Probiotic Agents for the Treatment of Irritable Bowel Syndrome in China: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

YAO Li , FU Ling ,  ZHAO Shengjun

Department of Pharmacy, Chinese Traditional Medicine Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, China;

Corresponding author：

ZHAO Shengjun, Email: zyysht0707@126.com

Keywords：

Probiotic agents; Irritable bowel syndrome; Meta-analysis; Systematic review

DOI：

10.7507/1672-2531.20120097

Video：

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Objective 　To compare the clinical therapeutic effect of probiotic agents in treating irritable bowel syndrome (IBS) by Meta-analysis.
Methods 　Such databases as MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and Chinese Biomedical Literature Database were searched from January 2001 to October 2011, and the domestic conference proceedings and relevant papers published in recent 1 year were also searched manually. All domestic randomized controlled trials (RCTs) on probiotic agents in treating irritable bowel syndrome (IBS) were collected, which were then selected according to the inclusion and exclusion criteria. The data were extracted, the methodological quality of the included studies was assessed, and the Meta-analysis was performed with Revman5.0.
Results 　A total of 11 RCTs involving 1 065 patients were included. The total effective rate of the probiotic agents plus conventional treatment group was superior to that of the conventional treatment (trimebutine meleate/ pinaverium bromide) group (RR=1.26, 95%CI 1.18 to 1.34, P lt;0.000 01), it could effectively relieve abdominal pain (RR=1.10, 95%CI 1.03 to 1.18, P=0.004) and diarrhea (RR=1.15, 95%CI 1.07 to 1.24, P=0.000 3). But there was no significant difference between the two groups in alleviating abdominal distention (RR=1.08, 95%CI 0.95 to 1.24, P=0.25). The effectiveness of probiotic agents used alone was similar to that of the conventional treatment used alone, without significant differences (RR=0.85, 95%CI 0.66 to 1.09, P=0.19).
Conclusion 　Probiotic agents combined with conventional drugs can improve the total therapeutic effect of IBS, especially in alleviating abdominal pain, diarrhea and so on. But the effectiveness of probiotic agents used alone is similar to that of the conventional treatment used alone. For the possibility of bias due to the lower quality of the included studies and unclear implementation of RCTs, this conclusion should be verified with more large-scale and high-quality RCTs.

Citation： YAO Li,FU Ling,ZHAO Shengjun. Probiotic Agents for the Treatment of Irritable Bowel Syndrome in China: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2012, 12(5): 602-607. doi: 10.7507/1672-2531.20120097 Copy

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4.	郑跃杰, 黄志华. 正确认识评价和使用益生菌药物. 中国实用儿科杂志, 2011, 26(1): 24-26.
5.	袁兴洪. 培菲康联合马来酸曲美布汀治疗肠易激综合征的临床疗效及肠道益生菌群变化分析. 现代预防医学, 2011, 38(3): 594-596.
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9.	高来龙, 常明花. 培菲康与匹维溴铵治疗腹泻型肠易激综合征疗效对比研究. 浙江中医药大学学报, 2008, 32(6): 777-778.
10.	Zhong YQ, Zhu J, Guo JN, et al. A randomized and case –control clinical study on trimebutine maleate in treating functional dyspepsia coexisting with diarrhea –dominant irritable bowel syndrome. Zhonghua Nei Ke Za Zhi, 2007, 46(11): 899-902.
11.	田景波, 李京军, 徐茗. 曲美布汀联合双歧三联活菌胶囊治疗肠易激综合征. 中国微生态学杂志, 2007, 19(2): 187-188.
12.	史志红, 高荣凯, 赵瑞敏. 曲美布汀联合双歧四联活菌片治疗腹泻型肠易激综合征34例. 郑州大学学报(医学版), 2005, 40(4): 770-771.
13.	袁淑芳, 张嘉斌, 陈方方. 马来酸曲美布汀联合美常安治疗腹泻型肠易激综合征. 中国新药杂志, 2011, 20(7): 616-618.
14.	邹开芳, 宋军. 钙通道拮抗剂与微生态活菌制剂联合治疗肠易激综合征. 同济医科大学学报, 2000, 29(5): 531-533.
15.	肖嘉新, 江芸, 王大海. 曲美布汀联合培菲康治疗肠易激综合征126例疗效观察. 海峡药学, 2011, 23(8): 167-168.

1. Thompson WG, Longstreth GF, Drossman DA, et al. Functional bowel disorders and functional abdominal pain. Gut, 1999, 45(suppl 2): 43-47.
2. Longstreth GF, Thompson WG, Chey WD, et al. Functional bowel disorders. Gastroenterology, 2006, 130: 1480-1491.
3. Chang FY, Lu CL. Irritable bowel syndrome in the 21st century: perspectives from Asia or South –east Asia. J Gastroenterol Hepatol, 2007, 22(1): 4-12.
4. 郑跃杰, 黄志华. 正确认识评价和使用益生菌药物. 中国实用儿科杂志, 2011, 26(1): 24-26.
5. 袁兴洪. 培菲康联合马来酸曲美布汀治疗肠易激综合征的临床疗效及肠道益生菌群变化分析. 现代预防医学, 2011, 38(3): 594-596.
6. 唐鄂. 双歧三联活菌联合马来酸曲美布汀治疗腹泻型肠易激综合征38例. 医药导报, 2010, 29(8): 1013-1015.
7. 张险峰, 江应安, 方春华. 美常安联合得舒特治疗腹泻型肠易激综合征的疗效观察. 临床消化病杂志, 2009, 21(1): 25-27.
8. 秦俊杰, 白平平. 美常安与马来酸曲美布汀治疗腹泻型肠易激综合征的疗效. 中国医药指南, 2009, 7(4): 18-20.
9. 高来龙, 常明花. 培菲康与匹维溴铵治疗腹泻型肠易激综合征疗效对比研究. 浙江中医药大学学报, 2008, 32(6): 777-778.
10. Zhong YQ, Zhu J, Guo JN, et al. A randomized and case –control clinical study on trimebutine maleate in treating functional dyspepsia coexisting with diarrhea –dominant irritable bowel syndrome. Zhonghua Nei Ke Za Zhi, 2007, 46(11): 899-902.
11. 田景波, 李京军, 徐茗. 曲美布汀联合双歧三联活菌胶囊治疗肠易激综合征. 中国微生态学杂志, 2007, 19(2): 187-188.
12. 史志红, 高荣凯, 赵瑞敏. 曲美布汀联合双歧四联活菌片治疗腹泻型肠易激综合征34例. 郑州大学学报(医学版), 2005, 40(4): 770-771.
13. 袁淑芳, 张嘉斌, 陈方方. 马来酸曲美布汀联合美常安治疗腹泻型肠易激综合征. 中国新药杂志, 2011, 20(7): 616-618.
14. 邹开芳, 宋军. 钙通道拮抗剂与微生态活菌制剂联合治疗肠易激综合征. 同济医科大学学报, 2000, 29(5): 531-533.
15. 肖嘉新, 江芸, 王大海. 曲美布汀联合培菲康治疗肠易激综合征126例疗效观察. 海峡药学, 2011, 23(8): 167-168.

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Probiotic Agents for the Treatment of Irritable Bowel Syndrome in China: A Meta-Analysis

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