摘要
目的采用Meta分析方法评价国内益生菌制剂治疗肠易激综合征的临床疗效。方法计算机检索MEDLINE(2001.1～2011.10)、EMbase(2001.1～2011.10)、The Cochrane Central Register of Controlled Trials和中国生物医学文献数据库(2001.1～2011.10),并手工检索最近1年国内已发表的有关论文及会议资料。收集中国地区应用益生菌制剂治疗肠易激综合征的所有随机对照试验(RCT)。按照纳入与排除标准选择文献、提取资料和评价纳入研究的方法学质量后,采用Cochrane协作网提供的RevMan 5.0软件进行Meta分析。结果共纳入11个RCT,1065例患者。Meta分析结果显示:益生菌制剂+常规治疗组的总体疗效优于常规治疗组(曲美布汀/匹维溴铵)[RR=1.26,95%CI(1.18,1.34),P<0.00001],能有效改善肠易激综合征患者的腹痛[RR=1.10,95%CI(1.03,1.18),P=0.004]和腹泻[RR=1.15,95%CI(1.07,1.24),P=0.0003],但对于腹胀症状,两组症状评分差异无统计学意义[RR=1.08,95%CI(0.95,1.24),P=0.25]。单用益生菌制剂组与常规治疗组(曲美布汀/匹维溴铵)相比,两者疗效相当,其差异无统计学意义[RR=0.85,95%CI(0.66,1.09),P=0.19]。结论益生菌制剂与常规药物联用可以提高肠易激综合征的总体疗效,尤其在改善患者腹痛、腹泻症状等方面疗效显著;而单独应用益生菌制剂的疗效与常规药物治疗的疗效相当。鉴于纳入研究的质量较低,随机对照试验的实施过程未清楚报告,存在偏倚的可能性大,上述结论尚需要更多高质量的随机对照试验结果证实。
Objective To compare the clinical therapeutic effect of probiotic agents in treating irritable bowel syndrome（IBS） by Meta-analysis.Methods Such databases as MEDLINE,EMBASE,the Cochrane Central Register of Controlled Trials,and Chinese Biomedical Literature Database were searched from January 2001 to October 2011,and the domestic conference proceedings and relevant papers published in recent 1 year were also searched manually.All domestic randomized controlled trials（RCTs） on probiotic agents in treating irritable bowel syndrome（IBS） were collected,which were then selected according to the inclusion and exclusion criteria.The data were extracted,the methodological quality of the included studies was assessed,and the Meta-analysis was performed with Revman5.0.Results A total of 11 RCTs involving 1065 patients were included.The total effective rate of the probiotic agents plus conventional treatment group was superior to that of the conventional treatment（trimebutine meleate/ pinaverium bromide） group（RR=1.26,95%CI 1.18 to 1.34,P〈0.00001）,it could effectively relieve abdominal pain（RR=1.10,95%CI 1.03 to 1.18,P=0.004） and diarrhea（RR=1.15,95%CI 1.07 to 1.24,P=0.0003）.But there was no significant difference between the two groups in alleviating abdominal distention（RR=1.08,95%CI 0.95 to 1.24,P=0.25）.The effectiveness of probiotic agents used alone was similar to that of the conventional treatment used alone,without significant differences（RR=0.85,95%CI 0.66 to 1.09,P=0.19）.Conclusion Probiotic agents combined with conventional drugs can improve the total therapeutic effect of IBS,especially in alleviating abdominal pain,diarrhea and so on.But the effectiveness of probiotic agents used alone is similar to that of the conventional treatment used alone.For the possibility of bias due to the lower quality of the included studies and unclear implementation of RCTs,this conclusion should be verified with more large-scale and high-quality RCTs.
出处
《中国循证医学杂志》
CSCD
2012年第5期602-607,共6页
Chinese Journal of Evidence-based Medicine
基金
国家自然科学基金(编号:81060318)
