益生菌治疗中国儿童手足口病疗效Meta分析

Efficacy of probiotics for treatment of hand-foot-mouth disease in Chinese children: a meta analysis

目的系统评价补充益生菌对中国儿童手足口病的疗效。方法电脑检索资料库,包括知网、万方、维普、PubMed、Medline、The Cochrane Library。检索时间为建库至2020年3月,搜集有关益生菌辅助治疗儿童手足口病疗效的随机对照试验,由两位研究者独立筛选文献,提取数据并进行质量评价。运用RevMan 5.3软件作数据分析。结果共纳入12项临床研究,计943例患儿。Meta分析结果显示,补充益生菌可缩短患儿皮疹消退时间[MD=-1.20 d, 95%CI(-1.63~-0.77),P<0.001]、体温恢复正常时间[MD=-0.67 d, 95%CI(-0.78~-0.56),P<0.001]、食欲好转时间[MD=-1.08 d, 95%CI(-1.22~-0.93),P<0.001],并提高3 d治疗有效率[OR=7.36,95%CI(4.09~13.23),P<0.001]。两组患儿在副反应发生率方面,差异无统计学意义(P<0.05)。结论现有证据表明,益生菌作为手足口病的辅助治疗方法,可减轻患儿临床症状,缩短病程且不增加副反应发生率。

Objective To systematically investigate the efficacy of probiotics in the treatment of hand-foot-mouth disease(HFMD) in Chinese children. Methods The databases CNKI, Wanfang, VIP, PubMed, Medline and The Cochrane Library were searched for all articles about randomized controlled trials(RCTs) on probiotics as adjuvant therapy for HFMD in children from inception to March 2020. Two researchers, working separately, selected the potentially relevant literaturesaccording to the inclusion criteria, assessed the eligibility of each article, extracted the data, and evaluated the risk of bias.The meta analysis was performed using RevMan 5.3 software. Results A total of 12 RCTs involving 943 patients were included. The meta analysis showed that the time to complete disappearance of rash[MD=-1.20 d, 95%CI(-1.63,-0.77), P<0.001], time to defervescence[MD=-0.67 d, 95%CI(-0.78,-0.56), P<0.001] and time to appetite improvement[MD=-1.08 d, 95%CI(-1.22,-0.93), P<0.001] were shorten in the observation group. Besides, probiotics can improve the efficiency rate for 3 days[OR=7.36, 95%CI(4.09, 13.23), P<0.001]. There was no statistically significant difference in the incidence of side effects between the two groups. Conclusion The available evidences showed that probiotics, as an adjuvant treatment for HFMD, can relieve clinical symptoms and shorten the course of disease while do not increase the incidence of side effects. However, due to the limited quality of included studies, larger sample and high quality of RCTs are needed to verify the conclusion.