摘要
目的:系统评价枯草杆菌二联活菌预防和治疗抗生素相关性腹泻(AAD)的疗效,以为临床治疗提供循证参考。方法:计算机检索中国生物医学文献数据库、中国期刊全文数据库、万方数据库,收集枯草杆菌二联活菌(试验组)对比安慰剂(对照组)预防和治疗AAD的随机对照试验(RCT),对符合纳入标准的临床研究进行资料提取和质量评价后,采用Rev Man 5.0统计软件进行系统评价。结果:共纳入21项RCT,合计3 881例患者,根据用药目的不同将其分为预防用药和治疗用药。Meta分析结果显示,预防试验组患者腹泻发生率显著低于对照组[OR=0.27,95%CI(0.22,0.32),P<0.001],平均住院时间显著短于对照组[MD=-53.19,95%CI(-79.63,-26.75),P<0.001];治疗试验组患者临床总有效率显著高于对照组[OR=6.76,95%CI(4.16,10.98),P<0.001],差异均有统计学意义。结论:枯草杆菌二联活菌预防和治疗AAD的疗效较好。但受纳入研究方法学和样本量限制,该结论有待更多设计严格、长期随访的大样本RCT加以验证。
OBJECTIVE： To systematically review the efficacy of Live combined bacillus subtilis and enterococcus faecium in the prevention and treatment of Antibiotic associated diarrhea （AAD）, and provide evidence-based reference for clinical treatment. METHODS： Retrieved from CBM, CJFD and Wanfang database, randomized controlled trials （RCT）of Live combined bacillus subtilis and enterococcus faecium（test group） versus placebo （control group） in the prevention and treatment of AAD. After data ex- tract and quality evaluation, systematical evaluation was performed by using Rev Man 5,0 statistics software. RESULTS： A total of 21 RCT were included, involving 3 881 patients. According to the purpose of different purpose of druguse, the RCT were divided into prevention group and treatment group. Results of Meta-analysis showed the incidence of diarrhea in prevention test group was significantly lower than control group[OR = 0.27,95 % CI （ 0.22,0.32 ）, P〈 0.001], the average hospitalization time in prevention test group was significantly less than control group [MD= -53.19,95%CI（-79.63,-26.75） ,P〈0.001], and the total clinical ef- fective rate in treatment test group was significantly higher than control group[OR=6.76, 95% CI（4.16, 10.98）, P〈0.001]. CON- CLUSIONS： The efficacy of Live combined bacillus subtilis and enterococcus faecium are good in the prevention and treatment of AAD. However, due to the limit of methodological quality and sample size, it remains to be further verified with more rigorously desianed and lone-term follow-uo of lar^e-scale RCT.
出处
《中国药房》
CAS
北大核心
2015年第27期3806-3808,共3页
China Pharmacy
关键词
枯草杆菌二联活菌
抗生素相关性腹泻
疗效
系统评价
Live combined bacillus subtilis and enterococcus faecium
Antibiotic associated diarrhea
Efficacy
Systematic re-view
