布拉氏酵母菌治疗小儿轮状病毒肠炎的Meta分析
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摘要
目的系统评价布拉氏酵母菌治疗小儿轮状病毒肠炎的疗效和安全性。方法在万方数据知识平台、中国知网、中国生物医学文献数据库、维普中文科技期刊数据库、PubMed、Web of Science、Embase、Cochrane图书馆等中检索布拉氏酵母菌治疗小儿轮状病毒肠炎的相关文献,并追索已纳入的参考文献。对文献进行评价与资料提取,使用Stata 14.0软件进行Meta分析。结果纳入12篇文献,共1 233例患儿(626例为试验组,607例为对照组),7篇文献采用止泻时间进行评价,显示布拉氏酵母菌能够缩短小儿轮状病毒肠炎腹泻时间[SMD=-0.73,95%CI(-1.05,-0.41),I~2=75.7%];5篇文献以住院时间进行评价,显示布拉氏酵母菌能够缩短小儿轮状病毒肠炎的住院时间[SMD=-0.99,95%CI(-1.24,-0.74),I~2=56.5%];10篇文献以总有效率进行评价,显示布拉氏酵母菌能够提高小儿轮状病毒肠炎的总有效率[RR=1.26,95%CI(1.19, 1.34),I~2=26.2%];仅有1篇文献报道了轻微的不良反应。结论布拉氏酵母菌治疗小儿轮状病毒肠炎疗效显著,且不良反应轻微,值得临床推广应用。
Objective To evaluate systematically the efficacy and safety of Saccharomyces boulardii in the treatment of rotavirus enteritis in children. Methods Literatures on treatment of rotavirus enteritis in children with Saccharomyces boulardii were retrieved in the WanFang database, CNKI database, Chinese biomedical literature database, VIP Chinese science and technology periodical database, PubMed database, Web of Science, Embase and Cochrane library etc. The data were extracted and evaluated by using Stata 14.0 software. Results A total of 12 articles were selected, including 1,233 cases(626 cases in the intervention group while 607 cases in the control group). Meta-analysis on 7 studies showed that Saccharomyces boulardii significantly shortened the duration of diarrhea [SMD=-0.73, 95%CI(-1.05,-0.41), I~2=75.7%]. Meta-analysis on 5 studies showed that Saccharomyces boulardii significantly shortened the days of hospitalization [SMD=-0.99, 95%CI(-1.24,-0.74), I~2=56.5%]. Meta-analysis on 10 studies reflected that Saccharomyces boulardii significantly improved the total efficiency [RR=1.26, 95%CI(1.19, 1.34), I~2=26.2%]. Only A mild adverse reaction was reported in one literature. Conclusion Saccharomyces boulardii is effective for the treatment of infant rotavirus enteritis with little adverse reaction and hence is deserved to be recommended in clinical trials.
Objective To evaluate systematically the efficacy and safety of Saccharomyces boulardii in the treatment of rotavirus enteritis in children. Methods Literatures on treatment of rotavirus enteritis in children with Saccharomyces boulardii were retrieved in the WanFang database, CNKI database, Chinese biomedical literature database, VIP Chinese science and technology periodical database, PubMed database, Web of Science, Embase and Cochrane library etc. The data were extracted and evaluated by using Stata 14.0 software. Results A total of 12 articles were selected, including 1,233 cases(626 cases in the intervention group while 607 cases in the control group). Meta-analysis on 7 studies showed that Saccharomyces boulardii significantly shortened the duration of diarrhea [SMD=-0.73, 95%CI(-1.05,-0.41), I~2=75.7%]. Meta-analysis on 5 studies showed that Saccharomyces boulardii significantly shortened the days of hospitalization [SMD=-0.99, 95%CI(-1.24,-0.74), I~2=56.5%]. Meta-analysis on 10 studies reflected that Saccharomyces boulardii significantly improved the total efficiency [RR=1.26, 95%CI(1.19, 1.34), I~2=26.2%]. Only A mild adverse reaction was reported in one literature. Conclusion Saccharomyces boulardii is effective for the treatment of infant rotavirus enteritis with little adverse reaction and hence is deserved to be recommended in clinical trials.
