【摘要】 目的:评价布拉氏酵母菌预防与治疗儿童抗生素相关性腹泻(antibiotic-associated diarrhea,AAD)的有效性和安全性。方法:检索Pub Med、EMbase、CENTRAL、CNKI、Wan Fang Data、CBM和VIP数据库,搜集关于布拉氏酵母菌预防儿童AAD的随机对照研究(RCT),同时追溯纳入文献和相关综述的参考文献,检索时限均为建库至2016年8月。由两位研究员独立筛选相关文献、提取数据资料和评价纳入研究的偏倚风险后,采用R语言进行分析。结果:最终纳入12项研究,共2 750例患儿。Meta分析结果显示:布拉氏酵母菌预防组患儿AAD发生率显著低于对照组[RR=0.54(95%CI=0.47~0.61,P<0.0001)],布拉氏酵母菌预防组患儿AAD发生后腹泻时间与住院时间显著短于对照组,SMD结果分别为-1.17(95%CI=-1.48~-0.87,P<0.0001)与-2.32(95%CI=-4.05~-0.60,P<0.0001)。两组患儿在治疗过程中未见明显不良反应。结论:布拉氏酵母菌对儿童AAD有预防作用,并能缩短AAD治疗过程中的腹泻与住院时间。但由于研究的异质性等因素,其对儿童AAD特别是门诊患儿应用的具体效应尚需进一步研究加以验证。更多还原

【Abstract】 Objective To systematically review the efficacy and safety of Saccharomyces boulardii for the prevention and treatment of antibiotic-associated diarrhea( AAD) in children. Methods We electronically searched Pub Med,EMbase,CENTRAL,CNKI,Wan Fang Data,CBM and VIP databases to collect randomized controlled trials( RCTs) about Saccharomyces boulardii for the prevention and treatment of AAD in children from inception to August 2016. Two reviewers independently screened the literatures according to the inclusion and exclusion criteria,extracted data,evaluated the quality and cross-checked. Then a meta-analysis was performed by using R software. Results A total of 12 RCTs were included,involving 2 750 children. The results of meta-analysis showed that the Saccharomyces boulardii group had a lower incidence of AAD in comparison with control group [Risk ratio( RR) = 0.54( 95%CI = 0.47 ~ 0.61,P<0.0001) ]. Saccharomyces boulardii also reduced the disease course of AAD and duration of hospitalization,their standardised mean difference were-1. 17( 95%CI =-1.48 ~-0.87,P<0.0001) and-2.32( 95%CI =-4.05 ~-0.60,P< 0.0001),respectively. Conclusion The pooled evidences found that Saccharomyces boulardii are associated with a reduction in AAD and duration of hospitalization in Children. Due to the heterogeneity of the included studies,more research is needed to verify the above conclusions.更多还原