Front Pharmacol:益生菌联合中药治疗溃疡性结肠炎的疗效和安全性

2022-06-11 August MedSci原创

益生菌联合中药(TCM)是治疗溃疡性结肠炎(UC)的一种前瞻性疗法,其疗效和安全性亟待评估。

溃疡性结肠炎 (UC) 是一种慢性炎症性肠病 (IBD),由对肠道共生微生物的不适当免疫反应引起。它的特点是慢性复发性炎症,损害患者的生活质量,是结直肠癌的危险因素。作为人口最多的国家,中国UC的年发病率约为每10万人1.2例,并呈稳步上升趋势

免疫异常被认为在 UC 中起重要作用,调节先天免疫系统的药物已成为主流治疗方法。一些专家认为,益生菌不仅应被视为一种简单的膳食补充剂,还应被视为 UC 的潜在治疗因素。然而,单独应用益生菌并不总能取得出色的临床效果。研究表明,中药(TCM)通过抑制异常炎症反应、保护肠道屏障、恢复肠道菌群失衡等方面具有治疗UC的价值。当整合到治疗计划中时,中医被认为可以提高疗效并减少药物的副作用。此外,益生菌联合中药在中国广泛应用于UC。因此,在循证医学的基础上进一步评价益生菌与中医药联合应用的临床价值具有重要意义。

方法:检索Pubmed、EMBASE、Cochrane图书馆、中国学术期刊(CNKI)、万方数据库、中国生物医学文献服务系统(CBM)、中国科技期刊(CQVIP)。根据不同的对照药物、疗程和益生菌种类设计亚组分析。Review Manager 软件(5.4.1 版)用于统计分析。

结果:对包含 1,154 名患者的 14 项原始研究进行了分析,结果表明益生菌与中药一起使用比单独使用 5-氨基水杨酸 (5-ASA)、益生菌或中药更有效。此外,益生菌联合中药可以抑制肠道炎症,降低复发率和不良事件的发生率。亚组分析表明,不同益生菌的混合物比单一菌株更有效。

结论:提示益生菌联合中药可有效控制临床症状,抑制肠道炎症反应,最终减缓疾病进展,减少疾病复发,不良事件较少。不同益生菌的混合物与单独定制的中药结合使用是治疗 UC 的潜在临床策略。

益生菌联合中药治疗UC的作用机制(益生菌和中药通过各自的作用发挥治疗作用,而它们之间的相互作用反映了这种组合的协同作用和必要性。):

综上所述,益生菌联合中药可提高UC患者的临床疗效,降低复发率和不良事件,提示该组合具有治疗UC的潜力,具有显着的临床推广价值。益生菌与中药的相互作用提高了它们对UC的治疗效果。以辨证论治为指导的不同益生菌与中药的结合是提高临床疗效的重要方案。尚需更多高质量的RCT来评价益生菌联合中药治疗UC的远期疗效和安全性。

 

原文:Hu Y, Ye Z, She Y, Li L, Wu M, Qin K, Li Y, He H, Hu Z, Yang M, Lu F, Ye Q. Efficacy and Safety of Probiotics Combined With Traditional Chinese Medicine for Ulcerative Colitis: A Systematic Review and Meta-Analysis. Front Pharmacol. 2022 Mar 7;13:844961. doi: 10.3389/fphar.2022.844961. PMID: 35321324; PMCID: PMC8936956.

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    2022-07-06 yb6560
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    2022-09-22 nymo
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[GetPortalCommentsPageByObjectIdResponse(id=1788482, encodeId=05201e884820a, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Thu May 11 11:35:42 CST 2023, time=2023-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1996482, encodeId=07b81996482e9, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Wed Jul 06 17:35:42 CST 2022, time=2022-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1695283, encodeId=d82c169528347, content=<a href='/topic/show?id=c76e6645438' target=_blank style='color:#2F92EE;'>#溃疡性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66454, encryptionId=c76e6645438, topicName=溃疡性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=787129789891, createdName=nymo, createdTime=Thu Sep 22 17:35:42 CST 2022, time=2022-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908711, encodeId=c8741908e113c, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, 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  5. [GetPortalCommentsPageByObjectIdResponse(id=1788482, encodeId=05201e884820a, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Thu May 11 11:35:42 CST 2023, time=2023-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1996482, encodeId=07b81996482e9, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, 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href='/topic/show?id=5d0ee2249b0' target=_blank style='color:#2F92EE;'>#益生菌#</a><a href='/topic/show?id=05c46645ec3' target=_blank style='color:#2F92EE;'>#溃疡性结肠炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22423, encryptionId=5c1d22423c8, topicName=中药), TopicDto(id=72249, encryptionId=5d0ee2249b0, topicName=益生菌), TopicDto(id=66457, encryptionId=05c46645ec3, topicName=溃疡性结肠炎)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Thu Aug 04 08:41:32 CST 2022, time=2022-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1721202, encodeId=1c661e212027b, content=<a href='/topic/show?id=634ee040179' target=_blank style='color:#2F92EE;'>#疗效和安全性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70401, encryptionId=634ee040179, topicName=疗效和安全性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16ef32982072, createdName=经常头晕, createdTime=Thu Oct 13 16:35:42 CST 2022, time=2022-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1225953, encodeId=87e3122595315, content=受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2018/08/25/1e161fbc4f0de069a5814bcc8c94282a.jpg, createdBy=be1d2427494, createdName=123ac12am01暂无昵称, createdTime=Sun Jun 12 11:30:47 CST 2022, time=2022-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367626, encodeId=d153136e62687, content=<a href='/topic/show?id=a52164664cb' target=_blank style='color:#2F92EE;'>#治疗溃疡性结肠炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64664, encryptionId=a52164664cb, topicName=治疗溃疡性结肠炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7d74253, createdName=wangtianj2007@, createdTime=Wed Jun 08 14:35:42 CST 2022, time=2022-06-08, status=1, ipAttribution=)]
    2023-04-14 jj000001
  6. [GetPortalCommentsPageByObjectIdResponse(id=1788482, encodeId=05201e884820a, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Thu May 11 11:35:42 CST 2023, time=2023-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1996482, encodeId=07b81996482e9, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, 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  7. 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  8. 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    2022-06-12 123ac12am01暂无昵称

    受益匪浅

    0

  9. 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