| Objective: Allergic rhinitis(AR)is a kind of disease of respiratory allergy,now some studies have shown that probiotics can provide a potential strategy for its management,and the corresponding randomized controlled trials(RCT)increased year by year.This study comprehensively and objectively collected and analyzed the related literatures published at home and abroad,and laid a foundation for the probiotics use of AR patients.Methods: According to the purpose of our study,we set out the inclusion and exclusion criteria according as the Cochrane Handbook system evaluation method,including the design of experiment(whether experiment registered or not,whether past the ethical approval,was a randomized double-blind controlled trials or not)and details of the item,the integrated retrieval was performed with keywords and Subject terms combined free word according to the different features of database.With the use of the internet,we systematically searched PubMed,the Cochrane Central Register of Controlled Trials(CENTRAL),EMBASE and so on,all relevant articles searched up to Mar.2014.Two authors independently screened the title and abstract of articles,according to the exclusion criteria,and excluded literatures,duplicate documents which did not accord with standard of this study,and screened out the document of randomized double-blind controlled clinical trials related to our study as much as possible.Then we selected the appropriate literatures according to the inclusion criteria under reading the full text.In the process,if the literature information was incomplete,we would contact the author as soon as possible to get complete information,then make a decision whether accepted the literature or not.Finally we merged all the articles,and any disagreement was resolved through discussion.Meta-analyses were performed with RevMan 5.2.7 software.Continuous data were expressed as the weighted mean difference(WMD)or standardised mean difference(SMD)with the 95% confidence interval(CI),Dichotomous data were expressed as odds ratios(OR).A P value <0.05 was considered significant.Results: A total of 11 RCTs were included in the analysis,all randomized,double-blind controlled trials.Five trials studied the preventive role of probiotics in AR.A total of 1,527 mothers and children were enrolled,including 758 in the probiotics group and 769 in the control group.Six trials studied the role of probiotics in the treatment of AR,which included 306 AR patients,173 of whom participated in probiotics groups and 133 in control groups.The outcome of the meta-analysis shown: 1.The role of probiotics in prevention for AR patients: no difference between the probiotic and placebo groups [OR=1.07,95%CI(0.81,1.42),P=0.64].2.Probiotics improve nasal symptoms(NSS)and quality of life(QOL)for AR patients: There was no significant change in frequency and level of bother in NSS[MD=-0.96,95%CI(-3.78,1.86),P=0.51] and [MD=-1.11,95%CI(-3.38,1.17),P=0.34,respectively] or in QOL [MD=-5.60,95%CI(-16.92,5.72),P=0.33] and [MD=-4.40,95%CI(-9.84,1.04)P=0.11,respectively].After integrating the NSS and QOL,the total outcome showed that probiotics can relieve overall symptoms of AR patients [MD=-2.97,95%CI(-4.77,1.16),P=0.001].3.The effect of probiotics on immunological indexes of AR patients: The data on eosinophil rates showed no significant difference [SMD=-0.39,95%CI(-0.95,0.17),P=0.18].Similarly,no significant difference was found for specific immuoglobulin-E(IgE)[SMD=0.10,95%CI(-0.29,0.49),P=0.62],inteflukin-10[(IL-10)SMD=0.43,95%CI(-0.05,0.90),P=0.08],interferon-γ(IFN-γ)[SMD=0.15,95%CI(-0.32,0.62),P=0.53]and the Th1/Th2 ratio[SMD=0.39,95%CI(-0.05,0.83),P=0.08],and the total outcome was also negative [SMD=0.10,95% CI(-0.13,0.32),P=0.40].Conclusion: 1.Probiotics has no effect on the prevention of AR.2.For AR patients,probiotics does not change their NSS or QOL,but it can relieve their overall symptoms.3.Probiotics does not influence the immunologic indices of AR patients.4.The conclusion of our study drawn from several trials with a high degree of heterogeneity,and it has certain limitations,so we need more high quality clinical trials to verify the therapeutic role of probiotics for AR. |
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