益生菌对婴儿湿疹及特应性湿疹预防作用的系统评价_《中国循证医学杂志》

作者：

王瑜 ¹ ,  曾果 ¹ , 朱彩蓉 ² , 黄璐娇 ¹ , 刘科 ³ , 余利 ¹

1. 四川大学公共卫生学院营养与食品卫生学教研室（成都 610041)；2. 四川大学公共卫生学院卫生统计教研室（成都 610041)；3. 自贡市疾病预防控制中心（自贡 643000）;

关键词：

益生菌婴儿湿疹特应性湿疹系统评价 Meta分析随机对照试验

DOI：

10.7507/1672-2531.20120214

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　系统评价益生菌对婴儿湿疹及特应性湿疹的预防作用。
方法　计算机检索PubMed、EMbase、MEDLINE（Ovid）、CENTRAL、CBM和 CNKI 数据库，收集益生菌预防婴儿湿疹及特应性湿疹的随机对照试验（RCT），检索时限均从建库至2012年2月。由２位评价员根据纳入和排除标准独立筛选文献、提取资料、评价质量和交叉核对后，采用RevMan 5.0软件进行 Meta 分析。
结果　最终纳入15个研究，共3 179例患儿。仅纳入8个质量较高的研究进行Meta分析，结果显示：益生菌组婴儿湿疹发生率低于安慰剂组，两组差异有统计学意义［RD=–0.06，95%CI（–0.10，–0.03），P lt;0.05］；益生菌对婴儿特应性湿疹无预防作用［RD=–0.02，95%CI（–0.08，0.03），P gt;0.05）］；益生菌对高危人群［RD=–0.09，95%CI（–0.15，–0.03），P lt;0.05］和普通人群［RD=–0.05，95%CI（–0.10，0.00），P lt;0.05］婴儿湿疹均有预防作用。
结论　益生菌对于婴儿湿疹有一定预防作用，但由于益生菌菌种、剂量、疗程等诸多方面的差异，其对婴儿湿疹及特应性湿疹的具体效应尚需进一步研究加以验证。

引用本文： 王瑜,曾果,朱彩蓉,黄璐娇,刘科,余利. 益生菌对婴儿湿疹及特应性湿疹预防作用的系统评价. 中国循证医学杂志, 2012, 12(11): 1372-1378. doi: 10.7507/1672-2531.20120214 复制

