A systematic review and meta-analysis: probiotics in the treatment of irritable bowel syndrome.
A systematic review and meta-analysis: probiotics in the treatment of irritable bowel syndrome.
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DOI：
10.1186/1471-230x-9-15
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发表时间：
2009-02-16
影响因子：
2.4
通讯作者：
Glasziou P
中科院分区：
文献类型：
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作者：
Hoveyda N;Heneghan C;Mahtani KR;Perera R;Roberts N;Glasziou P
肠易激综合征(IBS)是一种常见的慢性胃肠道疾病，大多数药物治疗IBS的疗效证据不足。一种流行的替代品是益生菌，它已经在几种情况下使用。包括肠易激综合征。益生菌是一种活的微生物食品补充剂。这项随机试验研究的系统性综述和荟萃分析的目的是评估益生菌在缓解肠易激综合征患者症状方面的疗效。我们检索了MEDLINE(1950-2007)、EMBASE(1980-2007)、CINAHL(1982-2007)、Amed(1985-2007)、Cochrane图书馆的Ovid版本，并手工检索检索到的论文。我们确定了14个随机安慰剂对照试验。综合数据表明，经过几周的治疗后，总体症状略有改善：对于来自7个试验的二分数据，总体优势比(OR)为1.6(95%CI，1.2至2.2)；对于来自6个试验的连续数据，标准化平均差异(SMD)为0.23(95%CI，0.07至0.38)。对于个别症状，结果在合并的二分法和合并的连续数据之间有所不同。试验因使用益生菌的时间长短(4-26周)、剂量、微生物和强度而不同。益生菌可能在缓解IBS的一些症状方面发挥作用，目前药物治疗对IBS疗效的证据很弱。然而，由于IBS是一种慢性疾病，通常是间歇性的，建议进行长期试验。此类研究应侧重于益生菌的类型、最佳剂量以及可能受益最大的患者亚群。
Irritable Bowel Syndrome (IBS) is a common chronic gastrointestinal disorder and the evidence for efficacy of most drug therapies in the treatment of IBS is weak. A popular alternative is probiotics, which have been used in several conditions. including IBS. Probiotics are live microbial food supplements. The aim of this systematic review and meta-analysis of randomized trials study was to evaluate the efficacy of probiotics in alleviating symptoms in patients with irritable bowel syndrome. We searched Ovid versions of MEDLINE (1950–2007), EMBASE (1980–2007), CINAHL (1982–2007), AMED (1985–2007), the Cochrane library and hand searched retrieved papers. We identified 14 randomized placebo controlled trials. Combined data suggested a modest improvement in overall symptoms after several weeks of treatment: for dichotomous data from seven trials the overall Odds Ratio (OR) was 1.6 (95% CI, 1.2 to 2.2); for continuous data from six trials the standardised mean difference (SMD) was 0.23 (95% CI, 0.07 to 0.38). For individual symptoms the results differed between the pooled dichotomous and pooled continuous data. Trials varied in relation to the length of treatment (4–26 weeks), dose, organisms and strengths of probiotics used. Probiotics may have a role in alleviating some of the symptoms of IBS, a condition for which currently evidence of efficacy of drug therapies is weak. However, as IBS is a condition that is chronic and usually intermittent longer term trials are recommended. Such research should focus on the type, optimal dose of probiotics and the subgroups of patients who are likely to benefit the most.