系统评价和荟萃分析:治疗小肠细菌过度生长的中草药

2021-10-19 August MedSci原创

小肠细菌过度生长 (SIBO) 是一种异质性综合征,其特征是小肠中细菌数量增加和/或异常类型,它是消化不良和吸收不良的公认原因。

小肠细菌过度生长 (SIBO) 是一种异质性综合征,其特征是小肠中细菌数量增加和/或异常类型,它是消化不良和吸收不良的公认原因。SIBO 被定义为结肠近端肠道细菌的过度生长,可导致多种临床表现,从完全无症状到吸收不良、脂肪泻和严重感染病例的体重减轻。

几十年来,SIBO 一直被认为是一种医学现象。发生 SIBO 的危险因素包括解剖异常、胃酸过少、运动障碍、器官系统功能障碍、年龄、药物和先前存在的疾病,如肠易激综合征、乳糜泻和非酒精性脂肪性肝炎。小肠培养被广泛认为是确立SIBO诊断的“最佳诊断方法”;推荐 ≥103 cfu/mL 的阈值作为 SIBO 的阳性测试结果,尤其是在进行十二指肠穿刺和培养时,因为在这种酸性环境中细菌计数非常低。呼气测试是一种安全且无创的 SIBO 诊断方法。然而,目前没有用于呼气测试的标准方法。抗生素的使用一直是治疗SIBO的基石。

自 1990 年代后期以来,SIBO 研究重新兴起,随着对肠道微生物组及其在人类健康和疾病中作用的认识不断增加,SIBO 研究得到进一步加强。其中包括一系列将 SIBO 与肠易激综合征、炎症性肠病、系统性硬化症、运动障碍、肝硬化、脂肪肝、胃切除术后综合征和各种其他疾病联系起来的文章。此外,SIBO 的治疗主要是经验性的

中医有独特的理论,中草药治疗是建立在中医系统的整体观念和辨证论治基础之上的。尽管抗生素仍然是 SIBO 治疗的中流砥柱,但也有各种替代或辅助疗法可用,包括促动力剂、饮食干预、益生菌和草药组合。越来越多的证据证明了越来越多的草药具有抗菌特性,包括大蒜、黑孜然、丁香、肉桂、百里香、全香料、月桂叶、芥末和迷迭香。这促使人们对用于治疗 SIBO 的草药疗法产生兴趣。目前还没有系统评价 CHM 治疗 SIBO 合并 PCOS 的疗效,因此该荟萃分析旨在对其进行综合探讨。同时,将提供高质量的证据,帮助患者、临床医生以及卫生决策者选择更好的 PCOS 治疗策略。

方法是将在不受日期、语言或出版状态限制的情况下搜索以下来源:PubMed、Web of Science、Cochrane 对照试验中央注册中心 (CENTRAL) Cochrane 图书馆、EMBASE 和中国国家知识基础设施。将结合医学主题词 (MeSH) 和自由文本术语,结合数据库特定的受控词汇和文本词来实施搜索策略。还将搜索在世界卫生组织国际临床试验注册平台中注册的正在进行的试验。此外,还将检索以前在 CHM 上对 SIBO 进行的相关审查和纳入研究的参考文献列表。结果:研究将为中西医治疗SIBO提供可靠依据。

综上所述,小肠细菌过度生长是一种以吸收不良综合征为特征的临床病症,因为微生物增加到超过105细菌/毫升空肠液的水平。抗生素治疗是SIBO治疗的基石。近年来有报道称,中草药对小肠细菌的过度生长有一定的治疗作用。尽管有几个问题需要理解,但 CHM 一直是 SIBO 的一种创新方法。此系统评价将探讨中草药治疗 SIBO 的有效性和安全性。希望这项研究可以为中医药治疗SIBO提供依据,并可能为此类患者提供更好的治疗选择。

原文:Ren X, Di Z, Zhang Z, et al. Chinese herbal medicine for the treatment of small intestinal bacterial overgrowth (SIBO): A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2020;99(51):e23737. doi:10.1097/MD.0000000000023737

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    2021-10-21 huagfeg

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