目的:本研究旨在评估补充益生菌治疗帕金森病(PD)的临床疗效和安全性。
方法:我们搜索了中国国家知识基础设施(CNKI),维普(VIP)数据库,万方数据库,Sinomed(CBM),PubMed,Embase,Cochrane图书馆和WebofScience数据库,用于从开始到1月4日的合格研究,2024.比较益生菌补充剂和安慰剂对PD患者的影响的随机对照试验(RCTS)。Meta分析采用ReviewManager5.4软件进行。根据Cochrane偏倚风险工具进行质量评估。
结果:本研究共纳入11项RCTs,共756例PD患者。我们发现益生菌可以增加每周完全排便(CBMs)的数量,并改善便秘患者生活质量评估问卷(PAC-QOL)的评分(SMD=0.73,95%CI:0.54-0.92,P<0.00001,I2=45%;SMD=-0.79,95%CI:-1.19-0.39,P<0.001,I2=55%,分别)与安慰剂组相比。然而,两组在改善PD患者粪便性状和排便能力方面无显著差异(SMD=0.87,95%CI:0.01-1.74,P=0.05,I2=94%;SMD=1.24,95%CI:-1.58-4.06,P>0.05,I2=98%,分别)。在PD综合量表评分方面:治疗后,益生菌组与安慰剂组之间的运动障碍社会-统一-帕金森病评分Ⅲ(MDS-UPDRSⅢ)评分无显着性差异(SMD=-0.09,95%CI:-0.35-0.16,P>0.05,I2=0%)。
结论:结论:根据现有RCT研究的总体结果,我们的研究结果提示益生菌在改善PD患者便秘症状方面的潜在价值。因此,益生菌可能是PD相关便秘患者的辅助治疗之一。这项研究的结果提供了更多证据支持益生菌的有效性,鼓励在PD患者的临床实践中单独使用益生菌或与其他疗法联合使用。然而,需要具有大样本量的更精心设计的RCT。
OBJECTIVE: This study aimed to evaluate the clinical efficacy and safety of probiotics supplementation in the treatment of Parkinson\'s disease (PD).
METHODS: We searched China National Knowledge Infrastructure (CNKI), Weipu (VIP) database, Wanfang Database, Sinomed (CBM), PubMed, Embase, Cochrane library and Web of Science databases for eligible studies from inception to January 4th, 2024. Randomized controlled trials (RCTS) comparing the effects of probiotic supplements and placebo in patients with PD. Meta-analysis was conducted with the software
Review Manager 5.4. The quality assessment was performed according to Cochrane risk of bias tool.
RESULTS: A total of 11 RCTs with 756 PD patients were included in this study. We found that probiotics could increase the number of complete bowel movements (CBMs) per week and improved the scores of Patient Assessment of
Constipation Quality of Life Questionnaire (PAC-QOL) (SMD = 0.73, 95 % CI: 0.54 to 0.92, P < 0.00001, I2 = 45 %; SMD = - 0.79, 95 % CI: - 1.19 to - 0.39, P < 0.001, I2 = 55 %, respectively) compared with the placebo group. However, there was no significant difference between the two groups in improving fecal traits and defecation efforts in PD patients (SMD = 0.87, 95 % CI: 0.01 to 1.74, P = 0.05, I2 = 94 %; SMD = 1.24, 95 % CI: - 1.58 to 4.06, P > 0.05, I2 = 98 %, respectively). In terms of PD composite scale scores: after treatment, there was no significant difference in Movement Disorder Society-Unified-Parkinson Disease Rating Scale Ⅲ score (MDS-UPDRSⅢ) between the probiotic group and the placebo group (SMD = - 0.09, 95 % CI: - 0.35 to 0.16, P > 0.05, I2 = 0 %).
CONCLUSIONS: In conclusion, based on the overall results of the available RCTs studies, our results suggested the potential value of probiotics in improving
constipation symptoms in PD patients. Therefore, probiotics may be one of the adjuvant therapy for PD-related
constipation patients. The findings of this study provide more proof supporting the effectiveness of probiotics, encouraging probiotics to be utilized alone or in combination with other therapies in clinical practice for PD patients. However, more well-designed RCTs with large sample sizes are required.