Inflammatory bowel disease (IBD) refers to chronic inflammatory disorders of the gut. Ulcerative colitis (UC) and Crohn’s disease (CD) are two subtypes of IBD. Evidence suggests that the intestinal microbiota plays a role in the pathogenesis of IBD, so probiotics have garnered a lot of interest as a potential treatment or prevention for IBD. However, clinical evidence of the efficacy of probiotics is still debatable. We performed a literature review. An advanced search considered clinical studies on probiotic for IBD from inception to 2023 in PubMed, Embase, Cochrane Library, and Web of Science. In the treatment of UC with probiotics, only Escherichia coli Nissle 1917 for maintenance treatment of UC in remission, and Bifidobacterium and VSL#3 for induction of remission in patients with mild to moderately active UC have shown strong evidence. Currently, there are no definitive conclusions regarding the effectiveness of probiotics in CD. The mechanism of probiotic treatment for IBD may be related to reducing oxidative stress, repairing the intestinal barrier, regulating intestinal flora balance, and modulating intestinal immune response. Differences in the benefits of probiotics between CD and UC may be attributable to the different lesion extent and immune-mediated pathophysiology. More robust randomized clinical trials are required to validate the efficacy and safety of diverse probiotic strains in IBD.

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益生菌治疗炎症性肠病：有足够的证据吗？

炎症性肠病（IBD）是指肠道的慢性炎症性疾病。溃疡性结肠炎 (UC) 和克罗恩病 (CD) 是 IBD 的两种亚型。有证据表明肠道微生物群在 IBD 的发病机制中发挥着重要作用，因此益生菌作为 IBD 的潜在治疗或预防手段引起了广泛关注。然而，益生菌功效的临床证据仍然存在争议。我们进行了文献综述。一项高级检索考虑了 PubMed、Embase、Cochrane Library 和 Web of Science 中益生菌治疗 IBD 的临床研究（从开始到 2023 年）。在用益生菌治疗 UC 时，仅大肠杆菌Nissle 1917 用于缓解期 UC 的维持治疗，以及双歧杆菌和 VSL#3 用于诱导轻度至中度活动性 UC 患者缓解已显示出强有力的证据。目前，关于益生菌对克罗恩病的有效性还没有明确的结论。益生菌治疗IBD的机制可能与减轻氧化应激、修复肠道屏障、调节肠道菌群平衡、调节肠道免疫反应有关。 CD 和 UC 之间益生菌益处的差异可能归因于不同的病变程度和免疫介导的病理生理学。需要更强有力的随机临床试验来验证不同益生菌菌株在 IBD 中的功效和安全性。