益生菌辅助治疗骨质疏松患者效果的Meta分析

A Meta-analysis of the Effect of Adjuvant Probiotics in Patients with Osteoporosis

目的系统评价益生菌治疗骨质疏松的效果。方法计算机检索Cochrane Library、Web of Science、PubMed、Embase、维普网、中国知网、万方数据知识服务平台,检索时限为2023年8月15日,纳入文献为益生菌治疗骨质疏松的随机对照实验。由2位研究人员独立筛选文献、提取数据,并评价纳入文献的偏倚风险。采用Stata.14和Revman.5.4软件分析益生菌治疗对患者骨密度、血钙、维生素D、甲状旁腺激素、骨钙素、骨碱性磷酸酶及不良反应的影响。结果最终纳入8篇文献,包括744例研究对象,Meta分析结果显示,在传统药物治疗的基础上加用益生菌,可以增加患者的髋关节骨密度[WMD 0.05(0.01,0.10)]g/cm^(3),增加患者血液中的钙离子浓度[WMD 0.26(0.02,0.50)]mmol/L,增加血液骨钙素的浓度[WMD 1.84(0.60,3.07)]ng/mL,也可以降低骨特异性碱性磷酸酶浓度[SMD-1.06(-2.06,-0.07)],并且可以降低恶心和腹泻的发生率,但对维生素D及甲状旁腺激素的改变,差异无统计学意义(P>0.05)。结论在常规治疗骨质疏松的基础上同时加用益生菌辅助治疗,或可进一步改善患者的骨密度水平,同时降低胃肠道的不良反应,更好的治疗骨质疏松,有利于患者的预后。

Objective Systematically evaluate the efficacy of probiotics in treating osteoporosis.Methods Computer search of Cochrane Library,Web of Science,PubMed,Embase,VIP,CNT and Wanfang data knowledge service platform,the search time limit of August 15,2023,included as a randomized controlled experiment of probiotics for the treatment of osteoporosis.Two researchers independently screened the literature,extracted the data,and evaluated the risk of bias in the included literature.The effects of probiotic treatment on BMD,blood calcium,vitamin D,parathyroid hormone,osteocalcin,bone alkaline phosphatase and adverse reactions were analyzed by using Stata A.14 and Revman.5.4 software.Results Eight articles were finally included,Including 744 study subjects,The results of the Meta-analysis showed that,Add probiotics to traditional drug therapy,Can increase hip bone mineral density in patients[WMD 0.05(0.01,0.10)]g/cm^(3),Increase the calcium ion concentration in the patient's blood[WMD 0.26(0.02,0.50)]mmol/L mmol/L,Increase the concentration of blood osteocalcin[WMD 1.84(0.60,3.07)]ng/mL,Lower the bone-specific alkaline phosphatase concentration[SMD-1.06(-2.06,-0.07)],And reduce the incidence of nausea and diarrhea,However,there was no significant change in vitamin D and parathyroid hormone.Conclusion The addition of probiotics on the basis of routine treatment may improve the level of bone mineral density and reduce the adverse reactions of gastrointestinal tract,which is beneficial to the prognosis of patients.