引文
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[5]ZHENG Limin,KONG Xiaonan.Comparison on clinical efficacy in three kinds of probiotics in treatment of infantile noninfectious diarrhea[J].Drugs&Clinic,2015,30(8):1008-1010.(in Chinese)郑丽敏,孔笑楠.三种微生态制剂治疗婴儿非感染性腹泻的疗效比较[J].现代药物与临床,2015,30(8):1008-1010.
[6]方鹤松.腹泻病疗效判断标准的补充建议[J].中国实用儿科杂志,1998,13(6):401-405.
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[10]Corrêa NB,Penna FJ,Lima FM,et al.Treatment of acute diarrhea with Saccharomyces boulardii in infants[J].J Pediatr Gastroenterol&Nutr,2011,53(5):497-501.
[11]■ O,Tanyeri B,Torun E,et al.The comparition of the efficacy of two different probiotics in rotavirus gastroenteritis in children[J].J Trop Med,2012,2012(6):1-5.
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[13]熊斌.布拉氏酵母菌佐治轮状病毒肠炎疗效观察[J].全科医学临床与教育,2014,12(2):206-208.
[14]李晓冬.布拉氏酵母菌治疗轮状病毒性肠炎75例疗效观察[J].中国保健营养旬刊,2014,24(3):1491-1491.
[15]杨香红,李艳莉,李月萍,等.布拉氏酵母菌对轮状病毒肠炎患儿血清IL-8和TNF-α水平的影响及疗效观察[J].中国中西医结合儿科学,2015,7(4):334-335.
[16]丁立,朱洁,顾晓艳,等.布拉氏酵母菌治疗儿童轮状病毒肠炎的临床研究[J].南通大学学报(医学版),2015,35(1):70-72.
[17]Das S,Gupta PK,Das RR.Efficacy and safety of Saccharomyces boulardii in acute rotavirus diarrhea:Double blind randomized controlled trial from a developing country[J].J Trop Pediatr,2016,62(6):464-470.
[18]XIA Liping.The clinical efficacy of saccharomyces boulardii powder in treatment of infantile rotavirus enteritis[J].J Clin&Patholog Res,2016,36(10):1487-1491.(in Chinese)夏利平.布拉氏酵母菌散剂辅助治疗轮状病毒性肠炎临床疗效观察[J].临床与病理杂志,2016,36(10):1487-1491.
[19]范晓莉.布拉氏酵母菌散治疗儿童轮状病毒肠炎的疗效观察[J].影像研究与医学应用,2018,12(2):255-256.
[20]LI Zhi,ZHANG Guangchao,ZHAO Baoling,et al.Clinical efficacy of Saccharomyces boulardii Sachets in the treatment of rotavirus enteritis and its effects on IL-6,TNF-α,IFN-γin serum and faeces[J].J Clin Psychosomatic Dis,2018,24(3):18-23.(in Chinese)李志,张广超,赵保玲,等.布拉氏酵母菌散治疗儿童轮状病毒性肠炎的疗效及对患儿血清和粪便IL-6、TNF-α和IFN-γ水平的影响[J].临床心身疾病杂志,2018,24(3):18-23.
[21]Cetina-Sauri G,Basto GS.Therapeutic evaluation of Saccharomyces boulardii in children with acute diarrhea[J].Annales De Pédiatrie,1994,41(1):397-400.
[22]Billoo AG,Memon MA,Khaskheli SA,et al.Role of a probiotic(Saccharomyces boulardii)in management and prevention of diarrhoea[J].World J Gastroenterol,2006,28(12):4557-4560.
[23]Kelesidis T,Pothoulakis C.Efficacy and safety of the probiotic Saccharomyces boulardii for the prevention and therapy of gastrointestinal disorders[J].Therap Adv Gastroenterol,2012,5(2):111-125.
