益生菌联合奥替溴铵治疗腹泻型肠易激综合征有效性与安全性的meta分析

Meta-analysis of efficacy and safety of Probiotics combined with Otilonium Bromide in the treatment of diarrheal irritable bowel syndrome

目的系统评价益生菌联合奥替溴铵治疗腹泻型肠易激综合征有效性与安全性,为临床治疗提供循证参考。方法本研究通过计算机检索EMBASE、Pubmed、Cochrane Library、万方、中国生物医学文献数据库、维普及中国知网,收集益生菌联合奥替溴铵治疗腹泻型肠易激综合征的随机对照试验,检索时间均为数据库建库时间至2020年11月。纳入符合条件的文献后提取数据并对文献质量进行评价,并使用REVman5.3软件进行meta分析。结果共纳入10项随机对照试验,共计956例。Meta分析结果显示,试验组总有效率[RR=1.25,95%CI:1.16~1.34,P<0.00001]显著高于对照组。治疗后肿瘤坏死因子-α浓度[SMD=-2.28,95%CI:-3.47~-1.10,P=0.0002]、治疗后白细胞介素-8水平[SMD=-2.16,95%CI:-3.14~-1.17,P<0.0001]、腹泻改善时间[SMD=-1.29,95%CI:-1.66~-0.92,P<0.00001]和腹部不适改善时间[SMD=-1.79,95%CI:-2.01~-1.56,P<0.00001]均显著低于对照组。在安全性上,试验组不良反应发生率与对照组比较,差异无统计学意义[RR=0.48,95%CI:0.18~1.29,P=0.14]。结论益生菌联合奥替溴铵能显著提高腹泻型肠易激综合征的疗效,且不增加不良反应的发生。

Objective To systematically evaluate the efficacy and safety of probiotics combined with otidine in the treatment of diarrheal irritable bowel syndrome(IBS),and to provide evidence-based reference for clinical treatment.Methods In this study,randomized controlled trials of probiotics combined with otimonium bromide in the treatment of IRRITABLE bowel syndrome(IBS)were collected through computer retrieval of EMBASE,Pubmed,Cochrane Library,Wanfang,China Biology Medicine disc,Viper and CnKI.The retrieval time was from November 2020 when the database was established.After the inclusion of qualified literatures,data were extracted and literature quality was evaluated,and Meta-analysis was performed using RevMan 5.3 software.Results A total of 10 randomised controlled trials involving 956 patients were included.Meta analysis results showed that the total effective rate of the experimental group was significantly higher than that of the control group[RR=1.25,95%CI:1.16~1.34,P<0.00001].After treatment,tumor necrosis factor concentration[SMD=-2.28,95%CI:-3.47~-1.10,P=0.0002],post-treatment interleuk-8 level[SMD=-2.16,95%CI:-3.14~-1.17,P<0.0001],improvement time of diarrhea[SMD=-1.29,95%CI:-1.66~-0.92,P<0.00001],improvement time of abdominal discomfort[SMD=-1.79,95%CI:-2.01~-1.56,P<0.00001]were significantly lower than the control group.In terms of safety,there was no statistically significant difference in the incidence of adverse reactions between the experimental group and the control group[RR=0.48,95%CI:0.18~1.29,P=0.14].Conclusion Probiotics combined with otimonium bromide can significantly improve the efficacy of diarrheal irritable bowel syndrome without increasing the incidence of adverse reactions.