OBJECTIVE: To systematically evaluate the efficacy and safety of Compound lactobacillus acidophilus in the adjuvant treatment of diarrhea irritable bowel syndrome（IBS-D）. METHODS: Randomized controlled trials about Compound lactobacillus acidophilus in the treatment of IBS were retrieved from the PubMed

Embase

the Cochrane library

CBM

CNKI

Wanfang Data and VIP up to Jan. 2022. After literature screening according to inclusion and exclusion criteria

data extraction and quality evaluation

Meta-analysis was performed by using RevMan 5.3 software. RESULTS: A total of 13 RCTs were included

involving 1 394 patients. Results of Meta-analysis showed that the total effective rate of Compound lactobacillus acidophilus combined with different antispasmodic agents（trimebutine

pinaverium bromide

otilonium bromide） in the treatment of IBS-D was higher than that of trimebutine alone（OR=3.47

95%CI=1.73-6.94）

pinaverium bromide alone（OR=3.94

95%CI=2.45-6.35）

otilonium bromide alone（OR=6.26

95%CI=3.21-12.22）

with statistical significance（P<0.05）. In terms of improving the clinical symptoms of IBS-D

compared with antispasmodic agents alone

it combined with Compound lactobacillus acidophilus could significantly reduce the abdominal pain score（MD=-0.33

95%CI=-0.38--0.27）

diarrhea score（MD=-0.32

95%CI=-0.39--0.26）

abnormal stool frequency（MD=-0.20

95%CI=-0.26--0.14）

and decreased average daily defecation times（MD=-1.74

95%CI=-2.14--1.34）

with statistical significance（P<0.05）. There was no statistical significance in the incidence of ADR between combined with Compound lactobacillus acidophilus and antispasmodic agents alone（OR=1.07

95%CI=0.51-2.25

P=0.85）.CONCLUSIONS: Compound lactobacillus acidophilus might have certain value in the adjuvant treatment of IBS-D

and have good safety.