摘要
目的系统评价肠道益生菌类制剂治疗非酒精性脂肪性肝病(NAFLD)的有效性。方法计算机检索Pub Med,EMbase,The Cochrane Library,中国知网(CNKI),万方数据库,维普网(VIP),中国生物医学文献数据库(CBM),检索肠道益生菌类制剂治疗NAFLD随机对照试验(RCT)的相关文献,检索时限均为建库至2015年11月。由2位研究者独立筛选文献、提取文献资料和评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果共纳入6个RCT研究、411例NAFLD患者。Meta分析结果显示,肠道益生菌制剂可以明显降低血脂,包括总胆固醇[MD=-0.06,95%CI(-0.14,0.02),P=0.14]和三酰甘油[MD=-0.36,95%CI(-0.56,-0.16),P=0.000 5]水平,明显改善肝功能,包括丙氨酸氨基转移酶(ALT)[MD=-16.58,95%CI(-22.01,-11.16),P<0.000 01]和天门冬酸氨基转移酶(AST)[MD=-9.03,95%CI(-9.97,-8.09),P<0.000 01]水平,以及明显降低肿瘤坏死因子-α(TNF-α)[MD=-0.32,95%CI(-0.47,-0.17),P<0.000 1]和稳态胰岛素评价指数(HOMA-IR)[MD=-0.50,95%CI(-0.77,-0.23),P=0.000 3]水平。但治疗前后体重指数(BMI)[MD=0.09,95%CI(-0.14,0.31),P=0.46]和空腹血糖(FBG)[MD=-0.06,95%CI(-0.14,0.02),P=0.14]改善水平无显著性差异。结论肠道益生菌类制剂能有效治疗NAFLD,为治疗该病提供了新方法 。
Objective To systematically review the efficacy and relationship of probiotics and nonalcoholic fatty liver disease（NAFLD）. Methods PubMed, EMbase, The Cochrane Library, CNKI, WanFang data, CBM, VIP were searched to collect randomized controlled trials （RCTs） on probiotics for nonalcoholic fatty liver disease（NAFLD） from inception to November 2015. Two reviewers indepen- dently screened literature, extracted data and assessed the risk of bias of included studies. Then meta- analysis was performed using RevMan 5.3 software. Results A total of 6 RCTs and 411 patients were included. The results showed that probiotic therapy signifi- cantly decreased the level of total - cholesterol[ MD = - 0. 06,95% CI（ - O. 14,0. 02）, P = 0. 14], triglyceride[ MD = - 0. 36,95% CI 4-0.56,-0.16）,P=0.0005],the hepatic function of alanine aminotransferase（ALT） [MD=-16.58,95% CI（-22.01, -11. 16）,P 〈 0.000 01],aspartate transaminase（AST） [MD= -9.03,95% CI（-9.97,-8.09）,P 〈 0.000 01],tumor necrosis factor-α（TNF-α） [MD=-0. 32,95% CI（-0.47,-0. 17）, P 〈 0.0001] and homeostasis model assessment of insulin resistance （HOMA - IR） [ MD = - 0. 50,95% CI（ - 0. 77, - 0. 23）, P = 0. 0003 ]. However, the use of probiotics was not associated with changes in body mass index （BMI） [MD=0.09,95% C1（-0.14,0.31）, P=0.46] and fasting blood glucose （FBG） [MD=-0.06, 95 % CI（ - 0. 14, 0. 02 ）, P = 0. 14 ]. Conclusion Probiotic is an effective treatment of NAFLD. Modulation of the gut microbiota rep- resents a new treatmem for NAFLD.
出处
《中国药业》
CAS
2016年第16期43-48,共6页
China Pharmaceuticals