1.	Lee J, Seto D, Bielory L. Meta-analysis of clinical trials of probiotics for prevention and treatment of pediatric atopic dermatitis. Journal of Allergy and Clinical Immunology, 2008, 121(1): 116-121.
2.	Thestrup-Pedersen K. Atopic eczema. What has caused the epidemic in industrialised countries and can early intervention modify the natural history of atopic eczema? Journal of Cosmetic Dermatology, 2003, 2(3-4): 202-210.
3.	van der Aa LB, Heymans HSA, van Aalderen WMC, et al. Probiotics and prebiotics in atopic dermatitis: review of the theoretical background and clinical evidence. Pediatric Allergy and Immunology, 2010, 21(2p2): e355-e367.
4.	West CE, Gothefors L, Granstrom M, et al. Probiotics during weaning reduce the incidence of eczema. Pediatric Allergy and Immunology, 2009, 20(5): 430-437.
5.	Larsen N, Vogensen FK, Gøbel R, et al. Predominant genera of fecal microbiota in children with atopic dermatitis are not altered by intake of probiotic bacteria Lactobacillus acidophilus NCFM and Bifidobacterium animalis subsp. lactis Bi-07. FEMS Microbiology Ecology, 2011, 75(3): 482-496.
6.	Gore C, Custovic A, Tannock GW, et al. Treatment and secondary prevention effects of the probiotics Lactobacillus paracasei or Bifidobacterium lactis on early infant eczema: randomized controlled trial with follow-up until age 3 years. Clinical and Experimental Allergy, 2012, 42(1): 112-122.
7.	吴红梅, 杨茗. 数据提取. 见: 刘鸣, 主编. 系统评价、Meta分析设计与实施方法. 第1版. 北京: 人民卫生出版社, 2011: 77-83.
8.	Wickens K, Black PN, Stanley TV, et al. A differential effect of 2 probiotics in the prevention of eczema and atopy: a double-blind, randomized, placebo-controlled trial. Journal of Allergy and Clinical Immunology, 2008, 122(4): 788-794.
9.	West CE, Hammarstrom ML, Hernell O. Probiotics during weaning reduce the incidence of eczema. Pediatric Allergy and Immunology, 2009, 20(5): 430-437.
10.	Rautava S, Kalliomaki M, Isolauri E. Probiotics during pregnancy and breast-feeding might confer immunomodulatory protection against atopic disease in the infant. Journal of Allergy and Clinical Immunology, 2002, 109(1): 119-121.
11.	Taylor AL, Dunstan JA, Prescott SL. Probiotic supplementation for the first 6 months of life fails to reduce the risk of atopic dermatitis and increases the risk of allergen sensitization in high-risk children: a randomized controlled trial. Journal of Allergy and Clinical Immunology, 2007, 119(1): 184-191.
12.	Niers L, Martín R, Rijkers G, et al. The effects of selected probiotic strains on the development of eczema (the PandA study). Allergy, 2009, 64(9): 1349-1358.
13.	Kalliomaki M, Salminen S, Arvilommi H, et al. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet, 2001, 357(9262): 1076-1079.
14.	Kukkonen K, Savilahti E, Haahtela T, et al. Probiotics and prebiotic galacto-oligosaccharides in the prevention of allergic diseases: a randomized, double-blind, placebo-controlled trial. Journal of Allergy and Clinical Immunology, 2007, 119(1): 192-198.
15.	Kopp MV, Hennemuth I, Heinzmann A, et al. Randomized,double- blind, placebo-controlled trial of probiotics for primary prevention:no clinical effects of Lactobacillus GG supplementation. Pediatrics, 2008, 121(4) : 850-856．.
16.	Kim JY, Kwon JH, Ahn SH, et al. Effect of probiotic mix (Bifidobacterium bifidum, Bifidobacterium lactis, Lactobacillus acidophilus) in the primary prevention of eczema: a double-blind, randomized, placebo-controlled trial. Pediatric Allergy and Immunology, 2010, 21(2 Pt 2): e386-393.
17.	Huurre A, Laitinen K, Rautava S, et al. Impact of maternal atopy and probiotic supplementation during pregnancy on infant sensitization: a double-blind placebo-controlled study. Clinical and Experimental Allergy, 2008, 38(8): 1342-1348.
18.	Dotterud CK, Storro O, Johnsen R, et al. Probiotics in pregnant women to prevent allergic disease: a randomized, double-blind trial. British Journal of Dermatology, 2010, 163(3): 616-623.
19.	Boyle RJ, Ismail IH, Kivivuori S, et al. Lactobacillus GG treatment during pregnancy for the prevention of eczema: a randomized controlled trial. Allergy, 2011, 66(4): 509-516.
20.	Bottcher MF, Abrahamsso TR, Fredriksson M, et al. Low breast milk TGF-beta2 is induced by Lactobacillus reuteri supplementation and associates with reduced risk of sensitization during infancy. Pediatric Allergy and Immunology, 2008, 19(6): 497-504.
21.	Abrahamsson TR, Jakobsson T, Bottcher MF, et al. Probiotics in prevention of IgE-associated eczema: a double-blind, randomized, placebo-controlled trial. Journal of Allergy and Clinical Immunology, 2007, 119(5): 1174-1180.
22.	Soh SE , Aw M, Gerez I, et al. Probiotic supplementation in the first 6 months of life in at risk Asian infants--effects on eczema and atopic sensitization at the age of 1 year. Clinical and Experimental Allergy, 2009, 39(4): 571-578.
23.	Jøhnke H, Vach W, Norberg LA, et al. A comparison between criteria for diagnosing atopic eczema in infants. British Journal of Dermatology, 2005, 153(2): 352-358.
24.	安颖, 王世宾. 益生菌LGG的益生功效及在乳制品中的应用. 食品科技, 2006, (7): 271-273.
25.	朱帝玲, 杨文旭, 杨慧明. 乳酸菌对婴幼儿湿疹一级预防的系统评价. 中国当代儿科杂志, 2010, 12(09): 734-739.

