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Probiotics in Helicobacter pylori eradication therapy: A systematic review and meta-analysis 被引量:43

Probiotics in Helicobacter pylori eradication therapy: A systematic review and meta-analysis
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摘要 AIM: To summarize the evidence from randomized controlled trials(RCTs) regarding the effect of probiotics by using a meta-analytic approach.METHODS: In July 2013, we searched PubM ed, EMBASE, Ovid, the Cochrane Library, and three Chinese databases(Chinese Biomedical Literature Database, Chinese Medical Current Content, and Chinese Scientific Journals database) to identify relevant RCTs.We included RCTs investigating the effect of a combination of probiotics and standard therapy(probiotics group) with standard therapy alone(control group).Risk ratios(RRs) were used to measure the effect of probiotics plus standard therapy on Helicobacter pylori(H.pylori) eradication rates, adverse events, and patient compliance using a random-effect model.RESULTS: We included data on 6997 participants from 45 RCTs, the overall eradication rates of the probiotic group and the control group were 82.31% and 72.08%, respectively.We noted that the use of probiotics plus standard therapy was associated with an increased eradication rate by per-protocol set analysis(RR = 1.11; 95%CI: 1.08-1.15; P < 0.001) or intention-totreat analysis(RR = 1.13; 95%CI: 1.10-1.16; P < 0.001).Furthermore, the incidence of adverse events was 21.44% in the probiotics group and 36.27% in the control group, and it was found that the probiotics plus standard therapy significantly reduced the risk of adverse events(RR = 0.59; 95%CI: 0.48-0.71; P < 0.001), which demonstrated a favorable effect of probiotics in reducing adverse events associated with H.pylori eradication therapy.The specific reduction in adverse events ranged from 30% to 59%, and this reduction was statistically significant.Finally, probiotics plus standard therapy had little or no effect on patient compliance(RR = 0.98; 95%CI: 0.68-1.39; P = 0.889).CONCLUSION: The use of probiotics plus standard therapy was associated with an increase in the H.pylori eradication rate, and a reduction in adverse events resulting from treatment in the general population.However, this therapy did not improve patient compliance. AIM: To summarize the evidence from randomized controlled trials(RCTs) regarding the effect of probiotics by using a meta-analytic approach.METHODS: In July 2013, we searched PubM ed, EMBASE, Ovid, the Cochrane Library, and three Chinese databases(Chinese Biomedical Literature Database, Chinese Medical Current Content, and Chinese Scientific Journals database) to identify relevant RCTs.We included RCTs investigating the effect of a combination of probiotics and standard therapy(probiotics group) with standard therapy alone(control group).Risk ratios(RRs) were used to measure the effect of probiotics plus standard therapy on Helicobacter pylori(H.pylori) eradication rates, adverse events, and patient compliance using a random-effect model.RESULTS: We included data on 6997 participants from 45 RCTs, the overall eradication rates of the probiotic group and the control group were 82.31% and 72.08%, respectively.We noted that the use of probiotics plus standard therapy was associated with an increased eradication rate by per-protocol set analysis(RR = 1.11; 95%CI: 1.08-1.15; P < 0.001) or intention-totreat analysis(RR = 1.13; 95%CI: 1.10-1.16; P < 0.001).Furthermore, the incidence of adverse events was 21.44% in the probiotics group and 36.27% in the control group, and it was found that the probiotics plus standard therapy significantly reduced the risk of adverse events(RR = 0.59; 95%CI: 0.48-0.71; P < 0.001), which demonstrated a favorable effect of probiotics in reducing adverse events associated with H.pylori eradication therapy.The specific reduction in adverse events ranged from 30% to 59%, and this reduction was statistically significant.Finally, probiotics plus standard therapy had little or no effect on patient compliance(RR = 0.98; 95%CI: 0.68-1.39; P = 0.889).CONCLUSION: The use of probiotics plus standard therapy was associated with an increase in the H.pylori eradication rate, and a reduction in adverse events resulting from treatment in the general population.However, this therapy did not improve patient compliance.
出处 《World Journal of Gastroenterology》 SCIE CAS 2015年第14期4345-4357,共13页 世界胃肠病学杂志(英文版)
基金 Supported by Grant from the Ministry of Science and Technology of China,No.2008ZX10002-007,No.2008ZX10 002-018,and No.2008ZX10002-025 the Leading Talents of Science in Shanghai 2010(022) the Key Discipline Construction of Evidence-Based Public Health in Shanghai,No.12GWZX0602 the National Science Foundation of China,No.81373105
关键词 PROBIOTICS HELICOBACTER PYLORI EradicationSystemat Probiotics Helicobacter pylori EradicationSystemat
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