摘要
目的评价益生菌制剂在肝硬化患者应用的疗效。方法检索MEDLINE、EMBASE、The Cochrane Central Register of Controlled Trials、中国期刊全文数据库等关于益生菌制剂在肝硬化患者中应用的临床随机对照试验（RCTs）,应用Review Manager 5.2软件对入选试验进行Meta分析。结果共纳入50项RCTs,与对照组相比,益生菌组的ALT（WMD=9.83,95%CI：4.29-15.37,P=0.0005）、血氨（SMD=0.89,95%CI：0.53-1.25,P〈0.00001）、内毒素（ETX）（SMD=0.81,95%CI：0.60-1.02,P〈0.00001）、肿瘤坏死因子-α（TNF-α）（SMD=3.28,95%CI：0.35-4.21,P〈0.0001）显著降低;小肠细菌过度生长（SIBO）发生率（RR=0.49,95%CI：0.36-0.68,P〈0.0001）、肝性脑病（HE）发生率（RR=0.52,95%CI：0.42-0.64,P〈0.00001）及自发性细菌性腹膜炎（SBP）发生率（RR=0.49,95%CI：0.36-0.68,P〈0.0001）显著降低;而T-BIL（WMD=3.39,95%CI：-2.65-9.42,P=0.27）无显著改变。结论益生菌制剂可通过调节肠道菌群,改善肠道屏障功能及内毒素血症,降低炎性因子,显著改善肝硬化患者各项生化指标,减少HE、SBP的发生。
Objective To evaluate the effect of probiotics in patients with liver cirrhosis. Methods MEDLINE、EMBASE、The Cochrane Central Register of Controlled Trials、 Chinese Journals Full-text Database were searched to retrieve randomized controlled trials about the effect of probiotics in the treatment of liver cirrhosis.Statistical analysis was performed by using Review Manager 5.2 software. Results Fifty RCTs were included in all.Compared to the control group,probiotics significantly decreased serum ALT（WMD=9.83,95%CI：4.29-15.37, P = 0.0005）, NH3（SMD=0.89,95%CI：0.53-1.25, P〈0.00001）, endotoxin（ETX）（SMD=0.81,95%CI：0.60-1.02, P〈0.00001）、TNF-α（SMD=3.28,95%CI：0.35-4.21, P〈0.0001）. There were significant differences in reduction of the morbidities of small intestinal bacterial overgrowth（SIBO）（RR=0.49,95%CI：0.36-0.68, P〈0.0001）, hepatic encephalopathy（HE）（RR=0.52,95%CI：0.42-0.64,P〈0.00001）and spontaneous bacterial peritonitis（SBP）（RR=0.49,95%CI：0.36-0.68, P〈0.0001）compared to the control group. There was no significant difference of T-BIL in both groups. Conclusion Probiotics can significantly improve the biochemical parameters and decrease the risk of HE and SBP by regulating the intestinal flora, improving the intestinal barrier function and reducing the level of endotoxin and inflammatory factors.
出处
《北京医学》
CAS
2015年第3期213-219,共7页
Beijing Medical Journal
基金
中国肝炎防治基金会王宝恩肝纤维化研究基金(xjs201302)
关键词
益生菌
肝硬化
荟萃分析
Probiotics Liver cirrhosis Meta analysis
