{"title":"作为根除幽门螺旋杆菌疗法的辅助药物，芦特氏乳杆菌与安慰剂的比较：随机对照试验的荟萃分析。","authors":"Meng Li, Xiaolei Wang, Xinhong Dong, Guigen Teng, Yun Dai, Weihong Wang","doi":"10.1177/17562848241258021","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Given the growing problem of antibiotic resistance, it is crucial to improve <i>Helicobacter pylori</i> (<i>H. pylori</i>) treatment interventions or provide adjunctive therapy. The objective of this meta-analysis was to evaluate whether <i>Lactobacillus reuteri</i> (<i>L. reuteri</i>) could improve <i>H. pylori</i> eradication rate, reduce the incidence of adverse events (AEs), and alleviate gastrointestinal symptoms.</p><p><strong>Design: </strong>A meta-analysis of randomized controlled trials (RCTs) comparing <i>L. reuteri</i> supplementation therapy with placebo was conducted.</p><p><strong>Sources and methods: </strong>We retrieved relevant studies from PubMed, Embase, and the Cochrane Library. The primary outcome was <i>H. pylori</i> eradication rate, and the scores on the Gastrointestinal Symptom Rating Scale and AEs were secondary outcomes.</p><p><strong>Results: </strong>Eight RCTs including 1087 patients were included in this analysis. The <i>L. reuteri</i> supplementation group showed significantly higher <i>H. pylori</i> eradication rates in both intention-to-treat (ITT) and per-protocol (PP) analysis [ITT: 80.0% <i>versus</i> 72.6%; <i>p</i> = 0.005, relative risk (RR): 1.10; 95% confidence interval (CI): 1.03-1.17; number needed to treat (NNT) = 14; PP: 81.8% <i>versus</i> 75.0%; <i>p</i> = 0.006, RR: 1.09; 95% CI: 1.03-1.16; NNT = 15]. Patients treated with <i>L. reuteri</i> showed greater improvements in gastrointestinal symptoms (pooled mean difference: -2.43, 95% CI: -4.56 to -0.29, <i>p</i> = 0.03). The incidence of AEs was significantly reduced in the <i>L. reuteri</i> supplementation group based on ITT and PP analysis (ITT: <i>p</i> < 0.00001, RR: 0.72, 95% CI: 0.67-0.78; PP: <i>p</i> < 0.00001, RR: 0.70, 95% CI: 0.65-0.77).</p><p><strong>Conclusion: </strong>The present meta-analysis demonstrated that supplementation with <i>L. reuteri</i> was beneficial for improving the eradication rate of <i>H. pylori</i>, reducing the overall incidence of side effects, and relieving gastrointestinal symptoms in patients during treatment. The findings provide new insights into clinical decision-making.</p><p><strong>Trial registration prospero: </strong>CRD42023424052.</p>","PeriodicalId":3,"journal":{"name":"ACS Applied Electronic Materials","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155330/pdf/","citationCount":"0","resultStr":"{\"title\":\"<i>Lactobacillus reuteri</i> compared with placebo as an adjuvant in <i>Helicobacter pylori</i> eradication therapy: a meta-analysis of randomized controlled trials.\",\"authors\":\"Meng Li, Xiaolei Wang, Xinhong Dong, Guigen Teng, Yun Dai, Weihong Wang\",\"doi\":\"10.1177/17562848241258021\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Given the growing problem of antibiotic resistance, it is crucial to improve <i>Helicobacter pylori</i> (<i>H. pylori</i>) treatment interventions or provide adjunctive therapy. The objective of this meta-analysis was to evaluate whether <i>Lactobacillus reuteri</i> (<i>L. reuteri</i>) could improve <i>H. pylori</i> eradication rate, reduce the incidence of adverse events (AEs), and alleviate gastrointestinal symptoms.</p><p><strong>Design: </strong>A meta-analysis of randomized controlled trials (RCTs) comparing <i>L. reuteri</i> supplementation therapy with placebo was conducted.</p><p><strong>Sources and methods: </strong>We retrieved relevant studies from PubMed, Embase, and the Cochrane Library. The primary outcome was <i>H. pylori</i> eradication rate, and the scores on the Gastrointestinal Symptom Rating Scale and AEs were secondary outcomes.</p><p><strong>Results: </strong>Eight RCTs including 1087 patients were included in this analysis. The <i>L. reuteri</i> supplementation group showed significantly higher <i>H. pylori</i> eradication rates in both intention-to-treat (ITT) and per-protocol (PP) analysis [ITT: 80.0% <i>versus</i> 72.6%; <i>p</i> = 0.005, relative risk (RR): 1.10; 95% confidence interval (CI): 1.03-1.17; number needed to treat (NNT) = 14; PP: 81.8% <i>versus</i> 75.0%; <i>p</i> = 0.006, RR: 1.09; 95% CI: 1.03-1.16; NNT = 15]. Patients treated with <i>L. reuteri</i> showed greater improvements in gastrointestinal symptoms (pooled mean difference: -2.43, 95% CI: -4.56 to -0.29, <i>p</i> = 0.03). The incidence of AEs was significantly reduced in the <i>L. reuteri</i> supplementation group based on ITT and PP analysis (ITT: <i>p</i> < 0.00001, RR: 0.72, 95% CI: 0.67-0.78; PP: <i>p</i> < 0.00001, RR: 0.70, 95% CI: 0.65-0.77).