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Probiotic monotherapy and Helicobacter pylori eradication: A systematic review with pooled-data analysis

查看全文 作　　者：Giuseppe [1]Losurdo;Rossella [1]Cubisino;Michele [1]Barone;Mariabeatrice [1]Principi;Gioacchino [2]Leandro;Enzo [1]Ierardi;Alfredo Di [1]Leo 高影响力作者 机构地区：[1]Section of Gastroenterology, Department of Emergency and Organ Transplantation,University 'Aldo Moro',Piazza Giulio Cesare;[2]National Institute of Gastroenterology,'S De Bellis' Research Hospital高影响力机构 出　　处：《World Journal of Gastroenterology》索引2018年第24卷第1期,共11页高影响力期刊 摘　　要：AIM To define probiotic monotherapy effect on Helicobacter pylori(H. pylori) status by performing a systematic review.METHODS Methods of analysis and inclusion criteria were based on PRISMA recommendations. Relevant publications were identified by searching Pub Med, MEDLINE, Science Direct, and EMBASE. The end-point was to estimate eradication rate and urea breath test delta value before and after probiotic monotherapy across all studies and, overall, with a pooled data analysis. Adverse events of probiotic therapy were evaluated. The data were expressed as proportions/percentages, and 95%CIs were calculated. For continuous variables, we evaluated the weighted mean difference. Odd ratios(ORs) were calculated according to the Peto method for the comparison of eradication rates between probiotics and placebo.RESULTS Eleven studies were selected. Probiotics eradicated H. pylori in 50 out of 403 cases. The mean weighted eradication rate was 14%(95%CI: 2%-25%, P =0.02). Lactobacilli eradicated the bacterium in 30 out of 235 patients, with a mean weighted rate of 16%(95%CI: 1%-31%). Saccharomyces boulardii achieved eradication in 6 out of 63 patients, with a pooled eradication rate of 12%(95%CI: 0%-29%). Multistrain combinations were effective in 14 out of 105 patients, with a pooled eradication rate of 14%(95%CI: 0%-43%). In the comparison of probiotics vs placebo, we found an OR of 7.91 in favor of probiotics(95%CI: 2.97-21.05, P < 0.001). Probiotics induced a mean reduction in delta values higher than placebo(8.61% with a 95%CI: 5.88-11.34, vs 0.19% for placebo, P < 0.001). Finally, no significant difference in adverse events was found between probiotics and placebo(OR = 1, 95%CI: 0.06-18.08).CONCLUSION Probiotics alone show a minimal effect on H. pylori clearance, thus suggesting a likely direct role. 关 键 词：HELICOBACTER PYLORI PROBIOTICS ERADICATION meta-analysis BREATH test
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