乳酸杆菌活菌制剂与甲硝唑类制剂治疗妊娠合并细菌性阴道病的系统评价

目的比较乳酸杆菌活菌制剂与甲硝唑类制剂治疗妊娠合并细菌性阴道病的疗效及对妊娠结局的影响。方法计算机检索PubMed、Cochrane图书馆、VIP、CNKI、万方数据库、中国生物医学文献数据库、西文生物医学期刊文献数据库、康健临床决策循证数据库等,纳入乳酸杆菌活菌制剂与甲硝唑类制剂比较治疗妊娠合并细菌性阴道病（BV）的疗效及对妊娠结局影响的随机对照试验（RCT）。对纳入RCT进行质量评价,采用RevMan 5.0.24软件进行Meta分析。结果最终纳入8篇文献,共计1687例受试者。Meta分析结果显示：两组疗效差异无统计学意义RR=1.04,95%C（I1.00,1.08）,P=0.08];乳酸杆菌活菌制剂治疗后复发率低,差异具有统计学意义RR=0.16,95%CI（0.06,0.43）,P=0.0004];乳酸杆菌活菌制剂治疗的早产发生率低于对照组RR=0.56,95%CI（0.33,0.94）,P=0.03],差异具有统计学意义;而胎膜早破、产褥感染、低体重儿、新生儿感染、新生儿黄疸等妊娠结局发生率方面,两组差异无统计学意义。结论①乳酸杆菌制剂与甲硝唑类制剂治疗妊娠合并BV的疗效相似。②乳酸杆菌制剂治疗妊娠合并BV的复发率低于甲硝唑类制剂。③乳酸杆菌制剂治疗妊娠合并BV后早产的发生率低于甲硝唑类制剂,但对于治疗后胎膜早破、产褥感染、低体重儿、新生儿感染、新生儿黄疸等妊娠结局发生率两者无明显差异。

Living Preparation of Lactobacillus versus Metronidazole for Bacterial Vaginosis in Pregnancy: A Systematic Review

Objective To analyze the effectiveness and effect on pregnant outcome about living preparation of lacto-bacillus versus metronidazole in the treatment of bacterial vaginosis in pregnancy.Methods We searched PubMed,The Cochrane Library,VIP,CNKI,Wangfang,CBM,FMJS,and FEBMT to identify randomized controlled trials（RCT） of living preparation of lactobacillus versus metronidazole for bacterial vaginosis in pregnancy.The quality of the included trials was assessed.RevMan 5.0.24 software was used for meta-analysis.Results Eight trials involving 1687 patients were included.The results of meta-analysis showed： no signi cant difference was found in the effectiveness between the two groups（RR=1.04,95%CI 1.00 to 1.08,P=0.08）;living preparation of lactobacillus had lower recurrence rate and lower premature delivery rate compared with metronidazole（RR=0.16,95%CI 0.06 to 0.43,P=0.0004;RR=0.56,95%CI 0.33 to 0.94,P=0.03）;no signi cant di erences were found in premature rupture of membrane,puerperal infection,infant of low-birth weight,infant infection,and infant jaundice between the two groups.Conclusion The effectiveness about living preparation of lactobacillus versus metronidazole for bacterial vaginosis in pregnancy is similar,but living preparation of lactobacillus has lower recurrence rate and lower premature delivery rate,the others of e ect on pregnant outcome are similar.