布拉氏酵母菌对比双歧杆菌三联活菌治疗儿童腹泻有效性和安全性的Meta分析

Meta-analysis of the efficacy and safety of Saccharomyces boulardii versus Bifidobacterium triple live bacteria in the treatment of pediatric diarrhea

目的比较布拉氏酵母菌与双歧杆菌三联活菌治疗儿童腹泻的有效性和安全性。方法计算机检索PubMed、Embase、the Cochrane Library、中国生物医学文献数据库、万方数据、中国知网、维普网,收集布拉氏酵母菌(布拉氏组)对比双歧杆菌三联活菌(双歧杆菌组)的随机对照试验(RCT)。筛选文献,提取资料及质量评价后,采用RevMan 5.3软件进行Meta分析。结果共纳入9项RCT,合计898例患儿。Meta分析结果显示,两组患儿的总有效率[OR=1.69,95%CI(0.93,3.09),P=0.09]、腹泻持续时间[MD=-1.39,95%CI(-3.35,0.57),P=0.16]、腹痛消失时间[MD=0.09,95%CI(-0.87,1.05),P=0.86]、不良反应发生率[OR=0.65,95%CI(0.05,8.03),P=0.74]比较,差异均无统计学意义;布拉氏组患儿治疗后大便次数显著少于双歧杆菌组[MD=-0.91,95%CI(-1.80,-0.02),P=0.04]。亚组分析结果显示,布拉氏组抗生素相关性腹泻患儿的腹泻持续时间显著少于双歧杆菌组(P<0.05)。结论布拉氏酵母菌与双歧杆菌三联活菌治疗儿童腹泻的疗效和安全性相当,但在治疗后大便次数、抗生素相关性腹泻患儿的腹泻持续时间方面布拉氏酵母菌显著优于双歧杆菌三联活菌。

OBJECTIVE To compare the efficacy and safety of Saccharomyces boulardii and Bifidobacterium triple live bacteria in the treatment of pediatric diarrhea.METHODS Retrieved from PubMed,Embase,the Cochrane Library,CBM,Wanfang data,CNKI and VIP,randomized controlled trials(RCTs)about S.boulardii(S.boulardii group)versus Bifidobacterium triple liver bacteria(Bifidobacterium group)were collected.After screening the literature,extracting data and evaluating the quality,meta-analysis was performed by using RevMan 5.3 software.RESULTS A total of 9 RCTs were included,involving 898 patients.Results of meta-analysis showed there was no statistical significance in total response rate[OR=1.69,95%CI(0.93,3.09),P=0.09],duration of diarrhea[MD=-1.39,95%CI(-3.35,0.57),P=0.16],the time of abdominal pain disappearance[MD=0.09,95%CI(-0.87,1.05),P=0.86]or the incidence of adverse reactions[OR=0.65,95%CI(0.05,8.03),P=0.74].The number of stools in S.boulardii group was significantly less than Bifidobacterium group[MD=-0.91,95%CI(-1.80,-0.02),P=0.04].The results of subgroup analysis showed that the duration of diarrhea in children with antibiotic-associated diarrhea in S.boulardii group was significantly shorter than Bifidobacterium group(P<0.05).CONCLUSIONS The efficacy and safety of S.boulardii are similar to those of Bifidobacterium in the treatment of diarrhea,but S.boulardii is better than Bifidobacterium in terms of stool number,the duration of diarrhea in children with antibiotic-associated diarrhea.