首页|布拉氏酵母菌治疗儿童腹泻的有效性和安全性分析

布拉氏酵母菌治疗儿童腹泻的有效性和安全性分析

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目的 比较布拉氏酵母菌与其他细菌类益生菌治疗儿童腹泻的有效性和安全性.方法 计算机检索PubMed、Embase、中国知网、中国生物医学文献数据库、万方数据、维普数据,收集布拉氏酵母菌(试验组)对比其他益生菌(对照组)的随机对照试验(RCT).筛选文献,提取资料及质量评价后,用RevMan 5.3、Stata 17.0软件进行Meta分析.结果 共纳入30项RCTs,共计3 082例患儿.Meta分析结果显示,2组患儿的腹泻持续时间[均值差(MD)=-0.65,95%置信区间(CI)=-1.44~0.14,P>0.05]、药物不良反应总发生率[比值比(OR)=0.85,95%CI=0.44~1.62,P>0.05]比较,在统计学上差异均无统计学意义.试验组治疗后的总有效率(OR=1.60,95%CI=1.08~2.36,P<0.05)、大便次数(MD=-0.66,95%CI=-1.00~-0.32,P<0.01)均显著优于对照组.2 组在治疗腹泻伴发热(MD=1.81,95%CI=1.12~2.49,P<0.01)和轮状病毒性肠胃炎(MD=-0.92,95%CI=-1.20~-0.64,P<0.01)患儿的腹泻持续时间比较,在统计学上差异均有统计学意义.在治疗腹泻伴发热时,对照组的腹泻持续时间明显短于试验组.在治疗轮状病毒性肠胃炎时,试验组的腹泻持续时间显著短于对照组;同时,试验组的腹泻持续时间显著短于对照组的双歧杆菌四联活菌(MD=-0.84,95%CI=-1.09~-0.58,P<0.01)、枯草杆菌二联活菌(MD=-1.35,95%CI=-2.30~0.39,P<0.01).结论 布拉氏酵母菌与其他益生菌安全性相当,布拉氏酵母菌治疗儿童腹泻的疗效和治疗后大便次数均显著优于其他益生菌.在治疗轮状病毒性肠胃炎患儿腹泻时,布拉氏酵母菌的腹泻持续时间短于其他益生菌;而在治疗抗生素相关性腹泻时,布拉氏酵母菌与其他益生菌腹泻持续时间相当;但在治疗腹泻伴发热患儿时,布拉氏酵母菌的腹泻持续时间长于其他益生菌.
Analysis of the efficacy and safety of Saccharomyces boulardii in the treatment of pediatric diarrhea
Objective To compare the efficacy and safety of Saccharomyces boulardii and other probiotics in the treatment of pediatric diarrhea.Methods Retrieved from PubMed,Embase,CBM,Wanfang data,CNKI and VIP,randomized controlled trial(RCTs)about Saccharomyces boulardii(treatment group)vs other probiotics(control group)were collected.After screening the literature,extracting data and evaluating the quality,Meta-analysis was performed by using RevMan 5.3 and Stata 17.0 software.Results A total of 30 RCTs were included,involving 3 082 children.Results of Meta-analysis showed there was no statistical significance in the duration of diarrhea[mean difference(MD)=-0.65,95%confidence interval(CI)=-1.44-0.14,P>0.05]or the total incidence of adverse reactions[odds ratio(OR)=0.85,95%CI=0.44-1.62,P>0.05].The total effective rate(OR=1.60,95%CI=1.08-2.36,P<0.05)and the number of stools(MD=-0.66,95%CI=-1.00--0.32,P<0.01)in the treatment group were significantly better than control group.There was statistically significant difference in the duration of diarrhea between the two groups treated with diarrhea with fever(MD=1.81,95%CI=1.12-2.49,P<0.01)and rotavirus gastroenteritis(MD=-0.92,95%CI=-1.20--0.64,P<0.01).In the treatment of diarrhea with fever,the duration of diarrhea in the control group was significantly shorter than that in the treatment group.The duration of diarrhea in the treatment group was significantly shorter than that control group.At the same time,the duration of diarrhea in children with diarrhea treated with treatment group was significantly shorter than that of control group Bifidobacterium tetragenous viable(MD=-0.84,95%CI=-1.09--0.58,P<0.01)and control group combined Bacillus subtilis and Enterococcus faecium enteric-coated(MD=-1.35,95%CI=-2.30-0.39,P<0.01).Conclusion The safety of Saccharomyces boulardii are similar to other probiotics.The efficacy and the number of stools with Saccharomyces boulardii are significantly better than other probiotics in the treatment of diarrhea.The duration of diarrhea in Saccharomyces boulardii group was significantly shorter than other probiotics,while in the treatment of antibiotic-associated diarrhea,the duration of diarrhea of Saccharomyces boulardii was the same as that of other probiotics.However,the duration of diarrhea in children with diarrhea treated with Saccharomyces boulardii was significantly longer than other probiotics.

Saccharomyces boulardiicombined Bacillus subtilis and Enterococcus faecium enteric-coatedBifidobacterium triple live bacteriaBifidobacterium tetragenous viablepediatric diarrheaMeta-analysis

牟丽莉、张潇丹、刘璐、陈春红、陈卓、尹慧、闫美兴

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青岛大学药学院,山东青岛 266000

日照市中心医院药学部,山东日照 276800

中国海洋大学医药学院,山东青岛 266003

青岛妇女儿童医院药学部,山东青岛 266034

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布拉氏酵母菌 枯草杆菌二联活菌 双歧杆菌三联活菌 双歧杆菌四联活菌 儿童腹泻 Meta分析

山东省药学会科研基金资助项目

SDSYXH-KY-202208

2024

中国临床药理学杂志
中国药学会

中国临床药理学杂志

CSTPCD北大核心
影响因子:1.91
ISSN:1001-6821
年,卷(期):2024.40(17)