Abstract：
BACKGROUND: Taurine is considered an immunomodulatory agent. From current reports on clinical studies, we conducted a systematic review and meta-analysis to investigate the effects of taurine-enhanced enteral nutrition (EN) on the outcomes of critically ill patients to resolve conflicting evidence in literature.
METHODS: Literature from PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, SINOMED, and WanFang databases were retrieved, and randomized controlled trials (RCTs) were identified. The time range spanned from January 1, 2000, to January 31, 2024. The Cochrane Collaboration Tool was used to evaluate the risk of bias. We used the GRADE approach to rate the quality of evidence and the I2 test to assess the statistical heterogeneity of the results. Risk ratio (RR), mean difference (MD), and 95% confidence interval (95% CI) were used to analyze measurement data.
RESULTS: Four trials involving 236 patients were finally included. The meta-analysis results indicated that taurine-enhanced EN did not reduce mortality (RR = 0.70, p = 0.45, 95% CI [0.28, 1.80], two trials, 176 participants, low quality). There was also no significant difference in length of stay in the intensive care unit (ICU) between the taurine-enhanced EN and control groups. Taurine-enhanced EN may reduce pro-inflammatory factor interleukin-6 (IL-6) levels in critically ill patients（the result about IL-6 cannot be pooled）. However, taurine-enhanced EN had no significant impact on high-sensitivity-C-reactive protein levels (MD = -0.41, p = 0.40, 95% CI [-1.35, 0.54], two trials, 60 participants, low quality).
CONCLUSIONS: Taurine-enhanced EN may reduce IL-6 levels and is not associated with improved clinical outcomes in critically ill patients, which may have potential immunoregulatory effects in critically ill patients. Given that published studies have small samples, the above conclusions need to be verified by more rigorously designed large-sample clinical trials.
METHODS: Literature from PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, SINOMED, and WanFang databases were retrieved, and randomized controlled trials (RCTs) were identified. The time range spanned from January 1, 2000, to January 31, 2024. The Cochrane Collaboration Tool was used to evaluate the risk of bias. We used the GRADE approach to rate the quality of evidence and the I2 test to assess the statistical heterogeneity of the results. Risk ratio (RR), mean difference (MD), and 95% confidence interval (95% CI) were used to analyze measurement data.
RESULTS: Four trials involving 236 patients were finally included. The meta-analysis results indicated that taurine-enhanced EN did not reduce mortality (RR = 0.70, p = 0.45, 95% CI [0.28, 1.80], two trials, 176 participants, low quality). There was also no significant difference in length of stay in the intensive care unit (ICU) between the taurine-enhanced EN and control groups. Taurine-enhanced EN may reduce pro-inflammatory factor interleukin-6 (IL-6) levels in critically ill patients（the result about IL-6 cannot be pooled）. However, taurine-enhanced EN had no significant impact on high-sensitivity-C-reactive protein levels (MD = -0.41, p = 0.40, 95% CI [-1.35, 0.54], two trials, 60 participants, low quality).
CONCLUSIONS: Taurine-enhanced EN may reduce IL-6 levels and is not associated with improved clinical outcomes in critically ill patients, which may have potential immunoregulatory effects in critically ill patients. Given that published studies have small samples, the above conclusions need to be verified by more rigorously designed large-sample clinical trials.
摘要：
背景：牛磺酸被认为是一种免疫调节剂。从目前的临床研究报告来看，我们进行了系统评价和荟萃分析,以研究牛磺酸增强肠内营养(EN)对危重患者结局的影响,从而解决文献中相互矛盾的证据.
方法：文献来自PubMed，EMBASE,WebofScience,科克伦图书馆,CNKI,SINOMED,并检索了万方数据库，并确定了随机对照试验（RCTs）。时间范围从2000年1月1日到2024年1月31日。Cochrane协作工具用于评估偏倚风险。我们使用GRADE方法对证据质量进行评分，并使用I2检验评估结果的统计异质性。风险比（RR），平均差(MD)，和95%置信区间(95%CI)用于分析测量数据。
结果：最终纳入了涉及236名患者的四项试验。荟萃分析结果表明，牛磺酸增强的EN并未降低死亡率（RR=0.70，p=0.45，95％CI[0.28，1.80]，两次试验,176名与会者低质量)。牛磺酸增强的EN组和对照组在重症监护病房（ICU）的住院时间也没有显着差异。牛磺酸增强的EN可降低危重患者的促炎因子白细胞介素-6（IL-6）水平（IL-6的结果无法汇总）。然而,牛磺酸增强的EN对高敏C反应蛋白水平没有显着影响（MD=-0.41，p=0.40，95％CI[-1.35，0.54]，两次试验,60名学员,低质量)。
结论：牛磺酸增强的EN可能会降低IL-6水平，并且与危重患者的临床结局改善无关。这可能对危重病人具有潜在的免疫调节作用。鉴于已发表的研究样本很小，上述结论需要通过更严格设计的大样本临床试验来验证。
方法：文献来自PubMed，EMBASE,WebofScience,科克伦图书馆,CNKI,SINOMED,并检索了万方数据库，并确定了随机对照试验（RCTs）。时间范围从2000年1月1日到2024年1月31日。Cochrane协作工具用于评估偏倚风险。我们使用GRADE方法对证据质量进行评分，并使用I2检验评估结果的统计异质性。风险比（RR），平均差(MD)，和95%置信区间(95%CI)用于分析测量数据。
结果：最终纳入了涉及236名患者的四项试验。荟萃分析结果表明，牛磺酸增强的EN并未降低死亡率（RR=0.70，p=0.45，95％CI[0.28，1.80]，两次试验,176名与会者低质量)。牛磺酸增强的EN组和对照组在重症监护病房（ICU）的住院时间也没有显着差异。牛磺酸增强的EN可降低危重患者的促炎因子白细胞介素-6（IL-6）水平（IL-6的结果无法汇总）。然而,牛磺酸增强的EN对高敏C反应蛋白水平没有显着影响（MD=-0.41，p=0.40，95％CI[-1.35，0.54]，两次试验,60名学员,低质量)。
结论：牛磺酸增强的EN可能会降低IL-6水平，并且与危重患者的临床结局改善无关。这可能对危重病人具有潜在的免疫调节作用。鉴于已发表的研究样本很小，上述结论需要通过更严格设计的大样本临床试验来验证。
