| Objective:The meta-analysis method was used to comprehensively and systematically evaluate the clinical efficacy of microecological preparations in the treatment of patients with chronic obstructive pulmonary disease(COPD).The aim was to provide reference and theoretical basis for clinical treatment and medication for patients with COPD in the future.Methods:All randomized controlled trials on the clinical efficacy of microecological preparations for chronic obstructive pulmonary disease were identified by searching PubMed,Medline Database,Embase Database,The Cochrane Library,Google academic(Google),WanFang academic journal full-text database,China biomedical literature database(CBM),Chinese sci-tech journal database(WeiPu)and China journal full-text database(CNKI)were searched from January 2008 to December 2018.Strict inclusion and exclusion criteria were established to screen the retrieved literature,and manual retrieval was conducted for the references of the included.The Cochrane systematic method was used for quality evaluation of the included studies,and Stata12.0 software was used for Meta-analysis of the included studies.Results: 16 randomized controlled clinical studies were included,with a total of 1262 patients with COPD.The treatment group was treated with micro-ecological preparations such as probiotics on the basis of conventional treatment in the control group.Meta-analysis of these 16 studies showed that compared with conventional therapy,microecological preparations in patients with COPD significantly reduced white blood cell counts(SMD=-1.11,95%CI:[-1.82,-0.40],z=3.05,P=0.002)、percentage of neutrophils(SMD=--0.84,95%CI:[-1.32,-0.36],z=3.41,P=0.001),incidence of diarrhea(OR=0.43,95%CI:[0.21,0.90],z=2.25,P=0.024)、the incidence of intestinal flora disorder(fecal rod ratio)(OR=0.40,95%CI:[0.29,0.56],z=5.39,P<0.001);However,the use of microecological preparations improved the patient’s mMRC dyspnea score(SMD=-0.09,95%CI:[-0.57,0.39],z=0.37,P=0.710),CRP(SMD=-0.15,95%CI:[-2.02,1.72],z=0.15,P=0.878),APACHE II(SMD=-0.56,95%CI:[-1.27,0.16],z=1.53,P=0.126),FEV1/FVC(SMD=0.24,95%CI:[-0.35,0.84],z=0.81,P=0.418)has no Significant meaning.Conclusion: The application of microecological preparations may effectively reduce the white blood cell count and the percentage of neutrophils in patients with COPD,and may also reduce the incidence of diarrhea and the incidence of intestinal flora disorder to some extent,and anti-infective for COPD patients.Prevention of diarrhea and intestinal flora disorders have certain clinical significance.However,whether microbial preparation can improve the patient’s breathing difficulties,APACHE II has no exact basis.At the same time,there is no clear unified plan for the optimal time,dose and treatment course of the application of microecologics in clinical practice,and it is still necessary to further carry out a large sample size of the relevant randomized controlled trial to explore. |
PDF Full Text Request