目的 系統(tǒng)評價益生菌制劑防治兒童反復(fù)呼吸道感染（RRTIs）的有效性和安全性，為臨床提供循證參考。方法計算機(jī)檢索PubMed、EMBase、Cochrane圖書館、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫（CBM）、中國學(xué)術(shù)期刊全文數(shù)據(jù)庫（CNKI）、維普中文期刊全文數(shù)據(jù)庫（VIP）和萬方數(shù)據(jù)庫，收集益生菌制劑（試驗組）防治兒童RRTIs的隨機(jī)對照試驗（RCT），檢索時限均為建庫起至2019年3月。提取資料，用Rev Man 5.3軟件進(jìn)行Meta-分析。結(jié)果 共納入12項研究，878例患者。Meta-分析結(jié)果顯示，試驗組在總有效率［RR=1.31，95%CI（1.22，1.41），P<0.001］、抗菌藥用藥時間［MD=-4.42，95%CI（-5.92，-2.91），P<0.001］、年呼吸道感染次數(shù)［MD=-2.30，95%CI（-2.70，-1.89），P<0.001］、臨床體征改善時間均優(yōu)于對照組（P<0.05）；免疫球蛋白IgG ［MD=1.80，95%CI （1.60，2.01），P<0.001］、IgA ［MD=0.37，95%CI（0.23，0.51），P<0.001］、IgM［MD=0.06，95%CI（0.02，0.09），P=0.002］，T淋巴細(xì)胞亞群CD3+［MD=4.48，95%CI（1.48，7.49），P=0.03］、CD4⁺［MD=3.17，95%CI（1.01，5.55），P=0.009］和CD8⁺［MD=-4.44，95%CI（-6.52，-2.36），P<0.05］改善情況均顯著優(yōu)于對照組，差異均有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 益生菌可有效治療兒童反復(fù)呼吸道感染，安全性較好。但由于納入研究數(shù)量少，研究質(zhì)量不統(tǒng)一，尚需要大樣本、高質(zhì)量的臨床隨機(jī)對照研究予以證實(shí)。

Objective To evaluate the efficacy and safety of probiotics for recurrent respiratory tract infections (RRTIs) of children, and to provide evidence-based reference for clinic. Methods Retrieved from PubMed, EMBase, Cochrane Library, CBM, CNKI, Wanfang database and VIP database, randomized controlled trials (RCTs) about probiotics (trail group) vs. non-probiotics (control group) for RRTIs of children were collected during database establishment to January 2018. After literature scanning and data extraction, the risk of bias of included trials were evaluated by using Cochrane 5.1.0 risk bias evaluation tool. Meta-analysis was performed by using Rev Man 5.3 software. Results A total of 12 RCTs involving 878 children were included. The results showed that the trial group was superior to control group in total response rate [RR=1.31, 95%CI(1.22, 1.41), P < 0.001], the time of antibiotics use [MD=-4.42, 95%CI(-5.92, -2.91), P < 0.001], respiratory infections per year [MD=-2.30, 95%CI(-2.70, -1.89), P < 0.001], clinical symptom improvement time; improvement of IgG [MD=1.80, 95%CI(1.60, 2.01), P < 0.001], Ig A [MD=0.37, 95%CI(0.23, 0.51), P < 0.001], IgM [MD=0.06, 95%CI(0.02, 0.09), P=0.002]; T lymphocyte subset of CD3+ [MD=4.48, 95%CI (1.48, 7.49), P=0.03], CD4⁺ [MD=3.17, 95%CI(1.01, 5.55), P=0.009] and CD8⁺[MD=-4.44, 95%CI(-6.52, -2.36), P < 0.001] than that of in control group, the difference were statistically significant (P < 0.05). Conclusions The current evidence shows that probiotics can reduce the frequencv of recurrent respiratory infection with safety. However, due to the number and quality of included studies, more large-scale and high-quality RCTs are needed.

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