国内双歧杆菌制剂预防小儿继发性腹泻临床疗效的Meta分析

目的系统评价国内双歧杆菌制剂临床预防小儿继发性腹泻的效果。方法按照系统评价的要求检索CBMd isc、VIP、CNK I以及万方数据库等,获得18篇符合纳入标准的文献,共计患儿4050例,对其进行M eta分析,并评价M eta分析结果的稳定性和发表偏倚。结果异质性检验χ^2=34.60,P=0.007〈0.05,采用随机效应模型进行M eta分析,合并RR=0.41,95%C I为0.35～0.49,总体效应检验,Z=10.39,P〈0.00001,差异具有非常显著性,固定效应模型RR值和95%C I与随机效应模型完全一致,剔除小样本报道后的合并RR=0.42,95%C I为0.35～0.50,与剔除前的结果基本一致,且本研究的发表偏倚得到了很好地控制。结论从现有的临床证据来看,双歧杆菌制剂能降低小儿继发性腹泻的发生率,对预防小儿继发性腹泻起到了满意的效果。

Meta analysis of Bifid-preparations in prevention of secondary diarrhea in infants in China

Objective To explore the clinical effect of Bifid-preparations in prevention of secondary diarrhea in infants in China.Method Eighteen studies containing 4050 secondary diarrhea patients consistent with the inclusion standards were chosen from CBMdisc,VIP,CNKI and WanFang database,and analyzed synthetically by Meta-analysis.The stability of the result was evaluated and the publication bias was recognized.Result The statistic was equal to 34.60 and the value was equal to 0.007〈0.05 in the heterogeneity test,so the random effect model was used for Meta-analysis.The overall effect Z=10.39,P〈0.00001.The combined RR was equal to 0.41,and its 95% confidence interval was between 0.35 and 0.49,which was identical with fixed effect model.After rejecting small sample studies,the combined RR=0.42,95 %CI was 0.35 to 0.50,which was basically coincident with the result before rejection.The publication bias of this study was controled perfectly.Conclusion Bifid-preparations could reduce the incidence rate of secondary diarrhea in infants according to the clinical evidence currently available.The effect of Bifid-preparations in prevention of secondary diarrhea in infants was very satisfactory.