[24]Huffnagle GB,Noverr MC.The emerging world of the fungal microbiome[J].Trends in Microbiol,2013,21(7):334-341.
[25]LI Guinan,WU Yunjin,LI Jun,Clinical research of using Saccharomyces boulardii to prevent secondary diarrhea in hospitalized neonates[J].Chin J Microecol,2014,26(1):72-74.(in Chinese)李贵南,吴运芹,李军,等.布拉氏酵母菌预防住院新生儿继发腹泻的临床研究[J].中国微生态学杂志,2014,26(1):72-74.
[26]Brandt LJ.Faecal microbiota transplantation:Past,present and future[J].Med J Aust,2013,29(1):79-84.
[27]Kassam Z,Lee CH,Yuan YH,et al.Fecal microbiota transplantation for clostridium difficile infection:Systematic review and Meta-analysis[J].Am J Gastroenterol,2013,108(4):500-508.
[28]Pinn DM,Aroniadis OC,Brandt LJ.Is fecal microbiota transplantation FMT)an effective treatment for patients with functional gastrointestinal disorders(FGID)?[J].Neurogastroenterol Motil,2015,27(1):19-29.
[29]许国铭,李兆申.上消化道内镜学[M].上海:上海科学技术出版社,2003:115.
[30]Barc MC,Charrinsarnel C,Rochet V,et al.Molecular analysis of the digestive microbiota in a gnotobiotic mouse model during antibiotic treatment:Influence of Saccharomyces boulardii[J].Anaerobe,2008,14(4):229-233.
[2]World Health Organization.Estimated rotavirus deaths for children under 5years of age:2013[R/OL],
[3]World Health Organization.Child rotavirus deaths by country2000-2013[R/OL],
[4]HU Yamei,JIANG Zaifang,SHEN Kunling,et al.Zhu Futang Practice of Pediatrics[M].8th Ed.Beijing:People′s Medical Publishing House,2015:1378-1394.(in Chinese)胡亚美,江载芳,申昆玲,等.诸福棠实用儿科学[M].8版.北京:人民卫生出版社,2015:1378-1394.
[5]ZHENG Limin,KONG Xiaonan.Comparison on clinical efficacy in three kinds of probiotics in treatment of infantile noninfectious diarrhea[J].Drugs&Clinic,2015,30(8):1008-1010.(in Chinese)郑丽敏,孔笑楠.三种微生态制剂治疗婴儿非感染性腹泻的疗效比较[J].现代药物与临床,2015,30(8):1008-1010.
[6]方鹤松.腹泻病疗效判断标准的补充建议[J].中国实用儿科杂志,1998,13(6):401-405.
[7]杨锡强,易著文.儿科学[M].6版.北京:人民卫生出版社,2004:292-301.
[8]Velsor-friedrich B,Pigott T,Srof B.A Practitioner-based asthma intervention program with African American inner-city school children[J].J Pediatr Health Care,2005,19(3):163-171.
[9]韦婉秋,卢华君.布拉氏酵母菌治疗婴幼儿轮状病毒肠炎的临床探讨[J].中国基层医药,2011,18(10):1376-1377.
[10]Corrêa NB,Penna FJ,Lima FM,et al.Treatment of acute diarrhea with Saccharomyces boulardii in infants[J].J Pediatr Gastroenterol&Nutr,2011,53(5):497-501.
[11]■ O,Tanyeri B,Torun E,et al.The comparition of the efficacy of two different probiotics in rotavirus gastroenteritis in children[J].J Trop Med,2012,2012(6):1-5.
[12]周文英,郭影霞,陈展伟,等.布拉氏酵母菌治疗轮状病毒性肠炎的临床疗效观察[J].中国医药指南,2013(26):123-124.
[13]熊斌.布拉氏酵母菌佐治轮状病毒肠炎疗效观察[J].全科医学临床与教育,2014,12(2):206-208.
[14]李晓冬.布拉氏酵母菌治疗轮状病毒性肠炎75例疗效观察[J].中国保健营养旬刊,2014,24(3):1491-1491.
