What are the advantages and disadvantages of probiotics? How to choose probiotics scientifically? How to choose probiotics with diarrhea and constipation? What are the applications of probiotics in other pediatric diseases? Teacher Crayon Xiaoxin will analyze it in detail.
Author | Guangzhou Women and Children’s Medical Center Pediatric Crashi Shinchi
Source | Pediatric Channel in the Medical Community
Dialectical look at the advantages and disadvantages of probiotics
In “The serious adverse reactions caused by probiotics!” “Is the probiotics really good and harmless? 》 In the two articles, pediatric Crayon Shinchan emphasizes the bad reactions of probiotics. The purpose is to remind everyone that probiotics do not have any adverse reactions, to emphasize that there are two sides, and do not excessively abuse.
The literature quoted by the article is found in patients with damage to immune function or basic diseases. It is pointed out that probiotics are not suitable for all patients. When using special groups such as newborn and immune deficit Pay attention to. But at the same time, receiving a message from many readers, fear of probiotics, and denying the clinical value of probiotics, this view is obviously incorrect. In order to avoid confusion, we need to see what the guide says.
Scientific selection of probiotics can follow
At the beginning of 2017, the Pediatric Team of the Micro Ecology Branch of the Chinese Prevention Medicine Association released the “Guide to the Practical Practical Clinical Application Certificate of Practical Practical Practical Magazine” in the “Chinese Practical Pediatric Magazine”, and published a series of articles on the application of probiotics in different pediatric diseases. , Summarize here to readers.
According to the standards of the level of clinical evidence and recommendation opinions of the Micro Ecological Branch of the China Prevention Medicine Society, according to the Ocebm Clinical Classification and Recommended Opinions. In this way, the guidelines for clinical application of probiotics used for domestic use for domestic use were formulated. From the perspective of the recommendation level: A> B> C> D, the recommendation level is based on the quality, consistency, clinical significance, and universality of the evidence. The more credible the research results, the scientific evaluation of the research results.
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How to choose probiotics with diarrhea and constipation?
Guide pointed out that probiotics can shorten diarrhea and reduce hospitalization time. Among them, the main treatment of acute diarrhea is to prevent and treat dehydration and diet therapy. It is recommended to use Bravin yeast loose (A), bisidobacterium trigaites (A), etc. As for the delayed diarrhea and chronic diarrhea, the guide emphasizes the active cause of the cause. Probiotics can help reduce symptoms and shorten the course of the disease to a certain extent. Therefore Wait for B as a B -level evidence. In addition, probiotics can significantly reduce the incidence of antibiotic -related diarrhea and reduce the degree of antibiotic -related diarrhea. It is recommended to use Bravin (A), Bisidobacterium Tittero Live Satisher/Capsules (A) Triple triple live bacteria (A), deprivorate di -couplet live bacteria (A), etc. (A) and so on.
Probiotics have a two -way regulating effect on the gastrointestinal tract, and have auxiliary treatment for diarrhea and constipation. Children’s functional constipation, probiotics can shorten feces transportation time, enhance the movement frequency of the intestine, and relieve and assist in treating constipation. It is recommended to use bisidobacterium tritenules (A), and the remaining probiotics are C -level evidence.
The types and evidence level recommended by the guide recommended
Blagmmococcus scattered (A), bisidobacterium tritermia (A), bisidobacterium tetraobacteria (B), Merusculobacterium di -linked bacteria granules (B), linochrobacteria Live bacteria ( B), deprivorbacillusbal bacteria di -linked living bacteria (B), Cloid Berbalobacteria live bacteria (B), composite lactic acid bacteria capsule (B), bisidobacterium lactobacillus tritermia tablets (B), and bisidobacterium trisidal living Capyatra capsules (B).
Prosperity and chronic diarrhea
It is recommended to use Bora yeast scattered (B), bisidobacterium tritermia (B), bisidobacterium triam triterma entero -soluble capsule (B), bisidobacteria tetraobacteria (B), and Vibrobacteria Lianhuo Granules (B), Teloxibactercococcus Live Bacteria (B)
Antibiotic -related diarrhea
Bladin (A) (A), deprivorbacillusbal bacteria di -linked bacteria (A), bisidobacterium tritermia 菌/capsule (A), bisidobacterium lactobacillus tritermia (A) Bacteria (B), Bacillus Bacillus Trina (B), and Clatter Bacillus (B). Difficultylla -related diarrhea is a serious type of AAD. It is recommended to use breasseil (A).
