目的 系统评价益生菌制剂防治儿童反复呼吸道感染（RRTIs）的有效性和安全性，为临床提供循证参考。方法计算机检索PubMed、EMBase、Cochrane图书馆、中国生物医学文献数据库（CBM）、中国学术期刊全文数据库（CNKI）、维普中文期刊全文数据库（VIP）和万方数据库，收集益生菌制剂（试验组）防治儿童RRTIs的随机对照试验（RCT），检索时限均为建库起至2019年3月。提取资料，用Rev Man 5.3软件进行Meta-分析。结果 共纳入12项研究，878例患者。Meta-分析结果显示，试验组在总有效率［RR=1.31，95%CI（1.22，1.41），P<0.001］、抗菌药用药时间［MD=-4.42，95%CI（-5.92，-2.91），P<0.001］、年呼吸道感染次数［MD=-2.30，95%CI（-2.70，-1.89），P<0.001］、临床体征改善时间均优于对照组（P<0.05）；免疫球蛋白IgG ［MD=1.80，95%CI （1.60，2.01），P<0.001］、IgA ［MD=0.37，95%CI（0.23，0.51），P<0.001］、IgM［MD=0.06，95%CI（0.02，0.09），P=0.002］，T淋巴细胞亚群CD3+［MD=4.48，95%CI（1.48，7.49），P=0.03］、CD4⁺［MD=3.17，95%CI（1.01，5.55），P=0.009］和CD8⁺［MD=-4.44，95%CI（-6.52，-2.36），P<0.05］改善情况均显著优于对照组，差异均有统计学意义（P<0.05）。结论 益生菌可有效治疗儿童反复呼吸道感染，安全性较好。但由于纳入研究数量少，研究质量不统一，尚需要大样本、高质量的临床随机对照研究予以证实。

Objective To evaluate the efficacy and safety of probiotics for recurrent respiratory tract infections (RRTIs) of children, and to provide evidence-based reference for clinic. Methods Retrieved from PubMed, EMBase, Cochrane Library, CBM, CNKI, Wanfang database and VIP database, randomized controlled trials (RCTs) about probiotics (trail group) vs. non-probiotics (control group) for RRTIs of children were collected during database establishment to January 2018. After literature scanning and data extraction, the risk of bias of included trials were evaluated by using Cochrane 5.1.0 risk bias evaluation tool. Meta-analysis was performed by using Rev Man 5.3 software. Results A total of 12 RCTs involving 878 children were included. The results showed that the trial group was superior to control group in total response rate [RR=1.31, 95%CI(1.22, 1.41), P < 0.001], the time of antibiotics use [MD=-4.42, 95%CI(-5.92, -2.91), P < 0.001], respiratory infections per year [MD=-2.30, 95%CI(-2.70, -1.89), P < 0.001], clinical symptom improvement time; improvement of IgG [MD=1.80, 95%CI(1.60, 2.01), P < 0.001], Ig A [MD=0.37, 95%CI(0.23, 0.51), P < 0.001], IgM [MD=0.06, 95%CI(0.02, 0.09), P=0.002]; T lymphocyte subset of CD3+ [MD=4.48, 95%CI (1.48, 7.49), P=0.03], CD4⁺ [MD=3.17, 95%CI(1.01, 5.55), P=0.009] and CD8⁺[MD=-4.44, 95%CI(-6.52, -2.36), P < 0.001] than that of in control group, the difference were statistically significant (P < 0.05). Conclusions The current evidence shows that probiotics can reduce the frequencv of recurrent respiratory infection with safety. However, due to the number and quality of included studies, more large-scale and high-quality RCTs are needed.

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