meta分析:益生菌在防治儿童特应性皮炎中的作用

Meta-analysis:the effect of probiotics on prevention and treatment of pediatric atopic dermatitis

目的系统评价益生菌在预防和治疗儿童特应性皮炎中的效果。方法通过检索相关数据库中关于防治特应性皮炎患儿对添加益生菌与安慰剂的随机双盲安慰剂对照试验研究,并应用国际Cochrane协作网的系统评价方法Revman4.3.1对其进行系统评价和敏感性分析。结果在检索到的5项临床试验研究中,691例添加益生菌的受试婴儿中有128例发生了特应性皮炎,患病率为18.5%(95%CI:0.16～0.21),在给予安慰剂的702例婴儿中186例发生了特应性皮炎,患病率为26.5%(95%CI:0.23～0.30),OR:0.55(95%CI:0.33～0.90)。仅一项治疗特应性皮炎的试验研究适合meta分析,SCORAD降低的WMD值为6.30(95%CI:0.28～12.32)。结论添加益生菌对预防儿童特应性皮炎有积极的效果,对于患有特应性皮炎的儿童可能也是有益的。更重要的是益生菌对于儿童肠道和全身免疫系统的发育有积极的影响。

Objectives Recent in vivo and in vitro studies demonstrate that using probiotics as a dietary intervention can modulate aberrant immune response of atopic dermatitis. To systematically evaluate whether oral administration of probiotics is effective to prevent and treat atopic dermatitis in the infants by meta-analysis. Methods Eligible articles were identified and collected by search of relevant electronic databases. All randomized trials comparing the effect of probiotics supplementation to placebo in high-risk infants or children with atopic dermatitis were included. Statistical analysis was performed with Review Manager 4.3.1. Subanalysis/sensitivity analysis was also performed. Results Five clinical trials were identified. Incidence of atopic dermatitis were 18.5% （95% CI： 0.16 - 0.21 ） （128 of 691 patients received probiotics supplementation） and 26.5% （95% CI： 0.23 - 0.30） （186 of 702 patients were in control groups）. The odd ratio （OR） was 0.55 （95% CI： 0.33 - 0.90）. Only 1 trial of probiotics treatment of atopic dermatitis is suitable to analyzed and WMD about decrease of SCORAD were 6.30 （95% CI： 0.28 - 12.32）. Conclusions Probiotic supplementation has positive effect in primary prevention of atopic dermatitis in infants and may be helpful for treating children with atopic dermatitis. Furthermore, the probiotics show a regulatory effect on intestinal and systemic immune system.