Lactobacillus therapy for acute infectious diarrhea in children:: A meta-analysis
Lactobacillus therapy for acute infectious diarrhea in children:: A meta-analysis
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DOI：
10.1542/peds.109.4.678
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发表时间：
2002-04-01
期刊：
影响因子：
8
通讯作者：
Christakis, DA
中科院分区：
文献类型：
--
作者：
Van Niel, CW;Feudtner, C;Christakis, DA
Objective.儿童腹泻占世界范围内发病率和死亡率的很大一部分。在儿童中的多项研究表明，口服乳酸杆菌可能具有抗真菌特性。我们进行了一项随机对照研究的荟萃分析，以评估乳酸杆菌治疗是否能改善急性感染性腹泻儿童的临床结局。在1966年至2000年出版的传统生物医学以及补充和替代医学文献的书目数据库中寻找研究。检索词为“竞争性抑制”、“腹泻”、“胃肠炎”、“乳酸杆菌”、“益生菌”、“轮状病毒”和“酸奶”。“我们纳入了充分随机化，盲法，对照试验的研究，其中治疗组接受乳酸杆菌，对照组接受适当的安慰剂，并报告了腹泻强度的临床结果指标。这些入选标准通过盲态审查和共识应用。原始检索得到26项研究，其中9项符合标准。多名观察员独立提取研究特征和临床结局。在纳入的研究中，分别有7项和3项研究的数据足以对乳酸杆菌对腹泻持续时间和第2天腹泻频率的影响进行荟萃分析。总结点估计表明，与接受安慰剂的参与者相比，接受乳酸杆菌的参与者在治疗第2天腹泻持续时间减少0.7天（95%置信区间：0.3-1.2天），腹泻频率减少1.6次大便（95%置信区间：大便减少0.7-2.6次）。治疗方案的细节因研究而异。预先计划的亚组分析表明存在剂量-效应关系。这项荟萃分析的结果表明，乳酸杆菌作为急性感染性腹泻儿童的治疗是安全有效的。
Objective. Childhood diarrhea accounts for substantial morbidity and mortality worldwide. Multiple studies in children have shown that Lactobacillus, administered orally, may have antidiarrheal properties. We conducted a meta-analysis of randomized, controlled studies to assess whether treatment with Lactobacillus improves clinical outcomes in children with acute infectious diarrhea.Methods. Studies were sought in bibliographic databases of traditional biomedical as well as complementary and alternative medicine literature published from 1966 to 2000. Search terms were "competitive inhibition," "diarrhea," "gastroenteritis," "Lactobacillus," "probiotic," "rotavirus," and "yog(h) urt." We included studies that were adequately randomized, blinded, controlled trials in which the treatment group received Lactobacillus and the control group received an adequate placebo and that reported clinical outcome measures of diarrhea intensity. These inclusion criteria were applied by blind review and consensus. The original search yielded 26 studies, 9 of which met the criteria. Multiple observers independently extracted study characteristics and clinical outcomes. Data sufficient to perform meta-analysis of the effect of Lactobacillus on diarrhea duration and diarrhea frequency on day 2 were contained in 7 and 3 of the included studies, respectively.Results. Summary point estimates indicate a reduction in diarrhea duration of 0.7 days (95% confidence interval: 0.3-1.2 days) and a reduction in diarrhea frequency of 1.6 stools on day 2 of treatment (95% confidence interval: 0.7-2.6 fewer stools) in the participants who received Lactobacillus compared with those who received placebo. Details of treatment protocols varied among the studies. A preplanned subanalysis suggests a dose-effect relationship.Conclusion. The results of this meta-analysis suggest that Lactobacillus is safe and effective as a treatment for children with acute infectious diarrhea.