Effect of probiotics in preventing overt hepatic encephalopathy in patients with minimal hepatic encephalopathy: A Meta-analysis

Yuhao YAO; Jiaxin ZHANG; Xiao XIA; Shun ZHU; Xiaoke LI; Yong'an YE

doi:10.3969/j.issn.1001-5256.2022.11.013

Volume 38 Issue 11

Nov. 2022

Turn off MathJax

Article Contents

Article Navigation > Journal of Clinical Hepatology > 2022 > 38(11): 2505-2509

PDF( 3743 KB)

Effect of probiotics in preventing overt hepatic encephalopathy in patients with minimal hepatic encephalopathy: A Meta-analysis

DOI: 10.3969/j.issn.1001-5256.2022.11.013

Yuhao YAO^{1, 2},
Jiaxin ZHANG^{2, 3},
Xiao XIA⁴,
Shun ZHU²,
Xiaoke LI^{2, 3
,
,
,},
Yong'an YE^{2, 3
,
,
,}

1.
First School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
2.
Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
3.
Liver Diseases Academy of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100700, China
4.
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China

Research funding:

National Natural Science Foundation of China (82174341);

National Administration of Traditional Chinese Medicine Research Fund (JDZX2015300);

Beijing University of Traditional Chinese Medicine Start-up Fund (2022-JYB-XJSJJ-050)

More Information

Corresponding author: LI Xiaoke, lixiaoke@vip.163.com(ORCID: 0000-0002-1775-3063); YE Yong'an, yeyongan@vip.163.com(ORCID: 0000-0001-9765-4665)
Received Date: 2022-04-06
Accepted Date: 2022-05-10
Published Date: 2022-11-20

Abstract

Abstract

Objective To review and analyze the effect of probiotics in preventing the overt hepatic encephalopathy (OHE) in patients with minimal hepatic encephalopathy (MHE). Methods Studies about this subject were searched in PubMed, Web of Science, Cochrane Library, Chinese journal full-text database (CNKI), WanFang data knowledge service platform (WanFang Data) from their establishment to November 2021. Meta-analysis was performed using RevMan 5.4. Description analysis was used for data that could not be pooled. The relative risk (RR) and 95% confidence interval (CI) were used to present pooled data. Results Six RCT studies with a total of 404 patients were included in this meta-analysis. The results showed probiotics users had a significant reduction of the OHE incidence, as compared with the controls (RR=0.46, 95%CI: 0.26 - 0.81; P=0.007), but an increase in the reversal MHE rate (RR=4.94, 95%CI: 2.82-8.66; P < 0.000 01). Conclusion This finding demonstrated that probiotics were able to effectively reduce the OHE incidence and improve the reversal MHE rate in the patients with MHE. This study could provide novel evidence for probiotics treatment of MHE.
- Hepatic Encephalopathy,
- Probiotics,
- Meta-Analysis

FullText(HTML)

References(26)

