目的:基于网状Meta分析,评价不同中药联合益生菌治疗抗生素相关性腹泻(AAD)的疗效及安全性,为临床安全用药方案提供循证医学依据。方法:在万方数据库、维普数据库、中国知网、中华医学期刊数据库、PubMed、Web of Science等数据库中检...目的:基于网状Meta分析,评价不同中药联合益生菌治疗抗生素相关性腹泻(AAD)的疗效及安全性,为临床安全用药方案提供循证医学依据。方法:在万方数据库、维普数据库、中国知网、中华医学期刊数据库、PubMed、Web of Science等数据库中检索中药联合益生菌治疗AAD的随机对照试验(观察组干预措施为中药联合益生菌,对照组干预措施为单纯使用益生菌),检索时间截至2023年1月。采用贝叶斯网状Meta分析方法,对不同中药联合益生菌治疗AAD的安全性和有效性进行评价。结果:筛选出21篇随机对照试验文献,涉及患者2 093例;使用的中药包括健脾补肾固摄汤、人参败毒散或健脾止泻汤、四逆汤联合四神汤、参术止泻汤、乌梅丸、巴特日-7味丸、胃肠安丸、参苓白术颗粒(参苓白术散)、小儿腹泻散、参苓白术散+补肺汤、醒脾养儿颗粒、儿泻停颗粒、黄芪建中汤、马齿苋煎煮液、固本益肠片共15种。以总有效率为基础指标进行贝叶斯网状Meta分析,结果显示,人参败毒散或健脾止泻汤的效果最佳(OR=12,95%CI=3.1~78.0),且差异有统计学意义(P<0.05)。结论:文献研究前后患者的身体指标未见异常,15种中药联合益生菌治疗AAD的研究方案未对患者造成伤害;同时在鼠类的AAD模型复现上也得到了相应的证实,可以认为本次网状Meta分析的结果是安全、可靠的。本研究中的中药联合益生菌治疗AAD的疗效均优于单纯使用益生菌,能有效缩短病程,为临床用药提供了循证医学证据,但仍需要更多的研究支持和验证。展开更多
抗生素相关性腹泻(antibiotic-associated diarrhea, AAD)是使用抗生素治疗后的常见不良反应,儿童尤其常见,艰难梭菌(Clostridium difficile, CD)是重要条件致病菌。由于抗生素在临床中被广泛使用,AAD的发病率呈上升趋势,延长了患儿的...抗生素相关性腹泻(antibiotic-associated diarrhea, AAD)是使用抗生素治疗后的常见不良反应,儿童尤其常见,艰难梭菌(Clostridium difficile, CD)是重要条件致病菌。由于抗生素在临床中被广泛使用,AAD的发病率呈上升趋势,延长了患儿的疾病治疗时长,增加了医疗费用。AAD发病机制复杂,肠道菌群失调是基本机制。AAD通常是自限性疾病,但少数可危及生命,合理规范治疗意义重大。本文将从抗生素应用、益生菌的使用、粪菌移植、活体生物药等西医治疗及单味中药及其活性成分、中药复方、中医外治法等中医治疗以及中西医结合治疗儿童AAD做一综述,以期为临床治疗儿童AAD提供一定的帮助。Antibiotic-associated diarrhea (AAD) is a common adverse reaction after antibiotic treatment, especially in children. Clostridium difficile (CD) is an important opportunistic pathogen. Due to the widespread use of antibiotics in clinical practice, the incidence of AAD is on the rise, extending the duration of disease treatment for children and increasing medical costs. The pathogenesis of AAD is complex, and the basic mechanism is the imbalance of intestinal flora. AAD is usually a self-limiting disease, but a few can be life-threatening. Reasonable and standardized treatment is of great significance. In this paper, Western medicine treatments such as antibiotic application, the use of probiotics, fecal bacteria transplantation, living biological drugs and traditional Chinese medicine treatments including single traditional Chinese medicine and its active ingredients, compound traditional Chinese medicine, traditional Chinese medicine external treatment, as well as the combination of Chinese and Western medicine will be reviewed to treat AAD in children, in order to provide certain help for the clinical treatment of children’s AAD.展开更多
文摘目的:基于网状Meta分析,评价不同中药联合益生菌治疗抗生素相关性腹泻(AAD)的疗效及安全性,为临床安全用药方案提供循证医学依据。方法:在万方数据库、维普数据库、中国知网、中华医学期刊数据库、PubMed、Web of Science等数据库中检索中药联合益生菌治疗AAD的随机对照试验(观察组干预措施为中药联合益生菌,对照组干预措施为单纯使用益生菌),检索时间截至2023年1月。采用贝叶斯网状Meta分析方法,对不同中药联合益生菌治疗AAD的安全性和有效性进行评价。结果:筛选出21篇随机对照试验文献,涉及患者2 093例;使用的中药包括健脾补肾固摄汤、人参败毒散或健脾止泻汤、四逆汤联合四神汤、参术止泻汤、乌梅丸、巴特日-7味丸、胃肠安丸、参苓白术颗粒(参苓白术散)、小儿腹泻散、参苓白术散+补肺汤、醒脾养儿颗粒、儿泻停颗粒、黄芪建中汤、马齿苋煎煮液、固本益肠片共15种。以总有效率为基础指标进行贝叶斯网状Meta分析,结果显示,人参败毒散或健脾止泻汤的效果最佳(OR=12,95%CI=3.1~78.0),且差异有统计学意义(P<0.05)。结论:文献研究前后患者的身体指标未见异常,15种中药联合益生菌治疗AAD的研究方案未对患者造成伤害;同时在鼠类的AAD模型复现上也得到了相应的证实,可以认为本次网状Meta分析的结果是安全、可靠的。本研究中的中药联合益生菌治疗AAD的疗效均优于单纯使用益生菌,能有效缩短病程,为临床用药提供了循证医学证据,但仍需要更多的研究支持和验证。
文摘抗生素相关性腹泻(antibiotic-associated diarrhea, AAD)是使用抗生素治疗后的常见不良反应,儿童尤其常见,艰难梭菌(Clostridium difficile, CD)是重要条件致病菌。由于抗生素在临床中被广泛使用,AAD的发病率呈上升趋势,延长了患儿的疾病治疗时长,增加了医疗费用。AAD发病机制复杂,肠道菌群失调是基本机制。AAD通常是自限性疾病,但少数可危及生命,合理规范治疗意义重大。本文将从抗生素应用、益生菌的使用、粪菌移植、活体生物药等西医治疗及单味中药及其活性成分、中药复方、中医外治法等中医治疗以及中西医结合治疗儿童AAD做一综述,以期为临床治疗儿童AAD提供一定的帮助。Antibiotic-associated diarrhea (AAD) is a common adverse reaction after antibiotic treatment, especially in children. Clostridium difficile (CD) is an important opportunistic pathogen. Due to the widespread use of antibiotics in clinical practice, the incidence of AAD is on the rise, extending the duration of disease treatment for children and increasing medical costs. The pathogenesis of AAD is complex, and the basic mechanism is the imbalance of intestinal flora. AAD is usually a self-limiting disease, but a few can be life-threatening. Reasonable and standardized treatment is of great significance. In this paper, Western medicine treatments such as antibiotic application, the use of probiotics, fecal bacteria transplantation, living biological drugs and traditional Chinese medicine treatments including single traditional Chinese medicine and its active ingredients, compound traditional Chinese medicine, traditional Chinese medicine external treatment, as well as the combination of Chinese and Western medicine will be reviewed to treat AAD in children, in order to provide certain help for the clinical treatment of children’s AAD.
