双歧杆菌三联活菌制剂治疗溃疡性结肠炎临床疗效Meta分析

Live combined bifidobacterium, lactobacillus and enterococcus capsules/powder in the treatment of ulcerative colitis:a metaanalysis

目的采用Meta分析方法评价双歧杆菌三联活菌制剂治疗溃疡性结肠炎(ulcerative Colitis,UC)的临床疗效。方法计算机检索中国知网、万方、维普、Pubmed、EMbase、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UC的所有随机对照试验(randomized controlled trial,RCT)和前瞻性非随机对照试验(non-randomized controlled trial,non-RCT),纳入文献时间从2004年1月至2014年12月。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 Man5.2软件进行Meta分析。结果检索文献无RCT研究,纳入30篇前瞻性non-RCT研究文献,2147例患者,治疗组(对照组常规用药+双歧杆菌三联活菌制剂)1085例,对照组1062例。Meta分析结果显示:治疗组的总体疗效优于对照组[Odds Radio(OR)=4.01,95%Confidence Interval(CI)(2.98,5.39),P<0.00001];治疗后症状评分治疗组低于对照组[Mean Deviation(MD)=-1.52,95%CI(-2.24,-0.80),P<0.0001];治疗后炎症评分治疗组低于对照组[MD=-1.50,95%CI(-2.53,-0.46),P=0.005];治疗组UC复发率低于对照组[OR=0.16,95%CI(0.04,0.72),P=0.02]。结论双歧杆菌三联活菌制剂与常规治疗药物联用可以提高UC的总体疗效,减轻相关症状,同时可以有效降低UC的复发率。

Objective To evaluate the dinical therapeutic effect of Live Combined Bifidobacterium, Lactobacillus and Enterococcus Capsules/Powder in the treatment of ulcerative colitis by Meta-analysis. Methods Such databases as China Knowledge Resource Integrated Database, Wanfang Database, Vip Database, Pubmed, Embase and Web of Science were searched dated from establishing database to December 2015 to coUect all Randomized controlled trials （RCTs） and prospective Non-randomized controlled trials （non-RCTs） on Live Combined Bifidobacterium, Lactobacillus and Enterococcus Capsules/Powder in the treatment ulcerative colitis. The time of all included studies ranged from January 2004 to December 2014 and 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 Meta-analysis was performed with Revman5.2. Results A total of 30 prospective non-RCTs involving 2147 patients were included, including 1 085 patients from treatment group （Live Combined Bifidobacterium, Lactobacillus and Enterococcus Capsules/Powder plus conventional treatment） and 1 062 patients from control group （conventional treatment）. The total effective rate of the treatment group was superior to that of the control group （OR=4.01, 95%CI 2.98 to 5.39, P〈0.00001）; the symptom score of the treatment group was lower than that of the control group （MD=-1.52, 95%CI -2.24 to -0.80, P〈0.0001）; the inflammation score of the treatment group was lower than that of the control group （MD=-1.50, 95%CI -2.53 to -0.46, P=0.005）; the recurernce rate of the treatment group was lower than that of the control group （OR=0.16, 95%CI 0.04 to 0.72, P=0.02）. Conclusion Live Combined Bifidobacterium, Lactobacillus and Enterococcus Capsules/Powder combined with conventional drugs can improve the total therapeutic effect of the treatment for ulcerative colitis, improve the related symptoms and reduce the recurernce rate of ulcerative colitis efficiently.