Synbiotics for Prevention and Treatment of Atopic Dermatitis A Meta-analysis of Randomized Clinical Trials
Synbiotics for Prevention and Treatment of Atopic Dermatitis A Meta-analysis of Randomized Clinical Trials
复制标题
DOI：
10.1001/jamapediatrics.2015.3943
复制
发表时间：
2016-03-01
期刊：
影响因子：
26.1
通讯作者：
Garcia-Romero, Maria T.
中科院分区：
文献类型：
--
作者：
Chang, Yung-Sen;Trivedi, Michelle K.;Garcia-Romero, Maria T.
特应性皮炎（AD）是一种高度流行的疾病，可能与胃肠道微生物群的改变有关，从而促进免疫环境更容易发生过敏性疾病。合生元是益生元和益生菌的混合物，已被用于AD的预防和治疗。目的探讨合生元在AD一级预防和治疗中的疗效。资料来源PubMed/MEDLINE、EMBASE、科克伦对照试验中心注册库和CAB摘要存档检索数据库，检索时间从所有数据库建立之日起至2015年10月15日。研究选择我们包括所有已发表的合生元预防和/或治疗AD的随机临床试验。为了纳入，出版物需要明确定义干预措施为合生元口服给药（益生菌和益生元的组合），并且必须包括AD疾病严重程度的评估，例如特应性皮炎严重程度评分（SCORAD）指数，或AD的发生率作为结局指标。在257个初步确定的研究中只有8个（3%）符合选择标准。数据提取和综合数据提取由多个观察者独立完成并交叉检查以避免错误。根据科克伦指南对所选研究的质量进行严格检查。主要结果和测量主要结果是SCORAD指数（治疗研究）和AD的相对风险（预防研究）。结果筛选出6项治疗研究（369名儿童入组;年龄0个月至14岁）和2项预防研究（1320名儿童入组;一项研究中年龄最大为6个月，
IMPORTANCE Atopic dermatitis (AD) is a highly prevalent condition that may be associated with an altered gastrointestinal microbiota that promotes an immune environment more susceptible to allergic disease. Synbiotics, a mixture of prebiotics and probiotics, have been used for the prevention and treatment of AD.OBJECTIVE To investigate the efficacy of synbiotics for primary prevention and treatment of AD.DATA SOURCES PubMed/MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and the CAB Abstracts Archive searchable database were searched from the inception of all databases to October 15, 2015, with no language restrictions.STUDY SELECTION We included all published randomized clinical trials of synbiotics for prevention and/or treatment of AD. To be included, a publication needed to clearly define the intervention as oral administration of synbiotics (combination of probiotics and prebiotics) and must have included an assessment of AD disease severity, such as the Severity Scoring of Atopic Dermatitis (SCORAD) index, or the incidence of AD as an outcome measure. Only 8 of 257 initially identified studies (3%) met selection criteria.DATA EXTRACTION AND SYNTHESIS Data extractionwas independently done by multiple observers and cross-checked to avoid errors. The quality of the selected studies was critically examined following the Cochrane guidelines. Data were pooled using a random-effects model.MAIN OUTCOMES AND MEASURES The primary outcomes were the SCORAD index (treatment studies) and the relative risk of AD (prevention studies). The hypothesis was formulated before data collection.RESULTS A total of 257 abstracts were screened to identify 6 treatment studies (369 children enrolled; aged 0 months to 14 years) and 2 prevention studies (1320 children enrolled; up to age 6 months in one study and term neonates aged