目的:評价益生菌在预防和治疗儿童喘息性疾病中的效果。方法:将393例喘息性疾病患儿分为观察组206例,对照组187例,对照组187例常规治疗,观察组206例在对照组187例常规治疗的基础上给予口服双歧杆菌三联活菌肠溶胶囊。结果:观察组治愈时间明显少于对照组,两组比较差异有显著性(Plt;005),观察组总复发率为342%,对照组总复发率为433%,两组比较差异有显著性(Plt;005)。结论:添加益生菌对预防和治疗儿童喘息性疾有积极的效果。
Objective To systematically evaluate the preventative effect of probiotics for infantile eczema and atopic eczema. Methods Databases including PubMed, EMbase, MEDLINE (Ovid), CENTRAL, CBM and CNKI were searched from inception to February 2012, so as to collect the randomized controlled trials (RCTs) on probiotics in preventing infantile eczema and atopic eczema. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, evaluated quality and cross-checked. Then the meta-analysis was conducted using RevMan 5.0 software. Result A total of 15 RCTs involving 3 179 infants were included. The results of meta-analyses on 8 high quality RCTs showed that: the incidence of infantile eczema was lower in the probiotics group than the placebo group, with a significant difference (RD=–0.06, 95%CI –0.10 to –0.03, Plt;0.05). Probiotics had no preventative effect on infantile atopic eczema (RD=–0.02, 95%CI –0.08 to 0.03, Pgt;0.05), and had preventative effects on both high risk population (RD=–0.09, 95%CI –0.15 to –0.03, Plt;0.05) and general population (RD=–0.05, 95%CI –0.10 to 0.00, Plt;0.05) of infantile eczema. Conclusion Probiotics have certain preventative effects on infantile eczema. Due to the differences of probiotics in the aspects such as probiotic strain, dosage, treatment course, etc., its specific effects on infantile eczema and atopic eczema should be further tested.
目的:探讨益生菌联合营养支持对胃肠外科术后患者肠功能和肠道菌群的影响。方法:36例胃肠道中等以上手术的患者,随机分为研究组和对照组,每组18例。两组术后均接受等氮等能量的营养支持,研究组患者于术后第3天开始每天加用益生菌制剂(6.6 × 10.7 colony forming units),共7天。监测治疗期间患者的胃肠道症状、生命体征、腹泻情况和菌群比例等。结果:两组患者术后腹痛、腹胀、肠鸣音异常等胃肠道症状均无显著差异 (Pgt;0.05),两组患者在术后第8和9天的腹泻比例和腹泻评分差异有显著性意义(Plt;0.05)。治疗结束后,研究组患者肠道双歧杆菌和乳酸杆菌计数均较对照组高,两组间差异有显著性意义(Plt;0.05)。 结论:在胃肠外科术后患者中应用益生菌可改善胃肠道症状、减轻腹泻程度和纠正肠道菌群失调。
Objectives To investigate the effect of the combined treatment with probiotics and lactulose of gastrointestinal function and postoperative infection after open cardiac surgery. Methods We retrospectively analyzed the clinical data of 264 patients underwent cardiopulmonary bypass in our hospital between August 2013 and June 2014. There were 129 males and 135 females at the mean age of 53.06±10.97 years. We divided those patients into a treatment group and a control group. In the treatment group, there were 58 males and 63 females at the mean age of 52.29±14.31 years. They took probiotics and lactulose from the first day to the seventh day after operation. In the control group, there were 71 males and 72 females at the mean age of 52.29±14.31 years. They didn’t take probiotics or lactulose after the surgery. Procalcitonin (PCT) and lipopolysaccharides (LPS) concentrations were measured before operation, at 24 hours postoperatively, at 72 hours and on the seventh day. We recorded the condition of postoperative infection, gastrointestinal disorders and relative informations. Results The PCT and LPS concentrations in the treatment group after 72 hours postoperatively were statistically lower than those of the control group (1.04±5.39 ng/ml vs. 3.51±4.28 ng/ml, P=0.04; 11.28±4.34 EU/ml vs. 21.59±7.34 EU/ml, P=0.03). The PCT and LPS concentrations in the treatment group were also statistically lower than those of the control group on the 7th day postoperatively (0.17±2.79 ng/ml vs. 1.98±4.62 ng/ml，P=0.04; 6.74±6.38 EU/ml vs. 15.96±4.61 EU/ml, P=0.01). The ICU stay time (43.25±14.36 h vs. 63.47±24.46 h, P=0.01) and postoperative hospital stay time (15.07±4.52 d vs. 21.08±6.49 d, P=0.02) were significantly less in the treatment group than those in the control group. The morbidity of infection and the morbidity of gastrointestinal disorders of the treatment group were statistically less than those of the control group (1.65% vs. 5.59%, P=0.00; 2.48% vs. 6.99%, P<0.001), and there was no statistical difference in mortality between the two groups (1.65% vs. 2.10%, P=0.12). Conclusions The combined treatment with probiotics and lactulose can improve the postoperative inflammatory reaction, gastrointestinal function, and reduce the morbidity of infection.
