| 摘要: |
| 目的:系统评价益生菌制剂预防先天性巨结肠(HD)患儿术后并发HD 相关性小肠结肠炎(HAEC) 的有效性。方法:检
索建库至2024 年10 月PubMed、EMBase、the Cochrane Library、Web of Science、中国知网、万方、维普数据库的相关中英文文献,
对照组采用安慰剂或术后常规治疗, 试验组在对照组治疗的基础上加用益生菌制剂; 由两位研究员严格对文献进行筛选、提
取及质量评价; 应用RevMan 5. 3 和Stata 18. 0 软件进行Meta 分析。结果:最终纳入10 篇文献, 包括9 篇随机对照试验(RCT)
和1 篇队列研究, 共计890 例HD 术后患儿(试验组447 例, 对照组443 例)。试验组HAEC 发生率(OR=0. 34, 95%CI 0. 23~
0. 50, P<0. 01)、治疗结束时的肿瘤坏死因子-α(MD=-3. 35, 95%CI -4. 58~ -2. 12, P<0. 01)、超敏C-反应蛋白(MD=-4. 80,
95%CI -5. 48~-4. 12, P<0. 01)、白细胞介素-6(MD= -7. 42, 95%CI -9. 69~ -5. 14, P<0. 01) 和术后6 个月的白细胞介素-6 (MD=-4. 61, 95%CI -5. 07~-4. 14, P<0. 01)低于对照组。试验组治疗结束后的白细胞介素-10( MD= 12. 51, 95%CI 9. 53~
15. 49, P<0. 01)、术后6 个月的白细胞介素-10( MD = 7. 00, 95%CI 6. 54~ 7. 46, P<0. 01) 高于对照组。两组患儿一般资料、
HAEC 严重程度分级占比(1~3 级)比较, 差异无统计学意义(P>0. 05)。结论:益生菌制剂能有效降低HD 患儿术后HAEC 的
发生率, 并减轻患儿的肠道炎症反应, 具有潜在的临床应用价值。 |
| 关键词: 先天性巨结肠 小肠结肠炎 益生菌 预防效果 Meta 分析 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2025.08.010 |
|
| 基金项目:基金项目:国家自然科学基金项目,编号82060884;国家中医药管理局高水平中医药重点学科建设项目,编号ZYYZDXK-2023190;云南省基
础研究计划重点项目,编号202501AS070157;云南省兴滇英才支持计划-医疗卫生人才专项,编号XDYC-YLWS-2023-0092;云南省万人计划
青年拔尖人才专项,编号YNWR-QNBJ-2019-196;熊磊全国名老中医药专家传承工作室建设项目。 |
|
| Meta-Analysis on Efficacy of Probiotics in Preventing Postoperative Hirschsprung-Associated Enterocolitisin Children |
| Wang Ziwei1, Li Wang1, Duan Lianlian1, Shu Xiaolan1, Gui Jing1, Wang Anmin1, Ming Xi2 ( |
| (1. Kunming Guandu
People’s Hospital, Kunming 650299, China; 2. The First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine,
Kunming 650021, China) |
| Abstract: |
| Objective: To systematically review the efficacy of probiotics in preventing postoperative Hirschsprung-associated
enterocolitis (HAEC) in children. Methods: Relevant Chinese and English literature were retrieved from databases including PubMed,
EMBase, the Cochrane Library, Web of Science, CNKI, Wanfang and VIP databases from the establishment of database to Oct. 2024.
The control group received placebo or routine postoperative treatment, and the experimental group was given probiotic preparations in
addition to the treatment of control group. Two researchers strictly carried out independent screening, collation, duplicate checking, data
extraction, and literature quality evaluation. Meta-analysis was performed by using RevMan 5. 3 and Stata 18. 0 software. Results:
Totally 10 literature were enrolled, including 9 randomized controlled trials (RCT) and 1 cohort study, there were 890 children after HD
surgery (447 cases in the experimental group and 443 cases in the control group). Meta-analysis showed that the incidence of HAEC
(OR=0. 34, 95%CI from 0. 23 to 0. 50, P<0. 01), the end-of-treatment tumor necrosis factor-α (MD=-3. 35, 95%CI from -4. 58 to
-2. 12, P<0. 01), high-sensitivity C-reactive protein (MD=-4. 80, 95%CI from -5. 48 to -4. 12, P<0. 01), interleukin-6 (MD=
-7. 42, 95%CI from -9. 69 to -5. 14, P<0. 01) and interleukin-6 levels at 6 months after surgery (MD=-4. 61, 95%CI from -5. 07
to -4. 14, P <0. 01) in the experimental group were lower than those in the control group. The interleukin-10 levels at the end of
treatment (MD=12. 51, 95%CI from 9. 53 to 15. 49, P<0. 01) and at 6 months after surgery (MD=7. 00, 95%CI from 6. 54 to 7. 46,
P<0. 01) in the experimental group were higher than those in the control group. There was no statistically significant difference in
general data and proportion of severity classification of HAEC (grade 1 to 3) between two groups (P>0. 05). Conclusion: Probiotics
can effectively reduce the incidence of postoperative HAEC in children with HD and attenuate the intestinal inflammatory response,
which has potential clinical application. |
| Key words: Hirschsprung’s disease enterocolitis probiotics preventive effect Meta-analysis |
