Meta-analysis of probiotics for the treatment of irritable bowel syndrome
Meta-analysis of probiotics for the treatment of irritable bowel syndrome
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DOI：
10.3748/wjg.14.2650
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发表时间：
2008-05-07
影响因子：
4.3
通讯作者：
Dublin, Sascha
中科院分区：
文献类型：
--
作者：
McFarland, Lynne V.;Dublin, Sascha
肠易激综合征（IBS）是一种影响3%-25%总人口的慢性疾病。由于没有有效的治疗方法，治疗的目的是减轻症状，往往收效甚微。由于在IBS中观察到正常肠道菌群的改变，益生菌（用于改善健康的有益微生物）可能有助于减轻症状。本文系统回顾了益生菌治疗肠易激综合征的随机、对照、盲法试验，并综合了高质量试验的疗效数据。检索了1982-2007年PubMed、Medline、谷歌Scholar、NIH临床试验注册、metareregister和Cochrane中央对照试验注册。我们还对参考文献列表、评论、评论、相关疾病的相关文章、书籍和会议摘要进行了二次检索。23个益生菌治疗组的20个试验，总共1404名受试者符合纳入标准。与安慰剂相比，益生菌的使用与整体IBS症状的改善相关[综合相对危险度（RRpooled） 0.77, 95%可信区间（95% CI） 0.62-0.94]。与安慰剂相比，益生菌也与较少的腹痛相关[RRpooled = 0.78(0.69-0.88)]。很少有研究报告了其他肠易激综合征症状或特定益生菌菌株的数据，无法估计综合的RR。虽然我们的分析表明，与安慰剂相比，益生菌的使用可能与IBS症状的改善有关，但考虑到相关研究的方法学局限性，这些结果应谨慎解释。益生菌作为肠易激综合征的潜在治疗方法值得进一步研究。(c) 2008年版权所有。
Irritable bowel syndrome (IBS) is a chronic condition affecting 3%-25% of the general population. As no curative treatment is available, therapy is aimed at reducing symptoms, often with little success. Because alteration of the normal intestinal microflora has been observed in IBS, probiotics (beneficial microbes taken to improve health) may be useful in reducing symptoms. This paper systematically reviews randomized, controlled, blinded trials of probiotics for the treatment of IBS and synthesizes data on efficacy across trials of adequate quality. PubMed, Medline, Google Scholar, NIH registry of clinical trials, metaRegister, and the Cochrane Central Register of Controlled Trials were searched from 1982-2007. We also conducted secondary searches of reference lists reviews, commentaries, relevant articles on associated diseases, books and meeting abstracts. Twenty trials with 23 probiotic treatment arms and a total of 1404 subjects met inclusion criteria. Probiotic use was associated with improvement in global IBS symptoms compared to placebo [pooled relative risk (RRpooled) 0.77, 95% confidence interval (95% CI) 0.62-0.94]. Probiotics were also associated with less abdominal pain compared to placebo [RRpooled = 0.78 (0.69-0.88)]. Too few studies reported data on other IBS symptoms or on specific probiotic strains to allow estimation of a pooled RR. While our analyses suggest that probiotic use may be associated with improvement in IBS symptoms compared to placebo, these results should be interpreted with caution, given the methodological limitations of contributing studies. Probiotics warrant further study as a potential therapy for IBS. (C) 2008 WJG. All rights reserved.