益生菌对放疗引起腹泻疗效的 Meta 分析

摘要

目的：评价益生菌对放疗所致腹泻的疗效。方法：计算机检索 PubMed 数据库（1950年1月－2014年6月）、Embase 数据库（1970年1月－2014年6月）、Cochrane 图书馆的临床对照试验数据库（CENTRAL，2014年第6期）、中国生物医学文献数据库（CBM，1978年1月－2014年6月）。纳入研究益生菌对放疗引起腹泻疗效的随机对照试验，对纳入文献的参考文献进一步扩大检索。纳入文献依据 Cochrane 风险偏倚评价工具进行质量评价。采用 Stata 12．0软件进行统计分析。结果：共纳入10篇英文文献，纳入放疗后患者1406例。Meta 分析结果显示：与对照组比较，益生菌未减少腹泻总发生率（OR ＝0．63，95％CI：0．35～1．14），但≥2级腹泻发生率明显降低（OR ＝0．30，95％CI：0．11～0．84）。此外，益生菌明显减少止泻药使用（OR ＝0．58，95％CI：0．41～0．81），但未减少水样便及腹痛发生率（OR ＝0．31，95％ CI ：0．07～1．41；OR ＝1．37，95％CI：0．56～3．31）。结论：益生菌对放疗所致腹泻有预防作用。%Objective:Whether probiotics could manage radiation induced diarrhea (RID)remains controversial. The aim of this study was to perform an update Meta -analysis to evaluate the efficacy of probiotics in RID.Meth-ods:Two reviewers independently conducted a systematic online literature research.PubMed,Embase,the Cochrane Central Register of Controlled Trials and Chinese BioMedical Literature Database were searched up to June 2014. Randomized controlled trials reporting the efficacy of probiotics in RID were included.References of included articles were also identified.The quality of each RCT was evaluated by the Cochrane collaboration's tool for assessing the risk of bias.Data analysis was performed with Stata 12.0 software to evaluate the efficacy of probiotics in RID.Results:Ten studies involving 1406 participants were included in our Meta -analysis.Probiotics did not significantly decrease overall incidence of RID [odds ratio (OR)=0.63,95% confidence interval (CI):0.35 ~1.14].However,inci-dence of grade ≥ 2 RID was significantly decreased when probiotics was used (OR =0.30,95%CI:0.11 ~0.84).In addition,probiotics significantly decreased the use of anti -diarrhea drugs (OR =0.58,95%CI:0.41 ~0.81).How-ever,incidences of liquid stools and abdominal pain were not decreased (OR =0.31,95%CI:0.07 ~1.41;OR =1. 37,95%CI:0.56 ~3.31).Conclusion:Probiotics is an effective agent for RID.