Chemotherapy -related diarrhea
Temoticulcococcus a living bacteria (B), Bisidobacterium Tetosilica (B), Bispiocobacterium Lactobacillus Trimary Bacteria (B), and Cloid Bacteria Live Bacterial Granules (B).
Bisidobacterium triterules (A); Blaza yeast and Bacillus Bacillus di -linked bacteria granules are C -class evidence.
The application of probiotics in other pediatric diseases
Probiotics not only regulate diarrhea and constipation, but also have auxiliary treatment effect on various digestive tract diseases in children. Clinically, when choosing a probiotic preparation, it should gradually change from experience treatment to evidence -based treatment, and formulate individualized treatment solutions suitable for children on the basis of evidence -based medicine. For different types of diseases, the guidelines recommend the use of probiotics and levels of evidence as follows:
Inflammatory bowel disease (IBD)
Probiotics is difficult to form a recommendation opinion in children’s IBD: bisidobacterium live bacteria, capsules (D), Bispillobacterium lactobacillus tritermia tablets (D), and Perysmiobacterium di -linked bacterial cytram capsule (D)
Enterprise Syndrome (IBS)
At present, there are no reports of domestic probiotics in children’s IBS. Adult standards: Recommended BMB & Trimotonosus Capsules (B), Peronymia Di -linked Live Capsule (B), Bisidobacterium Tetosoline Tablets (C) Capsules of Bacterium Bacterium (D).
Treatment of lactose intolerance
Bacterioplasics lactobacillus tritermia (B), Bacillus Bacillus di -linked bacteria granules (B), bisidobacterium tritermia (B), and deprivorbacol (B)
Helicobacter pylori (HP) infection
Blaza yeast (B); bisidobacterium tetraobacteria tablets, deprivorate di -luminobacterial fungus capsules, and Perysmiobacteria di -linked bacteria granules, etc. are C -class evidence.
Bilestification liver disease
As auxiliary treatment, probiotics can help prevent intestinal flora disorders, the displacement of bacteria and endoxin, repair the intestinal mucosal barrier, and promote bile excretion. However, there are fewer literature reports, and it is difficult to form recommendations.
The research of probiotic treatment of liver sclerosis and its complications is mainly concentrated in adults or animal experiments, and it is difficult to form children’s recommendations.
Newborn necrotic small intestinal colonitis (NEC)
Bisidobacterium tritermia (B), Bacterium Lactobacillus Trimary Trimary Trimary Tripplarly (B), Teloxibactercococcus Lives (B), Brara Yeast (B); For C -Class evidence.
Curburrazhali live bacteria granules (A), bisidobacterium tritermia/capsule (A), Lidobacteria live bacteria (B), Brara yeast (B), bisidobacterium tetraobacteria tablets (B) Trimary Lactobacillus Trinomyosiline (B) and Temulcous di -linked bacteria (B).
Premature babies feeding intolerance
Bacterioplasics lactobacillus tritermia (B), bisidobacterium tritermia/capsule (B), Bacterium Bacillus di -luminobacterium (B), deprivorbacillus bacteria Live bacteria (B) Bacteria (B), Tema Paracurbal Bacteria (B) and Bisidobacterium Live Capsules (B).
Bisidobacterium tritermia (C), Bacterium Lactobacillus Trimary Trimary Trimary (C), Teloxibactercococcus Lives (C), Bacillus Bacteria Trinomi Bacteria particles (C), and Blaza Yeast San ( C) wait;
For the auxiliary treatment of food allergies, allergic rhinitis, and asthma, there are only individual reports in China, and recommendations cannot be formed;
Prevention of repeated respiratory tract infections
Temotic bacteria Live Bacteria (A), Tema Verm Stylasia (C), and Bisidobacterium Trimolytic Bacteria (C);
The guide also pointed out that the role of probiotics has obvious strains and dosage dependence, that is, the therapeutic effect of a certain strain does not represent this role of the original or species. Different strains have different dosage, and even the dosage required for different diseases may be different. In addition, there is no evidence to prove that multiple probiotics combined with a better clinical efficacy than a single drug. If antibiotics are needed at the same time, the preparation should be increased or the medication time should be increased. Blaza yeast, clomarbacterium and germius preparations are not sensitive to antibiotics and can be used at the same time as antibiotics. There is an individual difference in the degree and method of intestinal flora disorders. Different patients may have differences in the same dose of the same drug, and they should be individualized when choosing to use.
The types and evidence level recommended by the guide recommended