摘要目的 评价国内柳氮磺吡啶联合益生菌治疗炎症性肠病的临床效果.方法 通过检索中国期刊全文数据库(CNKI)、中国维普全文数据库、PubMed等中英文数据库,收集国内应用柳氮磺吡啶联合益生菌制剂的病例为研究对象,以单独应用柳氮磺吡啶或柳氮磺吡啶联合甲硝唑治疗炎症性肠病的病例做对照.筛选随机对照试验,结果用比值比(OR)及95％置信区间(CI)表示.评估指标为有效缓解率.按照纳入与排除标准选择文献、提取资料,并对纳入研究的方法学进行质量评估,采用RevMan 5.3软件进行Meta分析.结果 纳入26项研究,共2 403例患者.其中13项研究柳氮磺吡啶联合益生菌组治疗炎症性肠病缓解率与单用柳氮磺吡啶组的比较,异质性检验x2=10.29,自由度(df)=12,I2=0％,P＜0.05,固定效应模型OR=3.70,95％ CI(2.62 ～5.21),提示联合用药优于单药治疗;10项研究柳氮磺吡啶联合益生菌组治疗溃疡性结肠炎缓解率与单用柳氮磺吡啶组的比较,异质性检验x2=2.59,df=9,I2=0％,P＜0.05,固定效应模型OR=3.84,95％ CI(2.52 ～5.86),提示联合用药优于单药治疗;有3项研究柳氮磺吡啶联合益生菌组治疗溃疡性结肠炎伴感染缓解率与柳氮磺吡啶联合甲硝唑组的比较,异质性检验x2 =0.07,df=2,I2=0％,P＜0.05,固定效应模型OR=4.77,95％ CI(2.27～ 10.02),提示柳氮磺吡啶联合益生菌联合用药优于柳氮磺吡啶联合甲硝唑.结论 柳氮磺吡啶联合益生菌治疗炎症性肠病能够提高有效缓解率.

abstractsObjective To evaluate the clinical efficacy of domestic sulfasalazine (SASP) combined with probiotics on the treatment of inflammatory bowel disease (IBD).Methods According to the search of Chinese periodical full-text database,PubMed and other Chinese databases as well as English databases,the cases of IBD treated with SASP combined with probiotics or metronidazole in China were collected and screened for randomized controlled trials (RCT).The results between combined group and control group were compared using odds ratio (OR) and 95％ Confidence Interval (CI) indicates.The evaluation indicator was the remission rate.According to the inclusion and exclusion criteria,the literature was selected,and data was extracted.Quality assessment of the included methodologies was performed,and RevMan 5.3 software was used for meta-analysis.Results 26 studies including a total of 2 403 patients were adopted in the present study.Among them,13 studies suggested that the remission rate of IBD in SASP combined with probiotics group was significantly improved compared with that in the SASP group alone (x2 =10.29,df =12,I2 =0％,P ＜0.05,the effect model OR =3.70,95％ CI as 2.62-5.21),demonstrating that the combined treatment was superior to monotherapy in IBD.10 studies suggested that the remission rate of ulcerative colitis (UC) in SASP combined with probiotics group was significantly improved compared with that in the SASP group alone (x2 =2.59,df =9,I2 =0％,P ＜ 0.05,the effect model OR =3.84,95％ CI as 2.52 -5.86),demonstrating that the combined treatment was superior in UC.The other 3 studies showed that the remission rate of UC with infection in SASP combined with probiotics group was significantly improved compared with that in SASP combined with metronidazole group (x2 =0.07,df =2,I2 =0％,P ＜ 0.05,the effect model x2 =4.77,95％ CI as 2.27-10.02),demonstrating that treatment of SASP combined with probiotics was superior in UC with infection.Conclusions SASP combined with probiotics can improve the effective response rate in the treatment of IBD.