摘要
目的系统评价益生菌辅助治疗儿童哮喘的有效性和安全性,为益生菌治疗儿童哮喘提供循证医学证据。方法以“哮喘、益生菌、儿童、随机”为主题词检索PubMed、EMbase、Cochrane Library、中国知网、万方、维普网和CBM数据库,搜集益生菌联合常规抗炎平喘药物为干预措施治疗儿童哮喘的随机对照试验研究,检索时间范围均为建库至2019年4月。两位研究者进行独立筛查文献、评价文献偏倚风险以及提取临床总有效率、复发率、一秒用力呼气容积(FEV1)、γ干扰素(IFN-γ)、免疫球蛋白E(IgE)和不良反应指标后,采用RevMan 5.3软件进行meta分析。结果最终纳入10项研究,共包括992例哮喘患儿。meta分析结果显示:与对照组比较,试验组临床总有效率提高(OR=3.57,95%CI:2.41~5.30,P<0.00001),FEV1增大(MD=0.29,95%CI:0.13~0.45,P=0.0003),IFN-γ水平升高(MD=30.28,95%CI:26.80~33.77,P<0.00001),IgE水平降低(MD=-24.03,95%CI:-31.15^-16.90,P<0.00001),复发率降低(OR=0.37,95%CI:0.19~0.72,P=0.003)。两组不良反应发生率比较,差异无统计学意义(OR=1.08,95%CI:0.49~2.39,P=0.85)。结论基于目前的临床证据,益生菌辅助治疗儿童哮喘可以有效提高临床疗效和患者生活质量,降低复发率。由于纳入研究的质量偏低、样本量较少,故确切结论尚需开展更多高质量、大样本量、多中心的临床研究加以验证。
Objective To systematically evaluate the efficacy and safety of probiotics in the adjuvant treatment of childhood asthma,so as to provide evidence-based medical evidence for probiotics in the treatment of childhood asthma.Methods Randomized controlled trials of probiotics combined with conventional anti-inflammatory and antiasthmatic drugs as intervention measures in the treatment of childhood asthma were collected in PubMed,EMbase,Cochrane Library,CNKI,Wanfang,VIP and CBM databases with the keywords“asthma,probiotics,children,random”.The searching time range was from the establishment of the database to April 2019.Meta analysis was performed with software RevMan 5.3 after independently screening the literature,evaluating the risk of literature bias,and extracting the clinical total effective rate,recurrence rate,FEV1,IFN-γ,IgE and adverse reaction indicators by the two investigators.Results A total of ten RCTs involving 992 asthma patients were included.Meta analysis results showed that:compared with control group,clinical total effective rate of experimental group improved(OR=3.57,95%CI:2.41-5.30,P<0.00001),FEV1 increased(MD=0.29,95%CI:0.13-0.45,P=0.0003),IFN-γlevel increased(MD=30.28,95%CI:26.80-33.77,P<0.00001),IgE level decreased(MD=-24.03,95%CI:-31.15 to-16.90,P<0.00001),recurrence rate decreased(OR=0.37,95%CI:0.19-0.72,P=0.003).There was no significant difference in the incidence of adverse reaction between two groups(OR=1.08,95%CI:0.49-2.39,P=0.85).Conclusion Based on the current clinical evidence,probiotics adjuvant treatment of childhood asthma can effectively improve the clinical efficacy and quality of life of patients,and reduce the recurrence rate.Due to the low quality and small sample size of the included studies,more high-quality,large sample size,multi center clinical studies are needed to verify the exact conclusion.
作者
杨福双
曹方
郭磊
郭婷婷
王中天
孙丽平
YANG Fushuang;CAO Fang;GUO Lei;GUO Tingting;WANG Zhongtian;SUN Liping(College of Chinese Medicine,Changchun University of Chinese Medicine,Jilin Province,Changchun130117,China;Child Care Centre,the Affiliated Hospital of Changchun University of Chinese Medicine,Jilin Province,Changchun130021,China)
出处
《中国医药导报》
CAS
2020年第30期112-117,共6页
China Medical Herald
基金
国家自然科学基金面上项目(81473729、81974579)
中医药传承与创新“百千万”人才工程(岐黄工程)-王烈国医大师传承工作室
吉林省中医药管理局科技项目(2014-ZD18、2019023)
吉林省卫生计生委科技项目(2018J 106)
长春中医药大学重点学科建设项目(长中大校办发〔2019〕18号)。
关键词
儿童哮喘
益生菌
肺与大肠相表里
随机对照试验
系统评价
META分析
Childhood asthma
Probiotics
Interior-exterior relationship between lung and large intestine
Randomized controlled trial
Systematic evaluation
Meta analysis
