Qingfan Zheng, Changfeng Li, Lei Yang, Yunfeng Qiu
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引用次数: 0
摘要
克罗恩病(CD)是一种慢性炎症性肠病,以缓解期和复发期为特征。益生菌被认为是治疗乳糜泻的潜在药物,但它们对临床结果的影响尚不清楚。本荟萃分析旨在评估益生菌对CD患者的疗效和安全性。在多个数据库中进行了系统检索,包括Medline、Embase、Cochrane Library、万方和中国知网。纳入了评估益生菌干预乳糜泻患者的随机对照试验(rct)。主要结局是临床缓解和复发,次要结局包括内镜下复发和安全性。采用随机效应模型计算风险比(RR)和95%置信区间(ci)。纳入16项随机对照试验,共1112例患者。益生菌显著增加活动性CD患者临床缓解的可能性(RR: 1.27, 95% CI: 1.09-1.47, p = 0.002),具有轻度异质性(I2 = 16%)。而缓解期患者对临床复发无显著影响(RR: 0.93, 95% CI: 0.68 ~ 1.28, p = 0.66)。此外,益生菌并没有降低回盲切除术后内镜下复发的风险(RR: 0.86, 95% CI: 0.63-1.18, p = 0.34),服用益生菌的患者和对照组的严重不良事件发生率相当(p = 0.82)。益生菌可能通过调节肠道菌群来帮助增强活动性乳糜泻患者的临床缓解。然而,在缓解期没有观察到对复发或内镜下复发的显著影响。
Efficacy and safety probiotics as adjuvant treatment for Crohn's disease: a meta-analysis of randomized controlled trials.
Crohn's disease (CD) is a chronic inflammatory bowel disease characterized by periods of remission and relapse. Probiotics have been suggested as potential therapeutic agents for managing CD, but their effects on clinical outcomes remain unclear. This meta-analysis aimed to evaluate the efficacy and safety of probiotics in patients with CD. A systematic search was conducted across multiple databases, including Medline, Embase, Cochrane Library, Wanfang, and CNKI. Randomized controlled trials (RCTs) assessing probiotic interventions in patients with CD were included. The primary outcomes were clinical remission and relapse, while secondary outcomes included endoscopic recurrence and safety. Risk ratios (RR) and 95 % confidence intervals (CIs) were calculated using a random-effects model. Sixteen RCTs involving 1112 patients were included. Probiotics significantly increased the likelihood of clinical remission in patients with active CD (RR: 1.27, 95 % CI: 1.09-1.47, p = 0.002) with mild heterogeneity (I2 = 16 %). However, no significant effect on clinical relapse was found in patients in remission (RR: 0.93, 95 % CI: 0.68-1.28, p = 0.66). In addition, probiotics did not reduce the risk of endoscopic recurrence after ileocecal resection (RR: 0.86, 95 % CI: 0.63-1.18, p = 0.34), and the incidence of severe adverse events was comparable between patients receiving probiotics and controls (p = 0.82). Probiotics may help enhance clinical remission in active CD patients possibly by modulating gut microbiota. However, no significant effect on relapse or endoscopic recurrence in remission was observed.
期刊介绍:
Current Research in Food Science is an international peer-reviewed journal dedicated to advancing the breadth of knowledge in the field of food science. It serves as a platform for publishing original research articles and short communications that encompass a wide array of topics, including food chemistry, physics, microbiology, nutrition, nutraceuticals, process and package engineering, materials science, food sustainability, and food security. By covering these diverse areas, the journal aims to provide a comprehensive source of the latest scientific findings and technological advancements that are shaping the future of the food industry. The journal's scope is designed to address the multidisciplinary nature of food science, reflecting its commitment to promoting innovation and ensuring the safety and quality of the food supply.