益生元对于婴幼儿特应性皮炎预防作用的Meta分析

Preventative effects of prebiotics for atopic dermatitis:a Meta-analysis

目的系统评价益生元对婴幼儿特应性皮炎的预防作用。方法计算机检索中国知网(CNKI)、万方、维普(VIP)、Cochrane、Embase、PubMed数据库,搜集益生元添加喂养方式与非益生元添加喂养方式婴幼儿特应性皮炎发生率比较的随机对照试验,检索时限从1995年6月至2019年8月。由两位研究者独立筛选文献,提取资料并评价纳入研究的偏倚风险,采用Revman5.3软件进行Meta分析。结果共纳入6个研究,1820例研究对象,其中益生元添加组894例,对照组926例。Meta分析结果显示:益生元添加并不能降低婴幼儿特应性皮炎的发生率(OR=0.81,95%CI:0.81~1.02,P=0.06),且无论是过敏高危婴幼儿还是过敏低危婴幼儿,益生元保护效应均不显著(高危婴幼儿组:OR=0.83,95%CI:0.64~1.08,P=0.17;低危婴幼儿组:OR=0.58,95%CI:0.31~1.08,P=0.08)。结论目前研究尚无法得出益生元能够预防特应性皮炎发生的结论,益生元预防婴幼儿特应性皮炎的具体效应尚需进一步研究加以验证。

Objective To systematically evaluate the preventative effect of prebiotics for atopic dermatitis.Methods CNKI,Wanfang,VIP,Cochrane,Embase and PubMed were searched for literatures of randomized controlled trials(RCTs)related to incidence of atopic dermatitis in infants and young children fed with and without prebiotic addition from June 1995 to August 2019.Literature screening,data extraction and quality assessment were conducted by two reviewers independently,basing on inclusion and exclusion criteria,while cross-check was also conducted.Then the meta-analysis was performed by using RevMan 5.3 software.Results A total of 6 RCTs were included for further analysis.There is no difference between the incidence of atopic dermatitis in prebiotics group and control group(OR=0.81,95%CI:0.81-1.02,P=0.06;high risk group:OR=0.83,95%CI:0.64-1.08,P=0.17;low risk group:OR=0.58,95%CI:0.31-1.08,P=0.08),basing on the results of Meta-analysis.Conclusion Preventative effects of prebiotics on atopic dermatitis was still uncertain.Due to differences in prebiotic strains,dosages and treatment courses of prebiotics addition,its preventative effect on atopic dermatitis should be further investigated.