摘要
目的评价乳糖酶治疗儿童腹泻继发乳糖不耐受的疗效与安全性,为儿童腹泻继发乳糖不耐受合理用药提供循证医学依据。方法计算机检索PubMed、EMbase、Cochrane library、CBM、CNKI、VIP、Wanfang数据库,检索时间均为建库至2019年1月。由2位研究员按照纳入标准和排除标准独立筛选文献、提取数据及评价文献质量并进行交叉核对后,运用RenMan 5.3统计软件进行Meta分析。结果共纳入9项随机对照研究,患者总数1296例,对照组643例,试验组653例。对照组采用口服补液、补锌、口服蒙脱石散等常规对症治疗,试验组在常规治疗的基础上,加用口服乳糖酶制剂治疗。结果显示:①乳糖不耐受发生率与年龄成反相关性,年龄越小,发生率越高;②不同病因的乳糖不耐受发生率不同,轮状病毒感染者引起乳糖不耐受比例最高;③Meta分析结果显示试验组治疗后显效率明显优于对照组(RR=1.64,95%CI 1.40~1.91,P <0.05),总有效率也明显优于对照组(RR=1.43,95%CI 1.26~1.61,P <0.05),治疗疗程明显缩短(MD=-1.99,95%CI-2.93^-1.04,P<0.05)。结论乳糖酶治疗治疗儿童腹泻继发乳糖不耐受可提高临床疗效,缩短治疗疗程。但受纳入研究数量和质量的限制,尚有待于大样本、多中心、高质量研究进一步加以论证。
Objective To evaluate the efficacy and safety of lactase in the treatment of children with diarrhea secondary to lactose intolerance,and to provide evidence for the rational use of lactose intolerance in children with diarrhea.Methods We searched PubMed,EMbase,Cochrane library,CBM,CNKI,VIP,and Wanfang databases from inception to January 2019.Two researchers independently screened the literature according to the inclusion cirtria and exclusion criteria,extracted data,and evaluated the quality of the literature.After completion,cross-checking was performed and Meta-analysis were conducted with RevMan 5.3 software.Results Nine randomized controlled trials were included.The total number of patients was 1296(643 in the control group and 653 in the experimental group).The control group was treated with oral rehydration,zinc supplementation,montmorillonite powder and other conventional symptomatic treatments.The experimental group was treated with oral lactase preparation in addition to the conventional treatment.Results①The incidence of lactose intolerance was inversely related to age,the younger the age,the higher the incidence;②The incidence of lactose intolerance was different for different causes,highest in rotavirus infections;③Meta-analysis showed that the effective rate of the experimental group was significantly better than that of the control group(RR=1.64,95%CI 1.40-1.91,P<0.05),and the total effective rate was also significantly better than that of the control group(RR=1.43,95%CI 1.26-1.61,P<0.05),and the treatment course was significantly shortened(MD=-1.99,95%CI-2.93--1.04,P<0.05).Conclusion Lactase treatment for children with diarrhea secondary to lactose intolerance improves clinical efficacy and shortens the course of treatment.However,due to the limitation of the quantity and quality of the research,it is quite necessary to further,multi-center,and high-quality research with large samples.
作者
罗婷
袁洪波
练湘红
LUO Ting;YUAN Hong-bo;LIAN Xiang-hong(Department of Pharmacy,West China Second University Hospital,Sichuan University,Chengdu610041;Evidence-Based Pharmacy Center,West ChinaSecond University Hospital,Sichuan University,Chengdu610041;Key Laboratory of Birth Defects andRelated Diseases of Women and Children(Sichuan University),Ministry of Education,Chengdu610041)
出处
《中南药学》
CAS
2019年第8期1283-1287,共5页
Central South Pharmacy
关键词
乳糖酶
儿童
腹泻
乳糖不耐受
系统评价
lactase
children
diarrhea
lactose intolerance
systematic review
