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目的采用Meta分析方法评价双歧杆菌三联活菌制剂治疗肠易激综合征(Irritable Bowel Syndrome,IBS)的临床疗效。方法计算机检索中国知网、万方、维普、Pubmed、EMbase、Web of Science数据库,检索时限均从建库至2015年12月,收集国内外应用双歧杆菌三联活菌制剂治疗IBS的所有随机对照试验(randomized controlled trial,RCT)和前瞻性非随机对照试验(Non-randomized controlled trial,non-RCT),纳入文献时间从2003年1月至2014年12月不等。按照纳入与排除标准选择文献、提取资料和评价纳入研究的方法学质量后,采用Cochrane协作网提供的Rev Man5.2软件进行Meta分析。结果检索文献无RCT研究,纳入25个核心前瞻性non-RCT,2580例患者,其中治疗组(对照组常规用药+双歧杆菌三联活菌制剂)1315例,对照组1265例。结果显示,治疗组总有效率高于对照组[比值比(Odds ratio,OR)=4.94,95%置信区间(Confidence interval,CI)(3.87,6.32),P<0.00001]。亚组分析显示,IBS-D治疗有效率治疗组高于对照组[OR=4.32,95%CI(3.02,6.18),P<0.00001],IBS-C治疗组有效率高于对照组[OR=7.85,95%CI(2.13,28.92),P=0.002]。结论双歧杆菌三联活菌制剂与常规治疗药物联用可以提高IBS的总体疗效。
Objective To evaluate the clinical efficacy of Bifidobacterium triple viable agent in the treatment of Irritable Bowel Syndrome (IBS) by Meta-analysis. Methods The databases of CNKI, Wanfang, Weipu, Pubmed, EMbase and Web of Science were retrieved by computer. All the search intervals were from the database to December 2015. All randomized controlled trials Randomized controlled trial (RCT) and non-randomized controlled trial (non-RCT) were included in the literature from January 2003 to December 2014. Meta-analysis was performed using RevMan5.2 software provided by the Cochrane Collaboration after selecting documents according to inclusion and exclusion criteria, extracting data and evaluating the quality of the included studies. Results There was no RCT in the retrieved literature, and 2580 patients were enrolled in 25 core prospective non-RCT patients. Among them, 1315 patients in the treatment group (conventional drug + Bifidobacterium triple active viable agent in the control group) and 1265 in the control group. The results showed that the total effective rate in the treatment group was higher than that in the control group [odds ratio (OR) = 4.94, 95% confidence interval (CI) (3.87, 6.32), P <0.00001]. Subgroup analysis showed that the effective rate of IBS-C treatment group was higher than that of the control group [OR = 4.32, 95% CI (3.02, 6.18, P <0.00001] 7.85, 95% CI (2.13, 28.92), P = 0.002]. Conclusion Bifidobacterium triple viable preparations can improve the overall efficacy of IBS in combination with conventional therapeutic agents.