[关键词]
[摘要]
目的 系统评价益生菌制剂治疗儿童手足口病的临床疗效和安全性。方法 计算机检索PubMed、Cochrane Library、中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)和维普中文期刊全文数据库(VIP)和万方数据库,搜集益生菌制剂治疗儿童手足口病的随机对照试验(RCTs),检索时限均为建库至2019年12月,采用RevMan 5.3软件进行Meta-分析。结果 共纳入16个RCTs,共1 605例患儿。Meta-分析结果显示,与常规治疗相比,联用益生菌制剂能显著提高临床有效率[RR=1.26,95% CI=(1.20,1.32)];缩短退热时间[MD=-0.76,95% CI=(-0.84,-0.36)]、疱疹结痂时间[MD=-1.23,95% CI=(-1.33,-1.13)]、口腔溃疡愈合时间[MD=-1.06,95% CI=(-1.36,-0.72)];减小二胺氧化酶水平[MD=-0.81,95% CI=(-0.96,-0.65)]、D-乳酸水平[MD=-2.40,95% CI=(-2.76,-2.03)]和内毒素水平[MD=-0.14,95% CI=(-0.15,-0.12)];降低TNF-α水平[MD=-0.87,95% CI=(-1.46,-0.28)]、CRP水平[MD=-0.35,95% CI=(-0.47,-0.24)]和IL-6水平[MD=-4.69,95% CI=(-7.09,-2.29)],组间比较差异均有统计学意义(P<0.01)。在不良反应发生率,两组的差异无统计学意义。结论 益生菌制剂能缩短儿童手足口病患者的临床体征改善时间、改善肠黏膜屏障功能、提高免疫功能和降低炎性因子水平,且安全性较好,值得临床推广。
[Key word]
[Abstract]
Objective To systematically evaluate the clinical efficacy and the safety of probiotics in the treatment of hand, foot and mouth disease (HFMD) in children. Methods Pubmed, Cochrane Library, CNKI, CBM, VIP and WanFang Data were electronically searched to collect randomized controlled trials (RCTs) of probiotics in the treatment of children with HFMD from inception to December 2019, Meta-analysis was performed by RevMan 5.3 software. Results A total of 16 RCTs involving 1 605 children were included. Meta-analysis results showed that compared with conventional treatment, combined probiotic preparations can significantly:improve total effective rate[RR=1.26, 95% CI=(1.20, 1.32)]; shorten fever time[MD=-0.76, 95% CI=(-0.84, -0.36)], herpes crusting time[MD=-1.23, 95% CI=(-1.33,-1.13)], oral ulcer healing time[MD=-1.06, 95% CI=(-1.36,-0.72)]; reduced DAO levels[MD=-0.81, 95% CI=(-0.96, -0.65)], D-LA levels[MD=-2.40, 95% CI=(-2.76, -2.03)] and ET levels[MD=-0.14, 95% CI=(-0.15, -0.12)]; reduce TNF-α levels[MD=-0.87, 95% CI=(-1.46, -0.28)], CRP levels[MD=-0.35, 95% CI=(-0.47,-0.24)] and IL-6 levels[MD=-4.69, 95% CI=(-7.09,-2.29)], the differences between two group were statistically significant (P<0.01). There were no significant differences in rate of ADR. Conclusion For the children with HFMD, probiotic can short the time for improvement, improve intestinal mucosal barrier function, improve immune function and reduce inflammatory factor levels, and have better safety, worth of clinical promotion.
[中图分类号]
R978.7;R985
[基金项目]