ObjectiveTo systematically review the efficacy and safety of probiotics for the treatment of Helicobacter pylori (H.pylori) infection in children. MethodsWe electronically searched The Cochrane Library, PubMed, EMbase, CNKI, VIP and WanFang Data databases to collect randomized controlled trials (RCTs) about probiotics for the treatment of H.pylori infection in children from inception to January 2015. The references of included studies and conference proceedings were manually searched for additional studies. Two reviewers independently screened literature, extracted data and assessed the risk of bias of include studies. Then, meta-analysis was performed by using RevMan 5.3 software. ResultsA total of twelve RCTs were included, involving 1 227 patients. The result of meta-analysis showed that the probiotics adjuvant therapy group was superior to the control group in H.pylori eradication rates (OR=2.23, 95%CI 1.66 to 2.99, P<0.000 01) and the incidence of adverse effect (OR=0.31, 95%CI 0.18 to 0.53, P<0.000 1). ConclusionCurrent evidence shows that probiotics adjuvant therapy may be a new effective and safe solution in the treatment of H.pylori infections in children. Due to the limited quality and quantity of the included studies, more higher quality studies are needed to verify the above conclusion.
ObjectiveTo systematically evaluate the efficacy and safety of probiotics for prevention of ventilator-associated pneumonia (VAP).MethodsThe Web of Science, Pubmed, OVID, Cochrane Library, CNKI, EMbase, Sciencedirect, Chinese biomedical database, and Wanfang database before August 2017 were searched, and the relevant data resources were also searched by hand to collect randomized controlled trials (RCTs) of probiotics for prevention of VAP. The quality of the included studies was evaluated using a modified version of the Jadad scale. Meta-analysis was performed with RevMan 5.3 software.ResultsA total of 16 RCTs were included. The use of probiotics can reduce the incidence of VAP [RR=0.71, 95%CI (0.62, 0.80), P<0.000 01], ICU days [MD=–3.28, 95%CI (–6.15, –0.41), P=0.03] and total duration of antibiotics [MD=–2.47, 95%CI (–4.89, –0.04), P=0.05], but can not reduce the mortality of ICU [RR=0.99, 95%CI (0.74, 1.32), P=0.94], hospital mortality [RR=0.77, 95%CI (0.58, 1.01), P=0.06], 28-day mortality [RR=1.01, 95%CI (0.69, 1.47), P=0.97], 90-day mortality [RR=1.00, 95%CI (0.72, 1.37), P=0.99], hospital stays [MD=–0.68, 95%CI (–3.88, 2.52), P=0.68], duration of mechanical ventilation [MD=–2.17, 95%CI (–4.78, 0.44), P=0.10], or the incidence of diarrhea [RR=0.96, 95%CI (0.80, 1.14), P=0.62]. No serious adverse events were reported in all included RCTs.ConclusionsThe use of probiotics can reduce the incidence of VAP, but it has no effect on the mortality, hospital stay, duration of mechanical ventilation or the incidence of diarrhea. However, considering the heterogeneity of research designs, we need more rigorous, large sample randomized controlled studies to increase the strength of evidence.
ObjectiveTo investigate the effect of Lactobacillus plantarum (LP) on the intestinal barrier function under inflammation. MethodsInterleukin-10 knockout (IL-10－/－) mice were used as the model of inflammatory bowel disease. IL-10－/－ and wild type (WT) mice received the LP or Ringer solutions for 4 weeks. Colitis was assessed by histological score and clinical manifestation was observed. The gut paracellular permeability was measured by Ussing chamber. The concentrations of tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) were detected by the ELISA method. The expressions and distributions of tight junction proteins were determined by Western blot and immunofluorescence, respectively. ResultsCompared with the WT group, the diarrhea, rectal prolapse, and weight loss were obvious (Plt;0.01), the concentrations of TNF-α and IFN-γ significantly increased (Plt;0.01), the infiltration of numerous inflammatory cells, even transmural ulcers, and crypt abscess were observed, the ultrastructure of tight junction was damaged, the mannitol permeability significantly increased (Plt;0.001) and transepithelial resistance (TER) significantly decreased (Plt;0.001), and the expressions of tight junction proteins (ZO-1, occludin, and claudin-1) significantly decreased (Plt;0.01) in the IL-10－/－ group. Compared with the IL-10－/－ group, the clinical and pathological manifestations of colitis significantly improved (Plt;0.01), the ultrastructural damage of tight junction was prevented, the mannitol permeability significantly decreased (Plt;0.001) and the TER significantly increased (Plt;0.001), the concentrations of TNF-α and IFN-γ significantly decreased (Plt;0.01), and the expressions of tight junction proteins (ZO-1, occludin, and claudin-1) significantly increased (Plt;0.01) in the IL-10－/－+LP group. ConclusionTreatment with LP ameliorates colonic epithelial barrier dysfunction by promoting the expressions of tight junctional proteins in IL-10－/－ mice.
