微生态制剂联合美沙拉嗪对溃疡性结肠炎疗效及血清炎症因子影响的Meta分析

Meta analysis of effects of probiotics combined with mesalazine on treatment and serum inflammatory factors in ulcerative colitis

目的Meta分析微生态制剂联合美沙拉嗪治疗溃疡性结肠炎(UC)的疗效及其对血清炎症因子的影响。方法计算机检索2018年以来中英文期刊数据库,包括知网、万方医学、维普、Pubmed、Cochrane、EMbase等,纳入微生态制剂联合美沙拉嗪治疗UC的随机对照试验报道并筛选、评价文献质量,对疗效及其对血清炎症因子的影响采用RevMan5.3软件进行Meta分析。结果本研究共纳入10篇文献资料,质量均合格;微生态制剂联合美沙拉嗪对UC的总有效率、血清白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)的影响报道经异质性检验差异均无统计学意义(P>0.05),均借助固定效应模型进行分析,结果发现微生态制剂联合美沙拉嗪较单纯美沙拉嗪能提高UC治疗的总有效率和血清IL-10水平(RR=1.42,95%CI为1.06~1.58,P=0.012;WMD=11.36,95%CI为7.83~14.29,P<0.001),降低血清TNF-α水平(WMD=-4.35,95%CI为-6.12~-1.28,P<0.001),且上述文献均未见明显偏倚风险,敏感性分析均证实Meta分析结果稳定性良好。结论微生态制剂联合美沙拉嗪治疗溃疡性结肠炎有效,且可减轻炎症反应。

Aim To carry out a Meta analysis about the effects of probiotics combined with mesalazine in the treatment of ulcerative colitis(UC)and influences on serum inflammatory factors.Methods The Chinese and English journal databases since 2018,including CNKI,Wanfang medicine,VIP,PubMed,Cochrane,EMbase,etc.,were searched.The randomized controlled trials of probiotics combined with mesalazine for the treatment of UC were included,screened and evaluated.Revman 5.0 software was used to evaluate the efficacy and impact on serum inflammatory factors for meta-analysis.Results A total of 10 literature were qualified and included in this study.The effects of probiotics combined with mesalazine on the total effective rate and serum interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)levels of UC were not statistically significant by heterogeneity test(P>0.05).The fixed effect model was used for analysis,and the results showed that probiotics combined with mesalazine could increase the total effective rate of UC and the level of serum IL-10(RR=1.42,95%CI:1.06~1.58,P=0.012;WMD=11.36,95%CI:7.83-14.29,P<0.001),and reduce serum TNF-αlevels(WMD=-4.35,95%CI:-6.12--1.28,P<0.001).No significant bias risk was found in the above literature,and sensitivity analysis confirmed that the results of Meta analysis were stable.Conclusion Microecological agents combined with mesalazine is effective in treating ulcerative colitis,and can reduce the inflammatory response.