Clinical effect of probiotics in treatment of liver cirrhosis: a Meta-analysis

Objective To investigate the clinical effect of probiotics in the treatment of liver cirrhosis through a systematic review. Methods PubMed, Embase, Cochrane Library, Chinese Scientific Journal Full-Text Database, VIP, and Wanfang Data were searched for randomized controlled trials ( RCTs) of probiotics for the treatment of liver cirrhosis. Rev Man 5. 3 software was used for the meta-analysis of the articles screened out. Rate difference ( RD) and its 95% confidence interval ( 95% CI) were used as effect size indicators for binary variables; weighted mean difference ( WMD) was used for evaluating continuous variables with the same unit, and standardized mean difference ( SMD) and its 95% CI were used for evaluating continuous variables with different units. Funnel plots were used to analyze publication bias.Results A total of 15 RCTs which met the inclusion criteria were included, and there were 1411 patients with liver cirrhosis in total ( 726 in treatment group and 685 in control group) . Compared with the control group, the treatment group had significant improvements in overall response rate ( RD = 0. 28, 95% CI: 0. 22-0. 34, P < 0. 001) and biochemical parameters for liver function including alanine aminotransferase ( SMD =-0. 90, 95% CI:-1. 14 to-0. 66, P < 0. 001) , total bilirubin ( WMD =-15. 99, 95% CI:-26. 42 to-5. 57, P <0. 001) , albumin ( SMD = 0. 66, 95% CI: 0. 40-0. 93, P < 0. 001) , endotoxin ( SMD =-1. 13, 95% CI:-2. 11 to-0. 15, P <0. 001) , and blood ammonia ( WMD =-15. 86, 95% CI:-21. 54 to-10. 18, P < 0. 001) . Conclusion Probiotics can significantly improve liver function in patients with liver cirrhosis, effectively inhibit the progression of liver cirrhosis, reduce the risk of complications including hepatic encephalopathy, and increase overall response rate and have good tolerability.