益生菌對嬰兒濕疹及特應性濕疹預防作用的系統評價_《中國循證醫學雜志》

作者：

王瑜 ¹ ,  曾果 ¹ , 朱彩蓉 ² , 黃璐嬌 ¹ , 劉科 ³ , 余利 ¹

1. 四川大學公共衛生學院營養與食品衛生學教研室（成都 610041)；2. 四川大學公共衛生學院衛生統計教研室（成都 610041)；3. 自貢市疾病預防控制中心（自貢 643000）;

關鍵詞：

益生菌嬰兒濕疹特應性濕疹系統評價 Meta分析隨機對照試驗

DOI：

10.7507/1672-2531.20120214

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目的　系統評價益生菌對嬰兒濕疹及特應性濕疹的預防作用。
方法　計算機檢索PubMed、EMbase、MEDLINE（Ovid）、CENTRAL、CBM和 CNKI 數據庫，收集益生菌預防嬰兒濕疹及特應性濕疹的隨機對照試驗（RCT），檢索時限均從建庫至2012年2月。由２位評價員根據納入和排除標準獨立篩選文獻、提取資料、評價質量和交叉核對后，采用RevMan 5.0軟件進行 Meta 分析。
結果　最終納入15個研究，共3 179例患兒。僅納入8個質量較高的研究進行Meta分析，結果顯示：益生菌組嬰兒濕疹發生率低于安慰劑組，兩組差異有統計學意義［RD=–0.06，95%CI（–0.10，–0.03），P lt;0.05］；益生菌對嬰兒特應性濕疹無預防作用［RD=–0.02，95%CI（–0.08，0.03），P gt;0.05）］；益生菌對高危人群［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］嬰兒濕疹均有預防作用。
結論　益生菌對于嬰兒濕疹有一定預防作用，但由于益生菌菌種、劑量、療程等諸多方面的差異，其對嬰兒濕疹及特應性濕疹的具體效應尚需進一步研究加以驗證。

引用本文： 王瑜,曾果,朱彩蓉,黃璐嬌,劉科,余利. 益生菌對嬰兒濕疹及特應性濕疹預防作用的系統評價. 中國循證醫學雜志, 2012, 12(11): 1372-1378. doi: 10.7507/1672-2531.20120214 復制

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.	吳紅梅, 楊茗. 數據提取. 見: 劉鳴, 主編. 系統評價、Meta分析設計與實施方法. 第1版. 北京: 人民衛生出版社, 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.	安穎, 王世賓. 益生菌LGG的益生功效及在乳制品中的應用. 食品科技, 2006, (7): 271-273.
25.	朱帝玲, 楊文旭, 楊慧明. 乳酸菌對嬰幼兒濕疹一級預防的系統評價. 中國當代兒科雜志, 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. 吳紅梅, 楊茗. 數據提取. 見: 劉鳴, 主編. 系統評價、Meta分析設計與實施方法. 第1版. 北京: 人民衛生出版社, 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. 安穎, 王世賓. 益生菌LGG的益生功效及在乳制品中的應用. 食品科技, 2006, (7): 271-273.
25. 朱帝玲, 楊文旭, 楊慧明. 乳酸菌對嬰幼兒濕疹一級預防的系統評價. 中國當代兒科雜志, 2010, 12(09): 734-739.

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益生菌對嬰兒濕疹及特應性濕疹預防作用的系統評價

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