References

[1]	VILSTRUP H, AMODIO P, BAJAJ J, et al. Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver[J]. Hepatology, 2014, 60(2): 715-735. DOI: 10.1002/hep.27210.
[2]	DHIMAN RK, SARASWAT VA, SHARMA BK, et al. Minimal hepatic encephalopathy: consensus statement of a working party of the Indian National Association for Study of the Liver[J]. J Gastroenterol Hepatol, 2010, 25(6): 1029-1041. DOI: 10.1111/j.1440-1746.2010.06318.x.
[3]	Chinese Society of Hepatology, Chinese Medical Association. Guidelines on the management of hepatic encephalopathy in cirrhosis[J]. J Clin Hepatol, 2018, 34(10): 2076-2089. DOI: 10.3969/j.issn.1001-5256.2018.10.007. 中华医学会肝病学分会. 肝硬化肝性脑病诊疗指南[J]. 临床肝胆病杂志, 2018, 34(10): 2076-2089. DOI: 10.3969/j.issn.1001-5256.2018.10.007.
[4]	AMODIO P, DEL PICCOLO F, MARCHETTI P, et al. Clinical features and survivial of cirrhotic patients with subclinical cognitive alterations detected by the number connection test and computerized psychometric tests[J]. Hepatology, 1999, 29(6): 1662-1667. DOI: 10.1002/hep.510290619.
[5]	HARTMANN IJ, GROENEWEG M, QUERO JC, et al. The prognostic significance of subclinical hepatic encephalopathy[J]. Am J Gastroenterol, 2000, 95(8): 2029-2034. DOI: 10.1111/j.1572-0241.2000.02265.x.
[6]	INOUE E, HORI S, NARUMI Y, et al. Portal-systemic encephalopathy: presence of basal ganglia lesions with high signal intensity on MR images[J]. Radiology, 1991, 179(2): 551-555. DOI: 10.1148/radiology.179.2.2014310.
[7]	ROMERO-GÓMEZ M, BOZA F, GARCÍA-VALDECASAS MS, et al. Subclinical hepatic encephalopathy predicts the development of overt hepatic encephalopathy[J]. Am J Gastroenterol, 2001, 96(9): 2718-2723. DOI: 10.1111/j.1572-0241.2001.04130.x.
[8]	ROMERO-GÓMEZ M, CÓRDOBA J, JOVER R, et al. Value of the critical flicker frequency in patients with minimal hepatic encephalopathy[J]. Hepatology, 2007, 45(4): 879-885. DOI: 10.1002/hep.21586.
[9]	SAXENA N, BHATIA M, JOSHI YK, et al. Electrophysiological and neuropsychological tests for the diagnosis of subclinical hepatic encephalopathy and prediction of overt encephalopathy[J]. Liver, 2002, 22(3): 190-197. DOI: 10.1034/j.1600-0676.2002.01431.x.
[10]	DHIMAN RK, KURMI R, THUMBURU KK, et al. Diagnosis and prognostic significance of minimal hepatic encephalopathy in patients with cirrhosis of liver[J]. Dig Dis Sci, 2010, 55(8): 2381-2390. DOI: 10.1007/s10620-010-1249-7.
[11]	FICHET J, MERCIER E, GENÉE O, et al. Prognosis and 1-year mortality of intensive care unit patients with severe hepatic encephalopathy[J]. J Crit Care, 2009, 24(3): 364-370. DOI: 10.1016/j.jcrc.2009.01.008.
[12]	SCHIFF ER, MADDREY WC, REDDY KR. Schiff's diseases of the liver[M]. REN H, translate. Beijing: China Science and Technology Press, 2021: 6. SCHIFF ER, MADDREY WC, REDDY KR. SCHIFF. 肝脏病学[M]. 任红, 主译. 北京: 中国科学技术出版社, 2021: 6.
[13]	BAJAJ JS, SAEIAN K, CHRISTENSEN KM, et al. Probiotic yogurt for the treatment of minimal hepatic encephalopathy[J]. Am J Gastroenterol, 2008, 103(7): 1707-1715. DOI: 10.1111/j.1572-0241.2008.01861.x.
[14]	BAJAJ JS, HEUMAN DM, HYLEMON PB, et al. Randomised clinical trial: Lactobacillus GG modulates gut microbiome, metabolome and endotoxemia in patients with cirrhosis[J]. Aliment Pharmacol Ther, 2014, 39(10): 1113-1125. DOI: 10.1111/apt.12695.
[15]	LUNIA MK. A randomised controlled trial on efficacy of probiotics on reversal of minimal hepatic encephalopathy and its correlation with improvement in small intestinal bacterial overgrowth and orocecal transit time in patients with cirrhosis[J]. United Eur Gastroent, 2013, 1(1): A153-A154. DOI: 10.1177/2050640613502900.
