双歧杆菌制剂对肿瘤化疗患者肠道菌群影响的Meta分析

探讨双歧杆菌制剂对肿瘤化疗患者肠道菌群的影响。

通过检索PubMed、Embase、The Cochrane Library、Web of Science以及CBM、CNKI、WanFang Data和VIP数据库，收集各数据库从建库至2022年7月发表的所有关于肿瘤化疗患者应用双歧杆菌制剂的随机对照试验，由2名研究者独立筛选文献，按照系统评价的要求对文献质量进行评估，使用Revman 5.4和Stata 17.0统计学软件进行Meta分析。

共纳入25篇文献（2 152例患者），Meta分析结果显示，双歧杆菌制剂组患者肠道中双歧杆菌和乳杆菌的数量高于对照组[SMD = 2.89，95% CI（2.28，3.49），P＜0.001；SMD = 2.20，95% CI（1.57，2.84），P＜0.001]，双歧杆菌制剂组患者肠道中大肠埃希菌、肠杆菌和肠球菌的数量低于对照组[SMD = −1.08，95% CI（−1.64，−0.52），P＜0.001；SMD = −0.88，95% CI（−1.58，−0.17），P = 0.010；SMD = −0.98，95% CI（−1.68，−0.28），P = 0.006]。

在化疗的基础上添加双歧杆菌制剂对肠道主要菌群水平能起到显著的改善作用，降低不良反应发生率，值得在临床上推广及应用。

The effect of bifidobacterial preparation on intestinal flora in patients undergoing chemotherapy for cancer: a Meta-analysis

ObjectiveTo observe the effect of bifidobacterial preparation on intestinal flora in patients undergoing chemotherapy for cancer. MethodsAll randomized controlled trials on the application of bifidobacterial preparation in patients undergoing chemotherapy for cancer published in each database from their establishment to July 2022 were collected by searching PubMed, Embase, The Cochrane Library, Web of Science, CBM, CNKI, WanFang Data, and VIP databases. The literatures were screened by two investigators, and the quality of the literature was assessed according to the requirements of systematic evaluation. Meta-analysis was performed using Revman 5.4 and Stata 17.0 statistical softwares. ResultsA total of 25 publications (2,152 patients) were included. Meta-analysis showed that the counts of Bifidobacteria and Lactobacilli in the intestine were higher in the bifidobacterial preparation group than in the control group [SMD = 2.89, 95% CI (2.28, 3.49), P＜0.001; SMD = 2.20, 95% CI (1.57, 2.84), P＜0.001]. The counts of E. coli, Enterobacter and Enterococcus in the intestine of patients in the bifidobacterial preparation group was lower than in the control group [SMD = ‒1.08, 95%CI (‒1.64, ‒0.52), P＜0.001; SMD = ‒0.88, 95% CI (‒1.58, ‒0.17), P = 0.010; SMD = ‒0.98, 95% CI (‒1.68, ‒0.28), P = 0.006]. ConclusionBifidobacterial preparation can significantly improve the level of major intestinal flora and reduce the incidence of adverse reactions, which is worth promoting and applying in clinical practice.