罗伊氏粘液乳杆菌 DSM 17938 治疗儿童急性胃肠炎的有效性和安全性：随机对照试验的系统综述和荟萃分析。
完整摘要 · 中文译文
引言：急性胃肠炎（AGE）仍然是全球儿科人群的主要临床关注问题。本系统综述和荟萃分析旨在评估罗伊氏粘液乳杆菌 DSM 17938 治疗儿童急性胃肠炎的有效性和安全性，以腹泻持续时间作为主要结局。 方法：在 MEDLINE（通过 PubMed）、Embase、Scopus 和 Science Citation Index Expanded 中进行了从建库至 2026 年 4 月 1 日的全面文献检索。两名独立评价者使用 Cochrane RoB 2 工具进行研究选择、数据提取和偏倚风险评估。随机效应模型合并均数差（MD）和风险比（RR），并通过 GRADE 方法评价证据确定性。 结果：六项随机对照试验共纳入 565 名随机化儿童（527 名纳入主要结局分析）符合纳入标准。罗伊氏粘液乳杆菌 DSM 17938 显著缩短腹泻持续时间，均数差为 0.68 天（95% CI：-1.09 至 -0.27）。此外，益生菌组在 48 小时（RR 0.45，95% CI 0.29 至 0.69）和 72 小时（RR 0.41，95% CI 0.23 至 0.72）时腹泻持续率显著更低。各试验均未报告严重不良事件或与治疗相关的不良事件。由于高异质性和偏倚风险问题，腹泻持续时间的证据确定性被评为极低，48-72 小时持续率的证据确定性被评为低。 讨论：罗伊氏粘液乳杆菌 DSM 17938 对腹泻持续时间产生适度缩短 腹泻，并且在48-72小时时持续缓解率大幅下降，同时伴有良好的安全性特征。然而，由于关于主要结局的证据确定性极低，在临床实践中应谨慎解读这些发现。 系统综述注册：https://www.crd.york.ac.uk/PROSPERO/view/CRD420261449562，PROSPERO CRD420261449562。
完整摘要 · 英文原文
INTRODUCTION: Acute gastroenteritis (AGE) remains a major global clinical concern in pediatric populations. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of Limosilactobacillus reuteri DSM 17938 for the treatment of acute gastroenteritis in children, with the duration of diarrhea as the primary outcome. METHODS: A comprehensive literature search was conducted across MEDLINE (via PubMed), Embase, Scopus, and the Science Citation Index Expanded from inception to April 1, 2026. Two independent reviewers performed study selection, data extraction, and risk of bias assessment using the Cochrane RoB 2 tool. Random-effects models pooled mean differences (MD) and risk ratios (RR), and the certainty of the evidence was appraised via the GRADE approach. RESULTS: Six randomized controlled trials involving 565 randomized children (527 analyzed for the primary outcome) met the inclusion criteria. Limosilactobacillus reuteri DSM 17938 significantly reduced the duration of diarrhea by a mean difference of 0.68 days (95% CI: -1.09 to -0.27). Furthermore, the persistence of diarrhea was significantly lower in the probiotic group at 48 hours (RR 0.45, 95% CI 0.29 to 0.69) and 72 hours (RR 0.41, 95% CI 0.23 to 0.72). No serious or treatment-related adverse events were reported across the trials. The certainty of the evidence was rated as very low for diarrhea duration and low for persistence at 48-72 hours due to high heterogeneity and risk of bias concerns. DISCUSSION: Limosilactobacillus reuteri DSM 17938 produces a modest reduction in the duration of diarrhea and a substantial decrease in persistence at 48-72 hours, accompanied by a favorable safety profile. However, due to the very low certainty of the evidence regarding the primary outcome, these findings should be interpreted with caution in clinical practice. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261449562, PROSPERO CRD420261449562.