[16]	LUNIA MK, SHARMA BC, SHARMA P, et al. Probiotics prevent hepatic encephalopathy in patients with cirrhosis: a randomized controlled trial[J]. Clin Gastroenterol Hepatol, 2014, 12(6): 1003-1008. e1. DOI: 10.1016/j.cgh.2013.11.006.
[17]	MITTAL VV, SHARMA BC, SHARMA P, et al. A randomized controlled trial comparing lactulose, probiotics, and L-ornithine L-aspartate in treatment of minimal hepatic encephalopathy[J]. Eur J Gastroenterol Hepatol, 2011, 23(8): 725-732. DOI: 10.1097/MEG.0b013e32834696f5.
[18]	VLACHOGIANNAKOS J, VASIANOPOULOU P, VIAZIS N, et al. The role of probiotics in the treatment of minimal hepatic encephalopathy. A prospective, randomized placebo-controlled, double-blind study[J]. Hepatology, 2014, 60: 376A. DOI: 10.1002/hep.27498.
[19]	LUO L. A study on the effect of probiotics on patients with mild hepatic encephalopathy in liver cirrhosis[D]. Luzhou: Southwest Medical University, 2019. 罗兰. 益生菌对肝硬化轻微肝性脑病患者的作用的研究[D]. 泸州: 西南医科大学, 2019.
[20]	SHARMA K, PANT S, MISRA S, et al. Effect of rifaximin, probiotics, and l-ornithine l-aspartate on minimal hepatic encephalopathy: a randomized controlled trial[J]. Saudi J Gastroenterol, 2014, 20(4): 225-232. DOI: 10.4103/1319-3767.136975.
[21]	XIA X, CHEN J, XIA J, et al. Role of probiotics in the treatment of minimal hepatic encephalopathy in patients with HBV-induced liver cirrhosis[J]. J Int Med Res, 2018, 46(9): 3596-3604. DOI: 10.1177/0300060518776064.
[22]	PRATAP MOULI V, BENJAMIN J, BHUSHAN SINGH M, et al. Effect of probiotic VSL#3 in the treatment of minimal hepatic encephalopathy: A non-inferiority randomized controlled trial[J]. Hepatol Res, 2015, 45(8): 880-889. DOI: 10.1111/hepr.12429.
[23]	SHAVAKHI A, HASHEMI H, TABESH E, et al. Multistrain probiotic and lactulose in the treatment of minimal hepatic encephalopathy[J]. J Res Med Sci, 2014, 19(8): 703-708.
[24]	YU FJ. Effect of lactulose combined with triplet viable bifidobacteria capsules on mild hepatic encephalopathy patients[J]. Chin J Microecol, 2020, 32(8): 929-932. DOI: 10.13381/j.cnki.cjm.202008014. 余芳杰. 乳果糖联合双歧杆菌三联活菌胶囊在轻微性肝性脑病患者中的应用效果[J]. 中国微生态学杂志, 2020, 32(8): 929-932. DOI: 10.13381/j.cnki.cjm.202008014.
[25]	LIU RM, LI L, XIE JT. Protective effect of bifidobacterium quadruple viable tablet combined with lactulose on inflammatory injury of intestinal mucosa in patients with mild hepatic encephalopathy[J]. Chin J Microecol, 2021, 33(10): 1181-1184. DOI: 10.13381/j.cnki.cjm.202110012. 刘荣明, 李亮, 解君挺. 双歧杆菌四联活菌片联合乳果糖对轻微型肝性脑病患者炎症性肠黏膜损伤的保护作用[J]. 中国微生态学杂志, 2021, 33(10): 1181-1184. DOI: 10.13381/j.cnki.cjm.202110012.
[26]	MUKHERJEE S, JOHN S. Lactulose[M]//StatPearls. Treasure Island (FL): StatPearls Publishing, 2021.

Relative Articles

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Figures(4) / Tables(2)

Get Citation

PDF

XML

Article Metrics

Article views (462) PDF downloads(71)

Effect of probiotics in preventing overt hepatic encephalopathy in patients with minimal hepatic encephalopathy: A Meta-analysis

DOI: 10.3969/j.issn.1001-5256.2022.11.013

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Effect of probiotics in preventing overt hepatic encephalopathy in patients with minimal hepatic encephalopathy: A Meta-analysis

DOI: 10.3969/j.issn.1001-5256.2022.11.013

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content