摘要
目的抗生素在儿童的应用很普遍,最常见的副反应是胃肠道反应,而腹泻是胃肠道反应的直接表现。儿童是否可以常规应用微生态制剂预防抗生素相关性腹泻(AAD)仍存争议。用循证医学评估微生态制剂预防儿童AAD的临床疗效。方法检索Medline(Pub Med作为检索工具)、Ovid、Web of Science、Embase和Cochrane Library、中国生物医学文献数据库,国期刊全文数据库和维普中文科技期刊数据库等,并辅于手工检索,检索时间均从建库至2009-06-31,对同质资料进行Meta分析。结果最终有8篇完全随机对照试验(RCT)符合纳入标准,经Q检验被纳入RCT无统计学意义,应用固定效应模型进行统计分析,微生态制剂组与对照组相比,差异有统计学意义,相对危险度(RR)=0.36,95%CI:0.27～0.48,需要治疗数(NNT)=6.37,95%CI:5.06～8.03。结论微生态制剂在一定程度上能够减少儿童AAD的发生率,且尚无相关副反应的报道,这为儿童抗生素的使用中是否应用微生态制剂提供一定的参考。由于亚组分析单一微生态制剂的RCT尚少,要进一步系统评估具体某一种微生态制剂的预防作用则仍需将来有更多的RCT被纳入。
Objective Application of antibiotics in children was widespread. The most common side effect is a response to the gastrointestinal tract. Diarrhea is a direct response to the performance of the side effect. It is a controversy that whether probiotics could be routinely used in prevention of antibiotic-associated diarrhea when antibiotics treatment is used. To systematically evaluate the effectiveness of probiotics in preventing antibiotic-associated diarrhea （AAD） in children. Methods A comprehensive search was performed in the web databases from the Database building time to 2009-06-31, including Medline （PubMed as a search tool） , Ovid, Web of Science, Embase Cochrane Libra,7, Chinese Biological Medicine Database, National Knowledge Infrastructure （CNKI） of China and Chongqing VIP Database. Manual search was also performed. Meta analysis was performed in all homogeneous data. Results Eight randomized control trials （RCT） met the inclusion criteria. All the RCTs had no heterogeneity difference by Q test. The fixed effect model was used in statistical analysis. The summary result showed the significant benefit for use of probiotics compared with control group; RR （relative risk） = 0.36, 95%CI： 0.27-0.48, NNT （number needed to treat）= 6.37, 95%CI： 5.06-8.03. Conclusion Probiotics can reduce antibiotic-associated diarrhea in pediatrics to a certain extent. This review also shows the moderate beneficial effect of routine use of probiotics while receiving antibiotics. And there is no report of adverse reactions. But more RCTs need to be included for analysis in the future when systematically assessing the specific effects of one certain kind of probiotics.
出处
《中国实用儿科杂志》
CSCD
北大核心
2010年第4期303-308,共6页
Chinese Journal of Practical Pediatrics
