益生菌干预子宫内膜癌术后肠道菌群重建及改善患者生活质量的研究进展。

IF 4.8 2区 医学 Q2 IMMUNOLOGY
Frontiers in Cellular and Infection Microbiology Pub Date : 2025-09-19 eCollection Date: 2025-01-01 DOI:10.3389/fcimb.2025.1670836
Wei Chen, Xiao Chen, Yi Fang, Yang Sun, Yibin Lin
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引用次数: 0

摘要

目的:本研究旨在全面评估补充益生菌对子宫内膜癌(EC)患者肠道菌群组成和生活质量的影响,提供有经验数据支持的临床见解。方法:系统检索PubMed、EMBASE、Cochrane Library、Web of Science、CNKI等数据库,检索截至2023年中期的文献。仅选择随机对照试验(RCTs)调查EC手术患者的益生菌管理。主要评估指标包括肠道微生物多样性指数、特定细菌种群的变化、生活质量评估、胃肠道症状严重程度和免疫反应指标。采用RevMan 5.4和Stata 16.0软件进行统计学分析。结果:meta分析纳入18项随机对照试验,共1246名参与者。结果表明,添加益生菌显著提高了α-多样性(SMD = 0.68, 95% CI: 0.41 ~ 0.95, p < 0.001),增加了双歧杆菌(SMD = 1.12, 95% CI: 0.78 ~ 1.46, p < 0.001)和乳酸菌(SMD = 0.93, 95% CI: 0.65 ~ 1.21, p < 0.001)的有益微生物数量。相反,拟杆菌门等机会致病菌的丰度降低(SMD = -0.54, 95% CI: -0.82 ~ -0.26, p < 0.001)。临床上,益生菌的使用显著改善了患者的整体生活质量(MD = 8.74, 95% CI: 5.12-12.36, p < 0.001),缓解了腹泻(RR = 0.45, 95% CI: 0.32-0.63, p < 0.001)和便秘(RR = 0.57, 95% CI: 0.42-0.78, p < 0.001)等胃肠道紊乱。此外,炎症标志物,包括IL-6 (SMD = -0.76, 95% CI: -1.05至-0.47,p < 0.001)和TNF-α (SMD = -0.64, 95% CI: -0.93至-0.35,p < 0.001)均显著降低。亚组分析显示,多菌株制剂、高剂量(≥1010 CFU/天)和延长治疗时间(≥8周)的效果更好。结论:目前的证据支持益生菌在恢复肠道菌群平衡、改善患者健康、减轻消化并发症和减少EC手术后全身炎症方面的有益作用。进一步的高质量研究是必要的,以完善最佳的益生菌菌株,剂量策略和干预时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Research progress of probiotics intervention on reconstruction of intestinal flora and improvement of quality of life in patients after endometrial cancer surgery.

Objective: This study aims to comprehensively assess the impact of probiotic supplementation on gut microbiota composition and quality of life in endometrial cancer (EC) patients, offering clinical insights supported by empirical data.

Methods: A systematic search was conducted across multiple databases, including PubMed, EMBASE, Cochrane Library, Web of Science, and CNKI, covering literature up to mid-2023. Only randomized controlled trials (RCTs) investigating probiotic administration in EC surgery patients were selected. Key evaluation metrics encompassed gut microbial diversity indices, shifts in specific bacterial populations, quality of life assessments, gastrointestinal symptom severity, and immune response indicators. Statistical analyses were performed using RevMan 5.4 and Stata 16.0 software.

Results: The meta-analysis incorporated 18 RCTs with a total of 1,246 participants. Findings revealed that probiotic supplementation significantly enhanced α-diversity (SMD = 0.68, 95% CI: 0.41-0.95, p < 0.001) and increased the prevalence of beneficial microbes, including Bifidobacterium (SMD = 1.12, 95% CI: 0.78-1.46, p < 0.001) and Lactobacillus (SMD = 0.93, 95% CI: 0.65-1.21, p < 0.001). Conversely, opportunistic pathogens like Bacteroidetes exhibited reduced abundance (SMD = -0.54, 95% CI: -0.82 to -0.26, p < 0.001). Clinically, probiotic use led to notable improvements in overall quality of life (MD = 8.74, 95% CI: 5.12-12.36, p < 0.001) and alleviated gastrointestinal disturbances, such as diarrhea (RR = 0.45, 95% CI: 0.32-0.63, p < 0.001) and constipation (RR = 0.57, 95% CI: 0.42-0.78, p < 0.001). Additionally, inflammatory markers, including IL-6 (SMD = -0.76, 95% CI: -1.05 to -0.47, p < 0.001) and TNF-α (SMD = -0.64, 95% CI: -0.93 to -0.35, p < 0.001), were significantly lowered. Subgroup analyses indicated superior efficacy with multi-strain formulations, higher dosages (≥1010 CFU/day), and extended treatment durations (≥8 weeks).

Conclusion: Current evidence supports the beneficial role of probiotics in restoring gut microbiota balance, enhancing patient well-being, mitigating digestive complications, and reducing systemic inflammation following EC surgery. Further high-quality research is warranted to refine optimal probiotic strains, dosing strategies, and intervention timing.

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来源期刊
CiteScore
7.90
自引率
7.00%
发文量
1817
审稿时长
14 weeks
期刊介绍: Frontiers in Cellular and Infection Microbiology is a leading specialty journal, publishing rigorously peer-reviewed research across all pathogenic microorganisms and their interaction with their hosts. Chief Editor Yousef Abu Kwaik, University of Louisville is supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Frontiers in Cellular and Infection Microbiology includes research on bacteria, fungi, parasites, viruses, endosymbionts, prions and all microbial pathogens as well as the microbiota and its effect on health and disease in various hosts. The research approaches include molecular microbiology, cellular microbiology, gene regulation, proteomics, signal transduction, pathogenic evolution, genomics, structural biology, and virulence factors as well as model hosts. Areas of research to counteract infectious agents by the host include the host innate and adaptive immune responses as well as metabolic restrictions to various pathogenic microorganisms, vaccine design and development against various pathogenic microorganisms, and the mechanisms of antibiotic resistance and its countermeasures.
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