微生态制剂对溃疡性结肠炎疗效的系统评价

背景：溃疡性结肠炎（UC）是一种病因尚未明确的慢性非特异性肠道炎症，微生态制剂在UC的治疗中起重要作用。目的：对微生态制剂联合标准方案（氨基水杨酸类制剂或糖皮质激素）治疗UC的疗效进行系统评价。方法：计算机检索Cochrane图书馆（截至2011．8）、MEDLINE（1966．11～2011．8）、EMBASE（1975．10－2011．8）、中国生物医学文献光盘数据库（1979．11-2011．8）和中文期刊全文数据库（1985．4－2011．8）等数据库．纳入微生态制剂组（微生态制剂联合标准方案）与对照组（标准方案联合安慰剂或空白对照）治疗UC的随机对照试验（RCT），采用RevMan4．2软件行系统分析。结果：共纳入8项RCT，包括533例患者。微生态制剂组的UC临床缓解率和总有效率明显优于对照组，OR分别为2．48（95％CI：1．54－4．00）和7．38（95％CI：1．65～33．06），临床有效率无明显差异（OR=2．64．95％CI：0．46～5．88），而复发率明显低于对照组（OR=0．22，95％CI：0．05。0．87）。结论：微生态制剂联合标准方案对诱导和维持UC缓解的疗效优于单用标准方案．

Therapeutic Effect of Probiotic Agents on Ulcerative Colitis: A Systematic Review

Background: Ulcerative colitis(UC) is a chronic non-specific intestinal inflammation with unknown etiology.Probiotic agents play important roles in the management of UC.Aims: To systematically review the therapeutic effect of probiotic agents combined with standard therapy(aminosalicylates or glucocorticoid) on UC.Methods: Databases including Cochrane Library(up to August 2011),MEDLINE(November 1966 to August 2011),EMBASE(October 1975 to August 2011),CBMDisc(November 1979 to August 2011) and SCIE(April 1985 to August 2011) were retrieved to enroll randomized controlled trials(RCT) that compared the therapeutic effect of standard therapy plus probiotic agents(probiotic agents group) with standard therapy plus placebo or blank control(control group).Systematic review was performed with RevMan 4.2 software.Results: Eight RCT involving 533 patients were included.The clinical remission rate and total response rate of UC in probiotic agents group were superior to those in control group,OR were 2.48(95% CI: 1.54-4.00) and 7.38(95% CI: 1.65-33.06),respectively;no significant difference in clinical response rate was found between the two groups(OR=2.64,95% CI: 0.46-5.88).Relapse rate in probiotic agents group was significantly lower than that in control group(OR=0.22,95% CI: 0.05-0.87).Conclusions: The combination of probiotic agents with standard therapy is superior to standard therapy alone in inducing and maintaining remission of UC.