生命早期益生菌干预预防儿童过敏性疾病的Meta分析

Effect of early probiotic intervention effect in preventing allergic diseases in children:a meta analysis

目的 系统评价生命早期益生菌干预预防儿童过敏性疾病的疗效。方法 采用计算机检索万方、中国知网、CBM、PubMed、Cochrane library、Embase和Web of science数据库有关生命早期益生菌干预对儿童过敏性疾病预防作用的随机对照试验研究,检索时间为建库至2020年9月,应用Stata 11.0软件对纳入研究进行Meta分析。结果 最终纳入36篇随机对照试验文献。Meta分析结果显示,生命早期益生菌干预对预防湿疹(RR=0.84,95%CI:0.73~0.98,P=0.022)和食物过敏(RR=0.82,95%CI:0.68~0.98,P=0.028)作用显著,但对预防哮喘(RR=0.92,95%CI:0.80~1.06,P=0.231)、喘息(RR=0.98,95%CI:0.89~1.07,P=0.635)、过敏性鼻炎(RR=0.99,95%CI:0.78~1.26,P=0.945)和过敏性鼻结膜炎(RR=1.13,95%CI:0.86~1.49,P=0.376)无显著作用。结论 生命早期益生菌干预对儿童湿疹、食物过敏具有预防作用,但对哮喘、喘息、过敏性鼻炎和过敏性鼻结膜炎无预防作用,对于其机制仍需进一步研究。

Objective To systematically evaluate the effect of probiotic intervention in early life for the prevention of allergic diseases in children. Methods A computer search of 7 domestic and foreign databases was performed for randomized controlled trials(RCTs) on the effect of early-life probiotic intervention on allergic diseases in children from the inception of database to September 2020. Stata 11.0 software was used to conduct a meta-analysis of the included studies. Results A total of 36 articles were included. The results showed that probiotics supplementation in early life had a significant effect for the prevention of eczema(RR=0.84,95% CI: 0.73-0.98, P=0.022) and food allergies(RR=0.82, 95% CI: 0.68-0.98, P=0.028). Probiotics supplementation in early life had no significant effect for the prevention of asthma(RR=0.92, 95% CI: 0.80-1.06, P=0.231), wheezing(RR=0.98, 95% CI: 0.89-1.07, P=0.635), allergic rhinitis(RR=0.99, 95% CI: 0.78-1.26, P=0.945) or allergic conjunctivitis(RR=1.13, 95% CI: 0.86-1.49, P=0.376). Conclusion Supplementation of probiotics in early life are beneficial to prevent the occurrence of eczema and food allergy in children. However, supplementation of probiotics in early life has no significant effect for the prevention of asthma, wheezing, allergic rhinitis and allergic conjunctivitis.