中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2015年
5期
445-451
,共7页
肠易激综合征%Meta分析%益生菌制剂
腸易激綜閤徵%Meta分析%益生菌製劑
장역격종합정%Meta분석%익생균제제
Irritable bowel syndrome%Meta-analysis%Probiotics
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.
目的 採用Meta分析評價益生菌製劑對腸易激綜閤徵(IBS)的臨床療效.方法 計算機檢索PubMed、Cochrane Library、Embase、中國期刊全文數據庫、中國生物醫學文獻數據庫、萬方數據庫中關于益生菌製劑治療IBS的RCT研究報道.文獻檢索時限均從建庫至2014年8月31日.由兩名評價人員按照Cochrane繫統評價手冊5.1.0標準獨立篩選文獻、提取資料和評價納入的文獻質量併交扠覈對後,使用RevMan5.20軟件對數據進行Meta分析.結果 共納入17項RCT,1 700例患者.Meta分析結果顯示:益生菌與安慰劑相比,在改善IBS總體癥狀(SMD=-0.20,95％ CI-0.33～-0.07,P=0.002)、腹痛/腹部不適(SMD=-0.19,95％ CI-0.29～-0.09,P＜0.001)、腹脹(SMD=-0.16,95％ CI-0.28～-0.03,P=0.020)、排便不適(SMD=-0.22,95％CI-0.42～-0.02,P=0.030)方麵,兩組差異均有統計學意義.但在總體生命質量評價(SMD=-0.08,95％ CI-0.07～0.23,P=0.290)及不良反應(RR =1.08,95％ CI0.79～1.49,P=0.630)方麵,兩組間差異無統計學意義.結論 益生菌製劑能改善患者IBS癥狀,具有一定臨床療效,且不良反應小,安全性好,但由于存在偏倚,仍需更多大規模、多中心、統一結跼指標的臨床RCT研究,進一步明確有效菌株,規範其用法、用量及療程.
목적 채용Meta분석평개익생균제제대장역격종합정(IBS)적림상료효.방법 계산궤검색PubMed、Cochrane Library、Embase、중국기간전문수거고、중국생물의학문헌수거고、만방수거고중관우익생균제제치료IBS적RCT연구보도.문헌검색시한균종건고지2014년8월31일.유량명평개인원안조Cochrane계통평개수책5.1.0표준독립사선문헌、제취자료화평개납입적문헌질량병교차핵대후,사용RevMan5.20연건대수거진행Meta분석.결과 공납입17항RCT,1 700례환자.Meta분석결과현시:익생균여안위제상비,재개선IBS총체증상(SMD=-0.20,95％ CI-0.33～-0.07,P=0.002)、복통/복부불괄(SMD=-0.19,95％ CI-0.29～-0.09,P＜0.001)、복창(SMD=-0.16,95％ CI-0.28～-0.03,P=0.020)、배편불괄(SMD=-0.22,95％CI-0.42～-0.02,P=0.030)방면,량조차이균유통계학의의.단재총체생명질량평개(SMD=-0.08,95％ CI-0.07～0.23,P=0.290)급불량반응(RR =1.08,95％ CI0.79～1.49,P=0.630)방면,량조간차이무통계학의의.결론 익생균제제능개선환자IBS증상,구유일정림상료효,차불량반응소,안전성호,단유우존재편의,잉수경다대규모、다중심、통일결국지표적림상RCT연구,진일보명학유효균주,규범기용법、용량급료정.
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.
