.26),P=0.69][RR=0.87,95%CI(0.59,1.29),P=0.50];牙菌斑中的变异链球菌和乳酸杆菌计数差异无统计学意义;乳牙龋坏发生率差异也无统计学意义;本文所纳入的10个RCT中,有3个研究并未报道是否发生不良事件,5个研究无不良反应,2个研究报道胃肠不适2例。结论当前证据显示双歧杆菌不能有效降低唾液和牙菌斑中的变异链球菌计数和乳酸杆菌计数,也不能降低乳牙龋坏的发生率,其安全性也有待进一步考量。Objective To systematically evaluate the efficacy and safety of Bifidobacteria in preventing caries.Methods Databases including PubMed,Embase,The Cochrane Library,Web of Science,Scopus,Clinicaltrials.gov,CNKI,WanFang Data and VIP were electronically searched from inception to April 2020 to collect randomized controlled trials of Bifidobacterium for caries.Meta⁃analysis was performed using Revman 5.4 software.Results In total,10 ran⁃domized controlled trials(RCT)of 518 patients,including 262 in the test group and 256 in the control group,were included.Meta⁃analysis results reveal no statistically significant differences in salivary Streptococcus mutans counts(SMD=⁃0.31,95%CI⁃0.66 to 0.04,P=0.08)(RR=0.53,95%CI 0.17 to 1.66,P=0.28)and salivary Lactobacilli counts(SMD=⁃0.07,95%CI⁃0.39 to 0.26,P=0.69)(RR=0.87,95%CI 0.59 to 1.29,P=0.50).No statistical differences in the counts of Streptococcus mutans and Lactobacillus counts were noted in dental plaque,and no statistical difference in the occurrence of caries in deciduous teeth.Three of the 10 RCTS included in this study did not report adverse events,5 had no adverse reactions,and 2 reported gastrointestinal discomfort.Conclusion Current evidence suggests that Bifidobacteria do not effectively reduce Streptococcus mutans counts and Lactobacillus counts in saliva and dental plaque,or reduce the occurrence of caries in deciduous teeth.The safety of this treatment also requires further investigation.

关 键 词：龋病 双歧杆菌 变异链球菌 乳酸杆菌 系统评价 META分析 随机对照试验 

分 类 号：R782.6[医药卫生—口腔医学]