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目的比较乳酸杆菌活菌制剂与甲硝唑类制剂治疗妊娠合并细菌性阴道病的疗效及对妊娠结局的影响。方法计算机检索PubMed、Cochrane图书馆、VIP、CNKI、万方数据库、中国生物医学文献数据库、西文生物医学期刊文献数据库、康健临床决策循证数据库等,纳入乳酸杆菌活菌制剂与甲硝唑类制剂比较治疗妊娠合并细菌性阴道病(BV)的疗效及对妊娠结局影响的随机对照试验(RCT)。对纳入RCT进行质量评价,采用RevMan 5.0.24软件进行Meta分析。结果最终纳入8篇文献,共计1687例受试者。Meta分析结果显示:两组疗效差异无统计学意义[RR=1.04,95%C(I1.00,1.08),P=0.08];乳酸杆菌活菌制剂治疗后复发率低,差异具有统计学意义[RR=0.16,95%CI(0.06,0.43),P=0.0004];乳酸杆菌活菌制剂治疗的早产发生率低于对照组[RR=0.56,95%CI(0.33,0.94),P=0.03],差异具有统计学意义;而胎膜早破、产褥感染、低体重儿、新生儿感染、新生儿黄疸等妊娠结局发生率方面,两组差异无统计学意义。结论①乳酸杆菌制剂与甲硝唑类制剂治疗妊娠合并BV的疗效相似。②乳酸杆菌制剂治疗妊娠合并BV的复发率低于甲硝唑类制剂。③乳酸杆菌制剂治疗妊娠合并BV后早产的发生率低于甲硝唑类制剂,但对于治疗后胎膜早破、产褥感染、低体重儿、新生儿感染、新生儿黄疸等妊娠结局发生率两者无明显差异。
Objective To compare the efficacy of Lactobacillus live preparation with metronidazole in the treatment of bacterial vaginosis in pregnancy and its effect on pregnancy outcome. Methods PubMed, Cochrane Library, VIP, CNKI, Wanfang database, China Biomedical Literature Database, Western Journal of Biomedical Literature Database, Kang Jian clinical decision-making evidence-based database were searched by computer. Lactobacillus live strains and metronidazole A Randomized Controlled Trials (RCT) Comparison of Therapeutic Efficacy in Treating Pregnancy Complicated with Bacterial Vaginosis (BV) and Its Impact on Pregnancy Outcome. The RCTs were included in the quality assessment and Meta-analysis was performed using RevMan 5.0.24 software. The results eventually included eight articles, a total of 1687 subjects. The results of Meta analysis showed that there was no significant difference between the two groups (RR = 1.04, 95% C (I1.00, 1.08), P = 0.08]; the relapse rate of Lactobacillus active preparation was low, the difference was statistically significant (RR = 0.16,95% CI (0.06,0.43), P = 0.0004]. The incidence of preterm birth was significantly lower in the Lactobacillus preparation than in the control group [RR = 0.56,95% CI 0.33,0.94, P = 0.03 ], The difference was statistically significant; while the premature rupture of membranes, puerperal infection, low birth weight infants, neonatal infections, neonatal jaundice incidence of pregnancy outcomes, the two groups showed no significant difference. Conclusion ① Lactobacillus preparation and metronidazole preparation for the treatment of pregnancy with BV similar efficacy. ② Lactobacillus preparation treatment of pregnant women with BV recurrence rate lower than metronidazole preparations. (3) The incidence of premature delivery of Lactobacillus after pregnancy combined with BV was lower than that of metronidazole, but the incidence of pregnancy outcomes such as premature rupture of membranes, puerperal infection, low birth weight infants, neonatal infection and neonatal jaundice No significant difference between the two.