复方嗜酸乳杆菌联合不同解痉剂治疗腹泻型肠易激综合征有效性和安全性的系统评价  

Efficacy and Safety of Compound Lactobacillus Acidophilus Combined with Different Antispasmodic Agents in the Treatment of Diarrhea Irritable Bowel Syndrome: A Systematic Review

作　　者：李代晓 李慧博[1] 邢亚兵[1,3] 赵荣生 LI Daixiao;LI Huibo;XING Yabing;ZHAO Rongsheng(Dept.of Pharmacy,Peking University Third Hospital,Beijing 100191,China;Dept.of Pharmacy,the Affiliated Hospital of Chengde Medical College,Hebei Chengde 067000,China;Dept.of Pharmacy,Children’s Hospital Affiliated to Zhengzhou University,Zhengzhou 450018,China)

机构地区：[1]北京大学第三医院药剂科,北京100191 [2]承德医学院附属医院药学部,河北承德067000 [3]郑州大学附属儿童医院药学部,郑州450018

出　　处：《中国医院用药评价与分析》2022年第12期1513-1516,1521,共5页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:系统评价复方嗜酸乳杆菌辅助治疗腹泻型肠易激综合征(IBS-D)的有效性和安全性。方法:检索PubMed、Embase、the Cochrane library、中国生物医学文献服务系统、中国知网、万方数据库及维普数据库等,收集复方嗜酸乳杆菌治疗IBS的随机对照试验,检索日期截至2022年1月。按照纳入与排除标准筛选文献、提取资料并进行质量评价,应用RevMan 5.3软件进行Meta分析。结果:纳入13项随机对照试验,涉及1 394例患者。Meta分析结果显示,复方嗜酸乳杆菌联合不同解痉剂(曲美布汀、匹维溴铵、奥替溴铵)治疗IBS-D的总有效率高于单纯使用曲美布汀(OR=3.47,95%CI=1.73~6.94)、单纯使用匹维溴铵(OR=3.94,95%CI=2.45~6.35)、单纯使用奥替溴铵(OR=6.26,95%CI=3.21~12.22),差异均有统计学意义(P<0.05)。在改善IBS-D临床症状方面,与单纯使用解痉剂比较,联合应用复方嗜酸乳杆菌能显著降低腹痛评分(MD=-0.33,95%CI=-0.38~-0.27)、腹泻评分(MD=-0.32,95%CI=-0.39~-0.26)、大便性状异常化率(MD=-0.20,95%CI=-0.26~-0.14),减少日均排便次数(MD=-1.74,95%CI=-2.14~-1.34),差异均有统计学意义(P<0.05)。联合应用复方嗜酸乳杆菌与单纯使用解痉剂的不良反应发生率比较,差异无统计学意义(OR=1.07,95%CI=0.51~2.25,P=0.85)。结论:复方嗜酸乳杆菌辅助治疗IBS-D具有一定的作用,且安全性良好。OBJECTIVE: To systematically evaluate the efficacy and safety of Compound lactobacillus acidophilus in the adjuvant treatment of diarrhea irritable bowel syndrome(IBS-D). METHODS: Randomized controlled trials about Compound lactobacillus acidophilus in the treatment of IBS were retrieved from the PubMed, Embase, the Cochrane library, CBM, CNKI, Wanfang Data and VIP up to Jan. 2022. After literature screening according to inclusion and exclusion criteria, data extraction and quality evaluation, Meta-analysis was performed by using RevMan 5.3 software. RESULTS: A total of 13 RCTs were included, involving 1 394 patients. Results of Meta-analysis showed that the total effective rate of Compound lactobacillus acidophilus combined with different antispasmodic agents(trimebutine, pinaverium bromide, otilonium bromide) in the treatment of IBS-D was higher than that of trimebutine alone(OR=3.47,95%CI=1.73-6.94), pinaverium bromide alone(OR=3.94,95%CI=2.45-6.35), otilonium bromide alone(OR=6.26,95%CI=3.21-12.22), with statistical significance(P<0.05). In terms of improving the clinical symptoms of IBS-D, compared with antispasmodic agents alone, it combined with Compound lactobacillus acidophilus could significantly reduce the abdominal pain score(MD=-0.33,95%CI=-0.38--0.27), diarrhea score(MD=-0.32,95%CI=-0.39--0.26), abnormal stool frequency(MD=-0.20,95%CI=-0.26--0.14), and decreased average daily defecation times(MD=-1.74,95%CI=-2.14--1.34), with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between combined with Compound lactobacillus acidophilus and antispasmodic agents alone(OR=1.07,95%CI=0.51-2.25,P=0.85).CONCLUSIONS: Compound lactobacillus acidophilus might have certain value in the adjuvant treatment of IBS-D,and have good safety.

关 键 词：复方嗜酸乳杆菌 腹泻型肠易激综合征 解痉剂 有效性 安全性 

分 类 号：R975[医药卫生—药品]