</p><p><strong>Conclusion: </strong>The present meta-analysis demonstrated that supplementation with <i>L. reuteri</i> was beneficial for improving the eradication rate of <i>H. pylori</i>, reducing the overall incidence of side effects, and relieving gastrointestinal symptoms in patients during treatment. The findings provide new insights into clinical decision-making.</p><p><strong>Trial registration prospero: </strong>CRD42023424052.</p>\",\"PeriodicalId\":3,\"journal\":{\"name\":\"ACS Applied Electronic Materials\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-06-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155330/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACS Applied Electronic Materials\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/17562848241258021\",\"RegionNum\":3,\"RegionCategory\":\"材料科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"ENGINEERING, ELECTRICAL & ELECTRONIC\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Electronic Materials","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17562848241258021","RegionNum":3,"RegionCategory":"材料科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"ENGINEERING, ELECTRICAL & ELECTRONIC","Score":null,"Total":0}
引用次数: 0
摘要
背景：鉴于抗生素耐药性问题日益严重，改进幽门螺旋杆菌（H. pylori）治疗干预措施或提供辅助治疗至关重要。这项荟萃分析的目的是评估纽崔莱乳杆菌（L. reuteri）是否能提高幽门螺杆菌根除率、降低不良事件（AEs）的发生率并缓解胃肠道症状：资料来源与方法：我们从 PubMed、Embase 和 Cochrane 图书馆检索了相关研究。主要结果为幽门螺杆菌根除率，胃肠道症状评分量表得分和AEs为次要结果：本次分析共纳入了 8 项 RCT，包括 1087 名患者。在意向治疗（ITT）和按方案（PP）分析中，补充 L. reuteri 组的幽门螺杆菌根除率明显更高[ITT：80.0% 对 72.6%；P = 0.005，相对风险 (RR)：1.10；95% 置信区间]：1.10；95% 置信区间 (CI)：1.03-1.17；治疗所需人数 (NNT) = 14；PP：81.8% 对 75.0%；P = 0.006，RR：1.09；95% CI：1.03-1.16；NNT = 15]。使用 L. reuteri 治疗的患者胃肠道症状得到了更大改善（汇总平均差：-2.43，95% CI：-4.56 至 -0.29，p = 0.03）。根据 ITT 和 PP 分析，补充 L. reuteri 组的 AEs 发生率明显降低（ITT：p p 结论：补充 L. reuteri 组的 AEs 发生率明显降低：本荟萃分析表明，补充 L. reuteri 有利于提高幽门螺杆菌的根除率，降低副作用的总体发生率，缓解治疗期间患者的胃肠道症状。这些发现为临床决策提供了新的见解：CRD42023424052。
Lactobacillus reuteri compared with placebo as an adjuvant in Helicobacter pylori eradication therapy: a meta-analysis of randomized controlled trials.
Background: Given the growing problem of antibiotic resistance, it is crucial to improve Helicobacter pylori (H. pylori) treatment interventions or provide adjunctive therapy. The objective of this meta-analysis was to evaluate whether Lactobacillus reuteri (L. reuteri) could improve H. pylori eradication rate, reduce the incidence of adverse events (AEs), and alleviate gastrointestinal symptoms.
Design: A meta-analysis of randomized controlled trials (RCTs) comparing L. reuteri supplementation therapy with placebo was conducted.
Sources and methods: We retrieved relevant studies from PubMed, Embase, and the Cochrane Library. The primary outcome was H. pylori eradication rate, and the scores on the Gastrointestinal Symptom Rating Scale and AEs were secondary outcomes.
Results: Eight RCTs including 1087 patients were included in this analysis. The L. reuteri supplementation group showed significantly higher H. pylori eradication rates in both intention-to-treat (ITT) and per-protocol (PP) analysis [ITT: 80.0% versus 72.6%; p = 0.005, relative risk (RR): 1.10; 95% confidence interval (CI): 1.03-1.17; number needed to treat (NNT) = 14; PP: 81.8% versus 75.0%; p = 0.006, RR: 1.09; 95% CI: 1.03-1.16; NNT = 15]. Patients treated with L. reuteri showed greater improvements in gastrointestinal symptoms (pooled mean difference: -2.43, 95% CI: -4.56 to -0.29, p = 0.03). The incidence of AEs was significantly reduced in the L. reuteri supplementation group based on ITT and PP analysis (ITT: p < 0.00001, RR: 0.72, 95% CI: 0.67-0.78; PP: p < 0.00001, RR: 0.70, 95% CI: 0.65-0.77).
Conclusion: The present meta-analysis demonstrated that supplementation with L. reuteri was beneficial for improving the eradication rate of H. pylori, reducing the overall incidence of side effects, and relieving gastrointestinal symptoms in patients during treatment. The findings provide new insights into clinical decision-making.
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