Meta Analysis Of Probiotics In Prevention And Treatment For Atopic Dermatitis

Background:Atopic dermatitis?AD?is the most common chronic inflammatory skin disease among children.Itching and recurrent eczema like lesions are its characteristics.At present,the incidence of AD in the world has increased significantly,which has become a heavy burden for families,society and even the country.Since AD is repeated and itchy,and long-term use of drugs can lead to side effects,so we need to find prevention and safe,new treatments.It is reported that there are intestinal flora abnormalities in AD patients.Some clinical trials use probiotics to interfere with AD patients,and find that they play a positive role in the prevention and treatment of AD.However,the prevention and cure effect of probiotics on AD is still controversial.Objective:In this study,randomized controlled trials?RCT?of probiotic in prevention and treatment for atopic dermatitis in children were collected in a comprehensive and objective way,and the preventive and therapeutic effects of probiotics on AD in children were analyzed and the basis for clinical application was provided.Methods:According to the purpose of our study,we set out the inclusion criteria,exclusion criteria and retrieval strategy.With the use of the internet,we systematically searched PubMed,the Cochrane Central Register of Controlled Trials?CENTRAL?,EMBASE.All relevant articles were searched up to February 2018.Through independent screening of titles,abstracts and full texts of the retrieved literatures,we screened the related double-blind RCTs.Finally,We extracted data from the included literatures.Meta-analyses were performed with Rev Man5.3 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:1.In the analysis of probiotic prophylaxis in AD,16 related literatures were included.Including 3826 pairs of mothers and infants,there were 1906 pairs in the probiotic group and 1918 pairs in the control group.11 related literatures were included in the analysis of probiotic treatment for AD in children.998 children with AD were enrolled,499children were in the probiotic group and 499 children in the control group.2.The results showed that in the probiotic prevention for AD there was a statistically significant difference between the probiotic group and the placebo group?OR=0.58,95%0.44-0.75,P<0.05?.Namely that probiotic had a preventive effect on AD in children.Both in pregnancy and postpartum were required to intervene,and use of lactobacillus only or single strain was more significant?P<0.00001,p<0.00001?.3.In the probiotic treatment for AD,the results showed that the probiotics group and the placebo group were statistically different[WMD=-5.60,95%?-9.26,-1.95?,P=0.003].And probiotic had a therapeutic effect on AD.Subgroup analysis indicated that older than 1 years of age or moderate to severe condition in children with AD,or the intervention of mixed strains was more significant.?P<0.00001,P=0.0003,p=0.006?.Conclusion:1.After meta analysis,we fond that probiotic can prevent AD in children.The intervention of Lactobacillus alone is significant and the effect is better if intervention in both pregnancy and postpartum.2.We also fond that probiotic can treat children with AD.The mixed bacteria are used for children more than 1 years old or children with moderate to severe condition,then the effect was more significant.3.Probiotic has effect on AD,using 10¹⁰ cfu/day or 10⁹ cfu/day doses of two orders of magnitude.4.Probiotic had less adverse reactions after intervention,and their safety was reliable.