1. Lee J, Seto D, Bielory L. Meta-analysis of clinical trials of probiotics for prevention and treatment of pediatric atopic dermatitis. Journal of Allergy and Clinical Immunology, 2008, 121(1): 116-121.
2. Thestrup-Pedersen K. Atopic eczema. What has caused the epidemic in industrialised countries and can early intervention modify the natural history of atopic eczema? Journal of Cosmetic Dermatology, 2003, 2(3-4): 202-210.
3. van der Aa LB, Heymans HSA, van Aalderen WMC, et al. Probiotics and prebiotics in atopic dermatitis: review of the theoretical background and clinical evidence. Pediatric Allergy and Immunology, 2010, 21(2p2): e355-e367.
4. West CE, Gothefors L, Granstrom M, et al. Probiotics during weaning reduce the incidence of eczema. Pediatric Allergy and Immunology, 2009, 20(5): 430-437.
5. Larsen N, Vogensen FK, Gøbel R, et al. Predominant genera of fecal microbiota in children with atopic dermatitis are not altered by intake of probiotic bacteria Lactobacillus acidophilus NCFM and Bifidobacterium animalis subsp. lactis Bi-07. FEMS Microbiology Ecology, 2011, 75(3): 482-496.
6. Gore C, Custovic A, Tannock GW, et al. Treatment and secondary prevention effects of the probiotics Lactobacillus paracasei or Bifidobacterium lactis on early infant eczema: randomized controlled trial with follow-up until age 3 years. Clinical and Experimental Allergy, 2012, 42(1): 112-122.
7. 吴红梅, 杨茗. 数据提取. 见: 刘鸣, 主编. 系统评价、Meta分析设计与实施方法. 第1版. 北京: 人民卫生出版社, 2011: 77-83.
8. Wickens K, Black PN, Stanley TV, et al. A differential effect of 2 probiotics in the prevention of eczema and atopy: a double-blind, randomized, placebo-controlled trial. Journal of Allergy and Clinical Immunology, 2008, 122(4): 788-794.
9. West CE, Hammarstrom ML, Hernell O. Probiotics during weaning reduce the incidence of eczema. Pediatric Allergy and Immunology, 2009, 20(5): 430-437.
10. Rautava S, Kalliomaki M, Isolauri E. Probiotics during pregnancy and breast-feeding might confer immunomodulatory protection against atopic disease in the infant. Journal of Allergy and Clinical Immunology, 2002, 109(1): 119-121.
11. Taylor AL, Dunstan JA, Prescott SL. Probiotic supplementation for the first 6 months of life fails to reduce the risk of atopic dermatitis and increases the risk of allergen sensitization in high-risk children: a randomized controlled trial. Journal of Allergy and Clinical Immunology, 2007, 119(1): 184-191.
12. Niers L, Martín R, Rijkers G, et al. The effects of selected probiotic strains on the development of eczema (the PandA study). Allergy, 2009, 64(9): 1349-1358.
13. Kalliomaki M, Salminen S, Arvilommi H, et al. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet, 2001, 357(9262): 1076-1079.
14. Kukkonen K, Savilahti E, Haahtela T, et al. Probiotics and prebiotic galacto-oligosaccharides in the prevention of allergic diseases: a randomized, double-blind, placebo-controlled trial. Journal of Allergy and Clinical Immunology, 2007, 119(1): 192-198.
15. Kopp MV, Hennemuth I, Heinzmann A, et al. Randomized,double- blind, placebo-controlled trial of probiotics for primary prevention:no clinical effects of Lactobacillus GG supplementation. Pediatrics, 2008, 121(4) : 850-856．.
16. Kim JY, Kwon JH, Ahn SH, et al. Effect of probiotic mix (Bifidobacterium bifidum, Bifidobacterium lactis, Lactobacillus acidophilus) in the primary prevention of eczema: a double-blind, randomized, placebo-controlled trial. Pediatric Allergy and Immunology, 2010, 21(2 Pt 2): e386-393.
17. Huurre A, Laitinen K, Rautava S, et al. Impact of maternal atopy and probiotic supplementation during pregnancy on infant sensitization: a double-blind placebo-controlled study. Clinical and Experimental Allergy, 2008, 38(8): 1342-1348.
18. Dotterud CK, Storro O, Johnsen R, et al. Probiotics in pregnant women to prevent allergic disease: a randomized, double-blind trial. British Journal of Dermatology, 2010, 163(3): 616-623.
19. Boyle RJ, Ismail IH, Kivivuori S, et al. Lactobacillus GG treatment during pregnancy for the prevention of eczema: a randomized controlled trial. Allergy, 2011, 66(4): 509-516.
20. Bottcher MF, Abrahamsso TR, Fredriksson M, et al. Low breast milk TGF-beta2 is induced by Lactobacillus reuteri supplementation and associates with reduced risk of sensitization during infancy. Pediatric Allergy and Immunology, 2008, 19(6): 497-504.
21. Abrahamsson TR, Jakobsson T, Bottcher MF, et al. Probiotics in prevention of IgE-associated eczema: a double-blind, randomized, placebo-controlled trial. Journal of Allergy and Clinical Immunology, 2007, 119(5): 1174-1180.
22. Soh SE , Aw M, Gerez I, et al. Probiotic supplementation in the first 6 months of life in at risk Asian infants--effects on eczema and atopic sensitization at the age of 1 year. Clinical and Experimental Allergy, 2009, 39(4): 571-578.
23. Jøhnke H, Vach W, Norberg LA, et al. A comparison between criteria for diagnosing atopic eczema in infants. British Journal of Dermatology, 2005, 153(2): 352-358.
24. 安颖, 王世宾. 益生菌LGG的益生功效及在乳制品中的应用. 食品科技, 2006, (7): 271-273.
25. 朱帝玲, 杨文旭, 杨慧明. 乳酸菌对婴幼儿湿疹一级预防的系统评价. 中国当代儿科杂志, 2010, 12(09): 734-739.

《中国循证医学杂志》

益生菌对婴儿湿疹及特应性湿疹预防作用的系统评价

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《中国循证医学杂志》

益生菌对婴儿湿疹及特应性湿疹预防作用的系统评价

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