PDF(Pubmed)
Abstract：
This study aimed to pool the efficacy in bowel movement and explore the change of gut microbiota on adult functional constipated patients after probiotics-containing products treatment.
Systematic review and meta-analysis.
PubMed, Cochrane Library for published studies and ClinicalTrials.gov for \'grey\' researches were independently investigated for randomised controlled trials up to November 2022.
The intervention was probiotics-containing product, either probiotics or synbiotics, while the control was placebo. The risk of bias was conducted. The efficacy in bowel movement was indicated by stool frequency, stool consistency and Patient Assessment of Constipation Symptom (PAC-SYM), while the change of gut microbiota was reviewed through α diversity, β diversity, change/difference in relative abundance and so on. The subgroup analysis, sensitivity analysis and random-effect meta-regression were conducted to explore the heterogeneity. The Grading of Recommendations Assessment Development and Evaluation was conducted to grade the quality of evidence.
17 studies, comprising 1256 participants, were included with perfect agreements between two researchers (kappa statistic=0.797). Compared with placebo, probiotics-containing products significantly increased the stool frequency (weighted mean difference, WMD 0.93, 95% CI 0.47 to 1.40, p=0.000, I²=84.5%, \'low\'), improved the stool consistency (WMD 0.38, 95% CI 0.05 to 0.70, p=0.023, I²=81.6%, \'very low\') and reduced the PAC-SYM (WMD -0.28, 95% CI: -0.45 to -0.11, p=0.001, I²=55.7%, \'very low\'). In subgroup analysis, synbiotics was superior to probiotics to increase stool frequency. Probiotics-containing products might not affect α or β diversity, but would increase the relative abundance of specific strain.
Probiotics-containing products, significantly increased stool frequency, improved stool consistency, and alleviated functional constipation symptoms. They increased the relative abundance of specific strain. More high-quality head-to-head randomised controlled trials are needed.
Systematic review and meta-analysis.
PubMed, Cochrane Library for published studies and ClinicalTrials.gov for \'grey\' researches were independently investigated for randomised controlled trials up to November 2022.
The intervention was probiotics-containing product, either probiotics or synbiotics, while the control was placebo. The risk of bias was conducted. The efficacy in bowel movement was indicated by stool frequency, stool consistency and Patient Assessment of Constipation Symptom (PAC-SYM), while the change of gut microbiota was reviewed through α diversity, β diversity, change/difference in relative abundance and so on. The subgroup analysis, sensitivity analysis and random-effect meta-regression were conducted to explore the heterogeneity. The Grading of Recommendations Assessment Development and Evaluation was conducted to grade the quality of evidence.
17 studies, comprising 1256 participants, were included with perfect agreements between two researchers (kappa statistic=0.797). Compared with placebo, probiotics-containing products significantly increased the stool frequency (weighted mean difference, WMD 0.93, 95% CI 0.47 to 1.40, p=0.000, I²=84.5%, \'low\'), improved the stool consistency (WMD 0.38, 95% CI 0.05 to 0.70, p=0.023, I²=81.6%, \'very low\') and reduced the PAC-SYM (WMD -0.28, 95% CI: -0.45 to -0.11, p=0.001, I²=55.7%, \'very low\'). In subgroup analysis, synbiotics was superior to probiotics to increase stool frequency. Probiotics-containing products might not affect α or β diversity, but would increase the relative abundance of specific strain.
Probiotics-containing products, significantly increased stool frequency, improved stool consistency, and alleviated functional constipation symptoms. They increased the relative abundance of specific strain. More high-quality head-to-head randomised controlled trials are needed.
摘要：
目的：本研究旨在综合应用含益生菌产品治疗成人功能性便秘患者的肠道功能及肠道菌群的变化。
方法：系统评价和荟萃分析。
方法：PubMed，截至2022年11月，已发表研究的Cochrane图书馆和用于“灰色”研究的ClinicalTrials.gov进行了随机对照试验的独立调查。
■干预措施是含有益生菌的产品，益生菌或合生元，而对照组是安慰剂。进行了偏倚的风险。排便的疗效以大便频率表示，大便稠度和患者便秘症状评估（PAC-SYM），虽然通过α多样性审查了肠道微生物群的变化，β多样性，相对丰度的变化/差异等。亚组分析，采用敏感性分析和随机效应meta回归分析异质性。进行了建议评估开发和评估的分级，以对证据质量进行分级。
结果：17项研究，由1256名参与者组成，包括两名研究人员之间的完美协议(kappa统计量=0.797)。与安慰剂相比，含益生菌的产品显着增加粪便频率(加权平均差，大规模杀伤性武器0.93，95%CI0.47至1.40，p=0.000，I²=84.5%，\'低\'),改善粪便稠度(WMD0.38，95%CI0.05至0.70，p=0.023，I²=81.6%，\'非常低\'）并降低了PAC-SYM（WMD-0.28，95％CI：-0.45至-0.11，p=0.001，I²=55.7％，\'非常低\')。在亚组分析中，合生元在增加粪便频率方面优于益生菌。含益生菌的产品可能不会影响α或β多样性，但会增加特定菌株的相对丰度。
结论：含益生菌的产品，大便频率显著增加，改善大便稠度，并缓解功能性便秘症状。它们增加了特定菌株的相对丰度。需要更多高质量的头对头随机对照试验。
方法：系统评价和荟萃分析。
方法：PubMed，截至2022年11月，已发表研究的Cochrane图书馆和用于“灰色”研究的ClinicalTrials.gov进行了随机对照试验的独立调查。
■干预措施是含有益生菌的产品，益生菌或合生元，而对照组是安慰剂。进行了偏倚的风险。排便的疗效以大便频率表示，大便稠度和患者便秘症状评估（PAC-SYM），虽然通过α多样性审查了肠道微生物群的变化，β多样性，相对丰度的变化/差异等。亚组分析，采用敏感性分析和随机效应meta回归分析异质性。进行了建议评估开发和评估的分级，以对证据质量进行分级。
结果：17项研究，由1256名参与者组成，包括两名研究人员之间的完美协议(kappa统计量=0.797)。与安慰剂相比，含益生菌的产品显着增加粪便频率(加权平均差，大规模杀伤性武器0.93，95%CI0.47至1.40，p=0.000，I²=84.5%，\'低\'),改善粪便稠度(WMD0.38，95%CI0.05至0.70，p=0.023，I²=81.6%，\'非常低\'）并降低了PAC-SYM（WMD-0.28，95％CI：-0.45至-0.11，p=0.001，I²=55.7％，\'非常低\')。在亚组分析中，合生元在增加粪便频率方面优于益生菌。含益生菌的产品可能不会影响α或β多样性，但会增加特定菌株的相对丰度。
结论：含益生菌的产品，大便频率显著增加，改善大便稠度，并缓解功能性便秘症状。它们增加了特定菌株的相对丰度。需要更多高质量的头对头随机对照试验。
