Meta-analysis of probiotics efficacy in the treatment of minimum hepatic encephalopathy

IF 6 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Liver International Pub Date : 2024-09-12 DOI:10.1111/liv.16081

Yu-Lian Zhou, Shu-Tao Pu, Jian-Bo Xiao, Jun Luo, Li Xue

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Abstract

Objective

This study aims to systematically evaluate the efficacy of probiotics in treating minimum hepatic encephalopathy (MHE).

Methods

A systematic search was conducted across three major databases: PubMed, China National Knowledge Infrastructure and Wanfang. The search period spanned from the inception of each database to 9 March 2023. The objective was to identify all randomised controlled trials (RCTs) examining the efficacy of probiotic preparations in treating MHE. The search terms included ‘probiotics’ along with other clinically relevant terms to comprehensively capture all pertinent studies.

Results

A total of 18 RCTs were included. The meta-analysis showed that probiotic treatment outperformed control groups in reducing blood ammonia levels (standard mean difference [MD] = −2.68, 95% confidence interval [CI]: −3.90 to −1.46, p < .0001), improving the remission rate of MHE (risk ratio [RR] = 2.79, 95% CI: 1.23–6.35, p = .01) and lowering alanine aminotransferase levels (MD = −11.10, 95% CI: −16.17 to −6.03, p < .0001). It also significantly reduced the Model for End-Stage Liver Disease scores (MD = −2.55, 95% CI: −3.56 to −1.54, p < .00001) and the incidence of MHE (RR = .18, 95% CI: .09–.34, p < .00001).

Conclusion

Our study demonstrates that probiotics effectively improve blood ammonia levels, liver function and cognitive function in patients with MHE. They significantly enhance the remission rate of MHE and effectively reduce its incidence, providing solid new evidence for treating MHE with probiotics.

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益生菌治疗最小肝性脑病疗效的元分析

本研究旨在系统评估益生菌治疗最小肝性脑病（MHE）的疗效：方法在三个主要数据库中进行了系统检索：PubMed、中国国家知识基础设施和万方数据库。检索期从每个数据库建立之初至 2023 年 3 月 9 日。目的是确定所有研究益生菌制剂治疗 MHE 疗效的随机对照试验 (RCT)。检索词包括 "益生菌 "以及其他临床相关术语，以全面收集所有相关研究。荟萃分析表明，益生菌治疗在降低血氨水平方面优于对照组（标准平均差 [MD] = -2.68，95% 置信区间 [CI]：-3.90 至 -1.46）：-3.90至-1.46，p <.0001）、提高MHE缓解率（风险比[RR] = 2.79，95% CI：1.23至6.35，p = .01）和降低丙氨酸氨基转移酶水平（MD = -11.10，95% CI：-16.17至-6.03，p <.0001）方面优于对照组。结论我们的研究表明，益生菌能有效改善 MHE 患者的血氨水平、肝功能和认知功能。研究结果表明，益生菌能有效改善 MHE 患者的血氨水平、肝功能和认知功能，明显提高 MHE 的缓解率并有效降低其发病率，为使用益生菌治疗 MHE 提供了可靠的新证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Liver International 医学-胃肠肝病学

CiteScore

13.90

自引率

4.50%

发文量

348

审稿时长

2 months

期刊介绍： Liver International promotes all aspects of the science of hepatology from basic research to applied clinical studies. Providing an international forum for the publication of high-quality original research in hepatology, it is an essential resource for everyone working on normal and abnormal structure and function in the liver and its constituent cells, including clinicians and basic scientists involved in the multi-disciplinary field of hepatology. The journal welcomes articles from all fields of hepatology, which may be published as original articles, brief definitive reports, reviews, mini-reviews, images in hepatology and letters to the Editor.