益生菌治疗变应性鼻炎临床疗效的Meta分析

The therapeutic effect of probiotics on allergic rhinitis:a Meta-analysis

目的:系统性评价益生菌对变应性鼻炎的疗效。方法:系统检索PubMed、The Cochrane Library、Web of SCIence和万方、中国知网、中国生物医学、维普数据库,检索以益生菌为干预措施治疗变应性鼻炎的随机对照试验,检索时限均从建库截至2016年4月。由2名研究者按照纳入与排除标准独立筛选文献、提取资料并评价质量,采用RevMan 5.2软件进行Meta分析。结果:最终纳入17个随机对照实验,共1 374例患者,其中益生菌组809例,安慰剂组568例。Meta分析结果显示:益生菌组的总体、鼻部和眼部RQLQ评分、血清嗜酸粒细胞计数均较安慰剂组降低,差异有统计学意义(MD=-4.43,CI为-8.65^-0.20;MD=-1.08,CI为-1.89~0.27;MD=-0.95,CI为-1.46^-1.44;MD=-28.40,CI为-43.53^-13.26);益生菌组的血清IgE水平与安慰剂组差异无统计学意义;乳酸菌组与双歧杆菌组治疗后NTSS值差异无统计学意义(P>0.05)。结论:与安慰剂组相比较,益生菌组对变应性鼻炎患者的症状改善明显,且不同菌属的益生菌治疗变应性鼻炎疗效差异无统计学意义。

Objective：To systemically review the therapeutic effect of probitics on allergic rhinitis（AR）.Method：Literatures about the effect of probitics on AR were searched in PubMed.The Cochrane Library,Web of Science and CNKI,WanFang Data and VIP inception to April 2016,and 2reviewers independently screened literatures according to the inclusion and exclusion criteria,extracted data,and assessed the risk of bias of included studies.Then meta-analysis was performed using RevMan5.2software.Result：A total of 16 RCTs involving1374patients were included in the meta-analysis,including 809 cases in the probitic group and 568 cases in the placebo group.The results of meta-analysis showed that the efficacy of probitic group was superior to the placebo group in total RQLQ,nasal RQLQ,eye RQLQ and the serum eosinophil count,the difference was statistically significant[MD=-4.43,95%CI（-8.65--0.20）;MD=-1.08,95%CI（-1.89-0.27）;MD=-0.95,95%CI（-1.46--1.44）;MD=-28.40,95%CI（-43.53--13.26）].There was no significant difference in Serum IgE between the probitic group and the placebo group（P〈0.05）.There was no significant difference in the NTSS value between the lactobacillus group and the bifidobacterium group（P〈0.05）.Conclusion：Compared to the placebo,probitics can effectively reduce symptom scores of patients with AR;and different strains of probitics indicated no significant differences in improving nasal symptoms.