双歧杆菌三联活菌联合美沙拉嗪治疗中国炎症性肠病患者疗效及安全性的Meta分析

Efficacy and safety of bifidobacterium triple viable bacteria combined with mesalmine for Chinese patients with inflammatory bowel disease: a Meta-analysis

目的系统评价双歧杆菌三联活菌联合美沙拉嗪治疗炎症性肠病(IBD)疗效及安全性。方法通过计算机检索The Cochrane Library(2017年5期)、Pub Med、CNKI、VIP、Wan Fang Data等数据库,收集采用随机对照试验(RCT)研究双歧杆菌三联活菌联合美沙拉嗪治疗IBD的相关文献,文献的来源日期为数据库建库时间到2017年5月。通过Rev Man 5.3软件,对由两个评价者根据纳入与排除标准分别单独筛选获得的经过偏倚风险评估后的文献及数据信息,进行相关性的统计分析。结果筛选获得14个RCTs,共1 020例患者。Meta分析结果显示:双歧杆菌三联活菌联合美沙拉嗪能明显提高总有效[OR=3.66,95%CI(2.42,5.54),P<0.000 01],减少炎症介质IL-8[MD=-6.15,95%CI(-7.49,-4.80),P<0.000 01],降低恶变指标CRP[MD=-3.16,95%CI(-2.71,-3.61),P<0.000 01],增加免疫因子IL-10[MD=12.62,95%CI(9.61,15.63),P<0.000 01],减少氧化产物MDA[MD=-1.25,95%CI(-1.54,-0.95),P<0.000 01]。同时二者联合使用能减少药物不良反应事件发生[OR=0.30,95%CI(0.10,0.47),P<0.000 01]。结论双歧杆菌三联活菌联合美沙拉嗪可显著控制炎症、修复肠道黏膜、调节人体免疫、改善生活质量,且减少药物不良反应事件发生,是治疗IBD安全有效的方法。

Objective To systematically evaluate the clinical efficacy and safety of bifidobacterium triple viable bacteria combined with mesalamine in the treatment of inflammatory bowel disease（ IBD）. Methods The Cochrane Library（ Issue 5,2017）,Pub Med,CNKI,VIP,and Wan Fang Data were electronically searched to collect the randomized controlled trials（ RCTs） about bifidobacterium triple viable bacteria combined with mesalamine in the treatment of IBD from inception to May 2017. Two reviewers independently screened the literature in accordance with the inclusion and exclusion criteria to extract information and assess the risk of bias. Statistical analysis was performed using Rev Man 5. 3 software. Results A total of 14 RCTs were enrolled in this study,including 1 020 patients. Meta-analysis showed that bifidobacterium triple viable bacteria combined with mesalamine significantly increased the total effective probability[OR = 3. 66,95% CI（ 2. 42,5. 54）,P 〈0. 000 01 ],reduced the release of inflammatory mediators IL-8 [MD =-6. 15,95% CI（-7. 49,-4. 80）,P 〈0. 000 01],reduced the malignancy indicators CRP[MD =-3. 16,95% CI（-2. 71,-3. 61）,P 〈0. 000 01],increased immune factor IL-10 [MD = 12. 62,95% CI（ 9. 61,15. 63）,P 〈0. 000 01],reduced the intra-individual oxidation reaction MDA[MD =-1. 25,95% CI（-1. 54,-0. 95）,P 〈0. 000 01]. While the combination of both reduced the adverse events of drug reactions[OR = 0. 30,95% CI（ 0. 10,0. 47）,P 〈0. 000 01]. Conclusion Bifidobacterium triple viable bacteria combined with mesalamine may significantly control the inflammation,repair intestinal mucosa,regulate the body＇s immune,improve the quality of life,and reduce the adverse events of drug reactions. It is a safe and effective way to treat IBD.