PDF(Pubmed)
Abstract：
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder with gut microbiota imbalance playing a significant role. There are increasing numbers of research studies exploring treatment options involving probiotics, prebiotics, synbiotics, and fecal microbiota transplantation (FMT), but it is still uncertain which treatment option is superior. The research was conducted on various databases and unpublished trial data (up to February 2023). Randomized controlled trials (RCTs) were screened for adult patients with IBS comparing interventions with placebo. Probiotics, prebiotics, synbiotics, and FMT were assessed for their impact using mean difference and Bayesian network meta-analysis. Out of 6528 articles, 54 were included for probiotics, 7 for prebiotics/synbiotics, and 6 for FMT. Probiotics showed improvement in IBS symptoms, particularly with Bifidobacterium and Lactobacillus strains. Prebiotics and synbiotics did not show significant improvement. Network meta-analysis indicated the favorable effects of probiotics (OR = 0.53, 95% CI, 0.48 to 0.59) and FMT (OR = 0.46, 95% CI, 0.33 to 0.64) on IBS, with no serious adverse events reported. In short, probiotics and FMT are effective for managing IBS, with Bifidobacterium and Lactobacillus being dominant strains. However, the most effective probiotic combination or strain remains unclear, while prebiotics and synbiotics did not show significant improvement.
摘要：
肠易激综合征（IBS）是一种常见的胃肠道疾病，肠道菌群失衡在其中起着重要作用。越来越多的研究探索涉及益生菌的治疗方案，益生元,合生元,和粪便微生物移植（FMT），但仍不确定哪种治疗方案更优。这项研究是在各种数据库和未发表的试验数据上进行的（截至2023年2月）。对IBS成年患者进行随机对照试验（RCT）筛选，比较干预措施与安慰剂。益生菌,益生元,合生元,使用均差和贝叶斯网络荟萃分析评估FMT和FMT的影响。在6528篇文章中，益生菌包括54个，7为益生元/合生元，FMT为6。益生菌显示改善IBS症状，特别是双歧杆菌和乳杆菌菌株。益生元和合生元没有显示出显著的改善。网络荟萃分析表明益生菌（OR=0.53，95％CI，0.48至0.59）和FMT（OR=0.46，95％CI，0.33至0.64）对IBS的有利作用，未报告严重不良事件。总之,益生菌和FMT对管理IBS有效，双歧杆菌和乳杆菌是优势菌株。然而,最有效的益生菌组合或菌株仍不清楚，而益生元和合生元没有显着改善。
