A Meta-analysis For The Treatment Effect Of Probiotics On Induction Of Remission And Maintenance In Patients With Ulcerative Colitis

Objective:To evaluate the effect of probiotics in induction of remission and maintenance treatment in ulcerative colitis (UC).Methods:To search the clinical randomized controlled trails of probiotics in induction of remission and maintenance treatment in UC by computer. PUBMED, Elsevier-SDOL and ISI-SCIE were searched from 1954 to 2010 (up to March), Qing Hua Tong Fang Chinese Journals Full-text Database, Wei Pu Chinese dissertation Full-text Database and Wan Fang Digital Journal Full-text database were searched from 1980 to 2010 (up to March), the review literatures were secondary researched, Statistical analysis was performed by meta-analysis using Review Manager 4.2.10.Results:Fifteen randomized controlled trials met the inclusion criteria (three of the trails were included into the induction treatment group and the maintenance treatment group, so there are eighteen trails to be induded in the meta-analysis). There are eight trails to evaluation the remission rate of active UC, of which six trails were compared by complex probiotics with placebo on the basis of traditional medicine, and of which two trails were compared by probiotics with mesalazine. There are ten trails to evaluate the relapse rate of UC, of which three trails were compared by probiotics with placebo, and of which seven trails were compared by probiotics with mesalazine. Meta-analysis shows that:①On the basis of combining with conventional therapy, complex probiotics was superior to placebo in clinical remission rate (OR=0.39,95%CI:0.27-0.56,P＜0.00001).②No significant difference was observed between probiotics and masalazine (OR=1.43,95%CI:0.83-2.47, P=0.20).③In the maintenance treatment of UC, probiotics was lower than placebo in relapse incidence (OR=0.05,95%CI: 0.02-0.16, P<0.00001). and no significant difference was observed between probiotics and masalazine (OR=1.06,95%CI:0.77-1.46, P=0.74). Further subgroup analysis showed that no significant difference was observed between whether complex probiotics (OR=1.19,95%CI: 0.69-2.05, P=0.54) or single probiotics (OR=0.99,95%CI:0.67-1.48, P=0.9%) and masalazine.Conclusion:①In active of UC, complex probiotics can improve the clinical remission rate of patients combined with conventional therapy, no significant difference was observed between probiotics and masalazine.②In remission of UC, single probiotics or complex probiotics as the maintenance therapy results in the same effect as mesalazine and is superior to placebo.