国内益生菌对轻中度溃疡性结肠炎诱导缓解作用的Meta分析

Effect of probiotics on inducing remission of mild to moderate ulcerative colitis in China: a Meta-analysis

目的应用Meta分析评价国内益生菌制剂对轻中度溃疡性结肠炎(UC)诱导缓解的作用。方法计算机检索中国期刊全文数据库(CNKI)(从1956年1月至2014年2月)、中文科技期刊全文数据库(VIP)(从1989年1月至2014年2月)、万方数据库(从1990年1月至2014年2月)关于益生菌制剂对轻中度UC诱导缓解治疗的随机对照试验(RCT),用RevMan 5.20软件对数据进行meta分析。结果共纳入22个RCT,包括1 543例患者。Meta分析结果显示:对于轻中度UC诱导缓解的疗效,益生菌联合柳氮磺吡啶(SASP)的未缓解率明显低于SASP[OR=0.16,95%CI(0.08,0.33),P<0.000 01];单用益生菌的未缓解率与美沙拉嗪相比无统计学差异[OR=1.41,95%CI(0.75,2.66),P=0.29];益生菌联合美沙拉嗪的未缓解率明显低于美沙拉嗪[OR=0.33,95%CI(0.23,0.48),P<0.000 01]。结论对于活动期轻中度UC患者,益生菌联合柳氮磺胺吡啶或美沙拉嗪可明显降低临床未缓解率,单用益生菌治疗时其疗效与美沙拉嗪相当。

Objective Meta-analysis was used to evaluate the inducing remission effect of domestic probiotics preparation on mild to moderate ulcerative colitis（UC）. Methods The randomized controlled trials（RCTs） of the induced remission therapy of domestic probiotics preparation on mild to moderate UC were retrieved in CNKI（from January 1956 to February 2014）, VIP（from January 1989 to February 2014） and Wanfang Database（from January 1990 to February 2014） by computer. The data were performed by Meta-analysis using RevMan 5.20 software. Results A total of 22 RCTs involving 1 543 patients were included. The results of Meta-analysis showed that the clinical remission rate of probiotics combined with SASP was much lower than that of SASP for the induced remission curative effect on mild to moderate UC[OR=0.16, 95% CI（0.08, 0.33）, P〈0.000 01]. There was no significant difference between the clinical remission rates of probiotics and masalazine [OR=1.41, 95% CI（0.75, 2.66）, P=0.29], and the clinical remission rate of probiotics combined with SASP was much less than that of masalazine [OR=0.33, 95% CI（0.23, 0.48）, P〈0.000 01]. Conclusion The clinical remission rate could be significantly reduced by probiotics combined with SASP or masalazine, and no significant difference was observed between the curative effect of probiotics and masalazine on the mild to moderate UC patients.