[15]杨香红,李艳莉,李月萍,等.布拉氏酵母菌对轮状病毒肠炎患儿血清IL-8和TNF-α水平的影响及疗效观察[J].中国中西医结合儿科学,2015,7(4):334-335.
[16]丁立,朱洁,顾晓艳,等.布拉氏酵母菌治疗儿童轮状病毒肠炎的临床研究[J].南通大学学报(医学版),2015,35(1):70-72.
[17]Das S,Gupta PK,Das RR.Efficacy and safety of Saccharomyces boulardii in acute rotavirus diarrhea:Double blind randomized controlled trial from a developing country[J].J Trop Pediatr,2016,62(6):464-470.
[18]XIA Liping.The clinical efficacy of saccharomyces boulardii powder in treatment of infantile rotavirus enteritis[J].J Clin&Patholog Res,2016,36(10):1487-1491.(in Chinese)夏利平.布拉氏酵母菌散剂辅助治疗轮状病毒性肠炎临床疗效观察[J].临床与病理杂志,2016,36(10):1487-1491.
[19]范晓莉.布拉氏酵母菌散治疗儿童轮状病毒肠炎的疗效观察[J].影像研究与医学应用,2018,12(2):255-256.
[20]LI Zhi,ZHANG Guangchao,ZHAO Baoling,et al.Clinical efficacy of Saccharomyces boulardii Sachets in the treatment of rotavirus enteritis and its effects on IL-6,TNF-α,IFN-γin serum and faeces[J].J Clin Psychosomatic Dis,2018,24(3):18-23.(in Chinese)李志,张广超,赵保玲,等.布拉氏酵母菌散治疗儿童轮状病毒性肠炎的疗效及对患儿血清和粪便IL-6、TNF-α和IFN-γ水平的影响[J].临床心身疾病杂志,2018,24(3):18-23.
[21]Cetina-Sauri G,Basto GS.Therapeutic evaluation of Saccharomyces boulardii in children with acute diarrhea[J].Annales De Pédiatrie,1994,41(1):397-400.
[22]Billoo AG,Memon MA,Khaskheli SA,et al.Role of a probiotic(Saccharomyces boulardii)in management and prevention of diarrhoea[J].World J Gastroenterol,2006,28(12):4557-4560.
[23]Kelesidis T,Pothoulakis C.Efficacy and safety of the probiotic Saccharomyces boulardii for the prevention and therapy of gastrointestinal disorders[J].Therap Adv Gastroenterol,2012,5(2):111-125.
[24]Huffnagle GB,Noverr MC.The emerging world of the fungal microbiome[J].Trends in Microbiol,2013,21(7):334-341.
[25]LI Guinan,WU Yunjin,LI Jun,Clinical research of using Saccharomyces boulardii to prevent secondary diarrhea in hospitalized neonates[J].Chin J Microecol,2014,26(1):72-74.(in Chinese)李贵南,吴运芹,李军,等.布拉氏酵母菌预防住院新生儿继发腹泻的临床研究[J].中国微生态学杂志,2014,26(1):72-74.
[26]Brandt LJ.Faecal microbiota transplantation:Past,present and future[J].Med J Aust,2013,29(1):79-84.
[27]Kassam Z,Lee CH,Yuan YH,et al.Fecal microbiota transplantation for clostridium difficile infection:Systematic review and Meta-analysis[J].Am J Gastroenterol,2013,108(4):500-508.
[28]Pinn DM,Aroniadis OC,Brandt LJ.Is fecal microbiota transplantation FMT)an effective treatment for patients with functional gastrointestinal disorders(FGID)?[J].Neurogastroenterol Motil,2015,27(1):19-29.
[29]许国铭,李兆申.上消化道内镜学[M].上海:上海科学技术出版社,2003:115.
[30]Barc MC,Charrinsarnel C,Rochet V,et al.Molecular analysis of the digestive microbiota in a gnotobiotic mouse model during antibiotic treatment:Influence of Saccharomyces boulardii[J].Anaerobe,2008,14(4):229-233.