| Objective:Probiotics have been proved to have therapeutic effects on a number of immunerelated or allergic diseases.In recent years,probiotics have also been studied as adjuvant therapy for allergic rhinitis(AR),but its effect is not clear.The purpose of the present meta-analysis is to systematically analyze the relevant research data at home and abroad,evaluate the impact of probiotics on AR,and provide basis for whether probiotics are conducive to the treatment of AR.Methods:Randomized controlled trials(RCTs)using probiotics as an intervention for AR were collected by searching electronic databases in English and Chinese,and the literature was screened piece by piece according to the established inclusion and exclusion criteria.Weighted Mean Difference(WMD)or Standardized Mean Difference(SMD)with 95% Confidence Interval(CI)were used to express the measures.Probiotics were systematically evaluated for their effects on the Rhinitis Quality of Life Questionnaire(RQLQ score),Rhinitis Total Symptom Scores(RTSS),Nasal or Eye Symptom Scores(NSS or ESS),and serum total Ig E,antigen-specific Ig E,eosinophil count and cytokines(IL-13,IL-4,IFN-γ,and Th1/Th1).Score(NSS or ESS)and the effects of total serum Ig E,antigen-specific Ig E,eosinophil count and cytokines(IL-13,IL-4,IFN-γ and Th1/Th2 ratio).Results:A total of 18 randomized controlled studies(RCTs)including 1720 patients with AR were included,including 886 in the probiotic treatment group and 834 in the placebo treatment group.Seventeen of these articles found that treatment with probiotics led to a significant improvement in at least one of the study outcomes compared to the placebo group.Meta-analysis showed that: overall RQLQ score [MD=-9.85,95% CI(-12.41,-7.29),P<0.00001],nasal RQLQ score [MD=-1.47,95% CI(-2.48,-0.46),P=0.004],eye RQLQ score [MD=-1.17,95% CI(-1.77,-0.56),P=0.0002],TSS [SMD=-1.54,95% CI(-2.99,-0.09,P= 0.04)],eosinophil count [SMD=-0.27,95% CI(-0.50,-0.03),P=0.03]and IFN-γ [SMD= 0.42,95% CI(-0.21,0.63),P<0.0001] were significantly improved compared with the placebo group,with statistically significant differences(P<0.05);However,the NSS [SMD=-0.84,95% CI(-1.89,0.21),P=0.12] and ESS [SMD=-1.42,95% CI(-2.85,0.01),P=0.05] were no statistically significant difference between the probiotic group and the placebo group,but there were a trend of improvement in symptoms.Total serum Ig E and antigen-specific Ig E were not statistically different in the probiotic group compared to the placebo group.Conclusion:Probiotics may help to improve the total symptoms of rhinitis and improve the quality of life and change some immunological indicators in AR patients,but due to the heterogeneity of studies,current research evidence is still limited,and more high-quality studies with the same study design and uniform outcome measures,reducing the heterogeneity of studies,are needed to better evaluate the effects of probiotics on AR treatment. |
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