基于“肺与大肠相表里”理论探讨益生菌辅助治疗儿童哮喘的系统评价及meta分析

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Abstract Objective To systematically evaluate the efficacy and safety of probiotics in the adjuvant treatment of childhood asthma, so as to provide evidence-based medical evidence for probiotics in the treatment of childhood asthma. Methods Randomized controlled trials of probiotics combined with conventional anti-inflammatory and antiasthmatic drugs as intervention measures in the treatment of childhood asthma were collected in PubMed, EMbase, Cochrane Library, CNKI, Wanfang, VIP and CBM databases with the keywords “asthma, probiotics, children, random”. The searching time range was from the establishment of the database to April 2019. Meta analysis was performed with software RevMan 5.3 after independently screening the literature, evaluating the risk of literature bias, and extracting the clinical total effective rate, recurrence rate, FEV1, IFN-γ, IgE and adverse reaction indicators by the two investigators. Results A total of ten RCTs involving 992 asthma patients were included. Meta analysis results showed that: compared with control group, clinical total effective rate of experimental group improved (OR = 3.57, 95%CI: 2.41-5.30, P ＜ 0.000 01), FEV1 increased (MD = 0.29, 95%CI: 0.13-0.45, P = 0.0003), IFN-γ level increased (MD = 30.28, 95%CI: 26.80-33.77, P ＜ 0.000 01), IgE level decreased (MD = -24.03, 95%CI: -31.15 to -16.90, P ＜ 0.00001), recurrence rate decreased (OR = 0.37, 95%CI: 0.19-0.72, P = 0.003). There was no significant difference in the incidence of adverse reaction between two groups (OR = 1.08, 95%CI: 0.49-2.39, P = 0.85). Conclusion Based on the current clinical evidence, probiotics adjuvant treatment of childhood asthma can effectively improve the clinical efficacy and quality of life of patients, and reduce the recurrence rate. Due to the low quality and small sample size of the included studies, more high-quality, large sample size, multi center clinical studies are needed to verify the exact conclusion.

Key words： Childhood asthma Probiotics Interior-exterior relationship between lung and large intestine Randomized controlled trial Systematic evaluation Meta analysis

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	YANG Fushuang1 CAO Fang1 GUO Lei1 GUO Tingting1 WANG Zhongtian1 SUN Liping2

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YANG Fushuang1 CAO Fang1 GUO Lei1 GUO Tingting1 WANG Zhongtian1 SUN Liping2. Systematical evaluation and meta analysis of adjuvant probiotic treatment in childhood asthma based on the theory of “interior-exterior relationship between lung and large intestine”[J]. 中国医药导报, 2020, 17(30): 112-117.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I30/112

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