摘要
Purpose Accumulating evidence showed that probiotics therapy might be effective in treating diarrhea-predominant irritable bowel syndrome (IBS-D). This study aimed to evaluate the effectiveness and safety of probiotics therapy for the treatment of IBS-D.MethodsWe performed a comprehensive literature search in eight electronic databases, and gray literature from inception to August 4, 2021. Randomized controlled trials (RCTs) of probiotics therapy for the treatment of IBS-D were included and the quality was assessed using the risk of bias tool recommended by the Cochrane Handbook version 5.1.0. RevMan 5.4 software was used to perform the meta-analysis on the outcomes of IBS-D symptoms, abdominal pain, quality of life, and abdominal distension. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of evidence.ResultsTen RCTs evaluating 943 patients were identified. Only one study had unclear risk of bias, while nine studies had a high risk of bias. The meta-analysis results showed that, compared to the placebo, probiotics therapy significantly decreased the score of IBS-D symptoms (SMD = − 0.55, 95% CI: [− 0.83, − 0.27], P < 0.05), abdominal pain (SMD = − 0.43, 95% CI: [− 0.57, − 0.29], P < 0.05), and abdominal distension (SMD = − 0.45, 95%CI: [− 0.81, − 0.09], P < 0.05). There was no statistical difference in the quality of life. However, all the certainty of evidence was very low.ConclusionVery low certainty evidence showed that probiotics might be an effective treatment for improving the IBS-D symptoms, abdominal pain, and abdominal distension, in adult IBS-D patients. However, these conclusions should be supported by high-quality evidence.
摘要译文
目的积累证据表明，益生菌疗法可能有效治疗腹泻促炎肠综合征（IBS-D）。这项研究旨在评估益生菌治疗IBS-D.Methodswe的有效性和安全性。Methodswe在八个电子数据库中进行了全面的文献搜索，并从成立到2021年8月4日进行了灰色文献。包括IBS-D治疗的治疗方法，并使用Cochrane手册5.1.0推荐的偏见工具的风险评估质量。Revman 5.4软件用于对IBS-D症状，腹痛，生活质量和腹部扩张的结果进行荟萃分析。建议评估，开发和评估方法（等级）方法的评分用于评估证据的确定性。鉴定了评估943例患者的反应RCT。只有一项研究的偏见风险不清，而九项研究的偏见风险很高。荟萃分析结果表明，与安慰剂相比，益生菌治疗显着降低了IBS-D症状的评分（SMD = - 0.55，95％CI：[ - 0.83， - 0.27]，p <0.05），腹痛（SMD = - 0.43，95％CI：[ - 0.57， - 0.29]，p <0.05）和腹部延伸（SMD = - 0.45，95％CI：[ - 0.81，-0.09]，p <0.05）。生活质量没有统计学差异。但是，所有证据的确定性都非常低。确定性的确定性证据表明，成人IBS-D患者的益生菌可能是改善IBS-D症状，腹痛和腹部扩张的有效治疗方法。但是，这些结论应得到高质量证据的支持。
Wang; Yan[1];Chen; Nan[2];Niu; Fangfen[3];Li; Yanfei[1];Guo; Kangle[4];Shang; Xue[1];E; Fenfen[1];Yang; Chaoqun[1];Yang; Kehu[1];Li; Xiuxia[1]. Probiotics therapy for adults with diarrhea-predominant irritable bowel syndrome: a systematic review and meta-analysis of 10 RCTs[J]. International Journal of Colorectal Disease, 2022,37(11): 2263-2276