双歧杆菌三联活菌制剂治疗婴幼儿轮状病毒肠炎临床疗效Meta分析

Live capsules/powder combining Bifidobacterium,Lactobacillus and Enterococcus for the treatment of infantile rotavirus enteritis:A meta-analysis

目的采用Meta分析方法评价双歧杆菌三联活菌制剂治疗轮状病毒肠炎的临床疗效。方法计算机检索中国知网、万方、维普、Pubmed、Embase和Web of Science数据库,检索时限均从建库至2015年12月,收集国内外应用双歧杆菌三联活菌制剂治疗轮状病毒肠炎的所有随机对照试验(RCT)和前瞻性非随机对照试验(non-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Rev Man 5.2软件于2016-02-05进行Meta分析。结果检索文献无RCT研究,纳入21篇包含23个前瞻性non-RCT研究文献,合计3388例患儿,其中治疗组(对照组常规治疗+双歧杆菌三联活菌胶囊或散剂)1804例,对照组1584例。Meta分析结果显示:治疗组有效率高于对照组[OR=4.59,95%CI(3.69,5.70),P<0.01];治疗组止泻所用时间少于对照组[平均差(MD)=-1.39,95%CI(-2.24,-0.53),P=0.001];治疗组总治疗时间少于对照组[MD=-1.32,95%CI(-2.19,-0.45),P=0.003]。结论 Meta分析评价现有文献认为,双歧杆菌三联活菌胶囊或散剂与常规治疗措施联用可提高轮状病毒肠炎的总体疗效,并有效缩短止泻时间和总治疗时间。

Objective To evaluate the clinical therapeutic effect of live capsules/powder combining Bifidobacterium, Lactobacillus and Enterococcus in treating infantile rotavirus enteritis by recta-analysis. Methods Such databases as China Knowledge Resource Integrated Database, Wanfang Database, Vip Database, Pubmed, Embase and Web of Science were searched from establishing database to December 2015 to collect all randomized controlled trials （RCT） and prospective non- randomized controlled trials （non-RCT） on live capsules/powder combining Bifidobacterium, Lactobacillus and Enterococcus in treating infantile rotavirus enteritis. The studies were selected according to the inclusion and exclusion criteria. The data were extracted, the methodological quality of the included studies was assessed, and the recta-analysis was performed with RevMan 5.2 in February 5,2016. Results A total of 23 prospective non-RCTs involving 3388 patients from 21 studies were included, including 1804 patients from treatment group （live capsules/powder combining Bifidobacterium, Lactobacil- lus and Enterococcus plus conventional treatment） and 1584 patients from control group （conventional treatment）. The total effective rate of the treatment group was superior to that of the control group （OR = 4.59, 95%CI 3.69 - 5.70, P 〈 0.01 ） ; the diarrhea relieving time of the treatment group was shorter than that of the control group （MD = -1.39, 95%CI -2.24 -0.53,P = 0.001 ） ; the total treatment time of the treatment group was shorter than that of the control group（MD = -1.32, 95% C1-2.19 -0.45, P = 0.003）. Conclusion Live capsules/ powder combining Bifidobacterium, Lactobacillus and En- terococcus combined with conventional drugs can improve the total therapeutic effect on infantile rotavirus enteritis and shorten the diarrhea relieving time and total treatment time.