Objective To evaluate the efficacy of probiotics for treating irritable bowel syndrome (IBS). Methods The following databases as PubMed, The Cochrane Library, Web of Science, EMbase, MD Consult, CNKI, CBM and WanFang Data were searched from the data of their establishment to June 2011 to collect the randomized controlled trials (RCTs) on probiotics for treating IBS. The data were extracted and cross-checked independently by two reviewers, the methodological quality of trials was evaluated with Cochrane Handbook 5.0.2 criteria, and Meta-analysis was conducted using RevMan 5.1 software. Results A total of 20 RCTs involving 1 713 patients were included. Results of meta-analyses showed that compared with the placebo, probiotics was statistically and significantly better in improving the overall symptoms, alleviating abdominal pain/discomfort and relieving abdominal distention. Conlusion Current evidence shows probiotics may play a role in improving the symptoms of IBS. Due to a lot of differences existing among the included studies in aspects of methodological quality, diagnostic criteria, evaluation methods, dosage and course of treatment, this conclusion should be further tested with more strictly-designed and high-quality RCTs.
Epilepsy is a common neurological disorder that affect patients' cognitive function and their mental health, imposing a huge burden on families and society. There are approximately 50 million epilepsy patients worldwide, with a prevalence rate of 4‰~7‰ in China, including about 6 million active epilepsy patients. Although scientists have been devoted to the research and exploration of epilepsy, the causes and pathological mechanisms of epilepsy are still poorly understood. The effectiveness of anti-seizure drugs is limited, and more effective methods is needed. With the deepening of microbiological research, many studies have found significant differences in the composition of the intestinal microbiota of epilepsy patients compared to healthy individuals. Analysis of the intestinal microbiota of epilepsy patients through sequencing has shown significantly lower abundances of Bacteroidetes and Firmicutes compared to the normal population. Many related clinical studies have found that adopting a ketogenic diet, taking probiotics orally, using antibiotics, or fecal microbiota transplantation (FMT) can effectively control epilepsy by normalizing the intestinal microbiota. Various studies suggest a possible connection between the intestinal microbiota and epilepsy, recognizing that the intestinal microbiota can have an impact on the central nervous system. As a result, gut-brain axisis gradually recognized by scientists. Therefore, the role of the intestinal microbiota in epilepsy is gradually being recognized, and recent clinical studies have confirmed that supplementing probiotics can effectively reduce seizure frequency and improve comorbidities, which may become a new method for treating epilepsy.
ObjectiveTo research and summarize the best evidences of probiotic-riched early enteral nutrition for postoperative liver transplantation, and provide references for precise and individual clinical nutrition and probiotics usage management in patients with liver transplantation.MethodsThe scientific problem was established according to the PIPOST. The British Medical Journal Best Practice, Cochrane Library, Jonna Briggs Institute, Guidelines International Network, National Guideline Clearinghouse, etc. were used to search the papers or relative data recordings. The evidence evaluation and summary were carried out based on the previous documents.ResultsOne evidence summary, 2 systematic reviews, and 5 randomized controlled studies were included. Based on the specific questions, 6 dimensions (24 evidences) were extracted and summarized: the early enteral nutrition was used within postoperative 24 h, starting with 20 mL/h, but not more than 125 mL/h, essential nutrients would be fine and tube feeding would be converted to oral feeding as soon as possible; Lactobacillus 20 mg and Bifidobacterium 15 mg were suggested, 3 times/d, probiotic-riched early enteral nutrition for postoperative liver transplantation should be lasted for at least 14 d.ConclusionsEvidence-based medicine is used to collect the best evidence of probiotic-riched early enteral nutrition for postoperative liver transplantation, there are few studies on early enteral nutrition after liver transplantation in China. Application of the best evidence needs to be analyzed and constructed according to current situation of liver transplantation in China.