目的 评估肠道微生态干预对成年非酒精性脂肪性肝病(NAFLD)患者的肝脏特异性、代谢、炎症和肠道微生物群影响的最新证据。方法 检索Embase、PubMed、Cochrane Library、Web of Science、中国知网、万方数据库，筛选符合条件的随机临床试验，对纳入研究的数据进行提取和分析。结果 纳入37项随机对照试验:20项评估益生菌，2项评估益生元，10项评估合生元，2项评估益生菌和益生元，3项评估益生菌、益生元和合生元，治疗时间7～48周。经网状meta分析，对于大部分临床指标，益生元与合生元组干预效果优于对照组，且呈现出时间相关性，但肠道微生态干预各组干预效果差异无统计学意义。结论 网状meta分析表明肠道微生态干预改善了 NAFLD的临床指标和肠道微生态，提示合生元可能是一种优于益生菌和益生元的干预措施，但需要足够的剂量和干预时间，我们的研究建议至少连续使用24周。
Effect of intestinal microecological intervention in patients with nonalcoholic fatty liver disease:systematic evaluation and network meta-analysis
Objective To assess the latest evidence on the effects of gut microecological intervention on liver-specificity,metabolism,inflammation,and gut microbiota in adult nonalcoholic fatty liver disease(NAFLD)patients.Methods Data-bases including Embase,PubMed,Cochrane Library,Web of Science,CNKI,and WanFang were searched to collect eli-gible randomized clinical trials(RCTs),and the data of the included studies were extracted and analyzed.Results A total of 37 RCTs were included,involving 20 probiotics,2 prebiotics,10 synbiotics,2 probiotics and prebiotics,and 3 probiot-ics,prebiotics and synbiotics,with a treatment duration of 7 to 48 weeks.According to the network meta-analysis,for most clinical indicators,the intervention effects in prebiotics and synbiotics groups were better than those in the control group,and showed a temporal correlation,but there were no statistical differences in the intervention effects among intestinal mi-croecological intervention groups.Conclusion Gut microecology intervention can improve the clinical indicators and gut microecology in NAFLD,although the analyses showed heterogeneity.Network meta-analysis suggests that synbiotics may be a superior intervention to probiotics and prebiotics but requires adequate dosage and intervention time,and our study re-commends continuous use for at least 24 weeks.
NETL
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万方数据
