益生菌对成人溃疡性结肠炎的辅助疗效和安全性的Meta分析  

Efficacy and safety of probiotics in ulcerative colitis of adults-a Meta-analysis

作　　者：任越 许灵玲 鲁苗苗 程炜馨 周雨薇 金希[1] REN Yue;XU Lingling;LU Miaomiao;CHENG Weixin;ZHOU Yuwei;JIN Xi(Department of Gastroenterology,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China)

机构地区：[1]浙江大学医学院附属第一医院消化内科,杭州310003

出　　处：《浙江医学》2022年第3期289-295,共7页Zhejiang Medical Journal

摘　　要：目的评价益生菌对成人溃疡性结肠炎(UC)诱导缓解和维持缓解的有效性和安全性。方法通过在Medline、PubMed、Embase、Cochrane图书馆、中国知网数据库和万方数据库中进行详尽的检索(2010年1月至2021年7月),查找益生菌治疗成人UC的随机对照试验。由2位研究者按纳入、排除标准独立进行筛选文献、提取资料和方法学质量评价,采用Review Manager 5.3软件进行荟萃分析。结果共有9篇文献纳入荟萃分析。其中6篇文献评估了益生菌诱导活动期UC缓解的疗效,共计458例患者(益生菌组228例,安慰剂组230例),荟萃分析结果显示益生菌组缓解率47.4%明显高于安慰剂组缓解率36.9%,差异有统计学意义(RR=1.31,95%CI:1.04~1.65,P=0.02)。3篇文献评估了益生菌预防静止期UC复发的疗效,共计284例患者(益生菌组147例,安慰剂组137例),荟萃分析结果显示益生菌组预防率59.2%,安慰剂组预防率56.2%,两组比较差异无统计学意义(RR=1.09,95%CI:0.90~1.33,P=0.37)。安全性方面益生菌组不良反应发生率19.2%,安慰剂组不良反应发生率12.5%,两组比较差异无统计学意义(RR=1.00,95%CI:0.69~1.46,P=0.99)。结论益生菌联合常规药物治疗活动期UC较安慰剂可显著提高缓解率,但并不能减少静止期UC的复发率。益生菌制剂不良反应发生率和安慰剂组相当,安全可用。Objective To evaluate the efficacy and safety of probiotics in ulcerative colitis(UC).Methods Medline,PubMed,Embase,the Cochrane library,CNKI and Wanfang database were searched from January 2010 to July 2021 to find randomized controlled trials of probiotics in adults with ulcerative colitis.Two researchers independently screened the literature,extracted data,and evaluated methodological quality according to the inclusion and exclusion criteria,and Revman5.3 software was used for meta-analysis.Results Nine studies were included in the meta-analysis.Six studies evaluated the efficacy of probiotics in inducing remission of active UC involving 458 patients(228 in the probiotic group and 230 in the placebo group).The meta-analysis showed that the remission rate in the probiotic group was 47.4%,which was significantly higher than that in the placebo group(36.9%)(RR=1.31,95%CI:1.04-1.65,P=0.02).Three studies evaluated the efficacy of probiotics in preventing recurrence of quiescent UC in 284 patients(147 in the probiotic group and 137 in the placebo group).The meta-analysis showed that the prevention rate in the probiotic group and placebo group was 59.2%and 56.2%,respectively(RR=1.09,95%CI:0.90-1.33,P=0.37).The incidence of adverse events in probiotic group and placebo group was 19.2%12.5%,respectively(RR=1.00,95%CI:0.69-1.46,P=0.99).Conclusion Probiotics used with conventional drugs can improve the remission rate of active ulcerative colitis compared with placebo,but can not reduce the recurrence rate of quiescent ulcerative colitis.The incidence of adverse events of probiotics was equivalent to that of placebo group,it is safe to use probiotics.

关 键 词：溃疡性结肠炎 益生菌 荟萃分析 

分 类 号：R574.62[医药卫生—消化系统]