Gut microbiota dysfunction is associated with multiple gastrointestinal and extra-gastrointestinal diseases, thus the possibility of its modulation with prebiotics, probiotics and symbiotics has gained interest in the last years. Many probiotics are available on the market and products characterized by combination of multiple strains have been proposed as particularly effective. However, evidences supporting their efficacy are often inadequate and not homogenous. We reviewed available data on clinical efficacy of multistrain probiotics and symbiotics in gastrointestinal diseases in adults, focusing on data from randomised, double-blind, placebo-controlled clinical trials. Twenty-nine multistrain products satisfied inclusion criteria. The principal areas of application are irritable bowel syndrome, Helicobacter pylori eradication and antibiotic-associated diarrhoea. The most represented probiotic species in the different probiotic formulations was L. acidophilus. The combination of L. paracasei, L. plantarum, L. acidophilus, L. delbrueckii subsp. bulgaricus, B. longum, B. infantis, B. breve and S. thermophilus (VSL#3) showed the highest number of RCTs.

肠道菌群功能障碍与多种胃肠道和胃肠外疾病有关，因此近年来益生元，益生菌和共生素对其进行调节的可能性引起了人们的关注。市场上有许多益生菌，并且已经提出了以多种菌株结合为特征的产品特别有效。但是，支持其功效的证据往往不足且不统一。我们回顾了关于多菌株益生菌和共生素在成人胃肠道疾病中的临床疗效的可用数据，重点是来自随机，双盲，安慰剂对照临床试验的数据。二十九个多菌株产品满足纳入标准。主要应用领域是肠易激综合症，幽门螺杆菌根除和抗生素相关性腹泻。在不同的益生菌配方中，最具代表性的益生菌是嗜酸乳杆菌。的组合干酪乳杆菌，植物乳杆菌，嗜酸乳杆菌，德氏乳杆菌亚种。保加利亚，长双歧杆菌，婴儿双歧杆菌，短小芽孢杆菌和嗜热链球菌（VSL＃3）的RCT数量最高。