目前对活动性溃疡性结肠炎(UC)的饮食管理知之甚少。由于缺乏针对该人群的临床指南,饮食选择可能基于临床医生的个人判断,没有可靠的证据.本系统综述的目的是评估当前有关活动性UC患者饮食管理的文献。在住院和门诊环境中,以确定临床结果是否因饮食处方而异。
PUBMED,CINAHL,EMBASE,在2020年3月和4月期间全面搜索了WebofScience和SCOPUS。符合条件的试验招募了患有活动性UC的成年人,比较了不同的饮食管理方法,包括肠内营养(EN),全胃肠外营养(TPN),消除饮食和标准口服饮食,在住院和门诊设置。
10项研究符合本定性综合的纳入标准。EN之间没有发现差异,与标准口服饮食相比,TPN和肠道在疾病活动测量方面的休息。这项研究的结果还显示了在门诊使用消除饮食的潜力,其中四项研究发现干预饮食和控制之间的疾病活动措施存在显着差异。
没有强有力的证据支持使用任何特定的饮食处方来改善活动性UC患者的临床结果。许多低质量的研究表明,遵循消除饮食的好处,然而,在提出更具体的建议之前,还需要更多高质量的研究.
The dietary management of active ulcerative colitis (UC) is currently poorly understood. Due to the lack of clinical guidelines for this population, diet choice may be based on the personal judgement of the clinician, and without sound evidence. The aim of this systematic
review was to appraise the current literature on the dietary management of individuals with active UC, in both inpatient and outpatient settings, to determine if clinical outcomes differ by diet prescription.
PUBMED, CINAHL, EMBASE, Web of Science and SCOPUS were comprehensively searched during March and April 2020. Eligible trials recruited adults with active UC comparing different methods of dietary management, including enteral nutrition (EN), total parenteral nutrition (TPN), elimination diets and standard oral diets, in both the inpatient and outpatient settings.
10 studies met inclusion criteria of this qualitative synthesis. No difference was found between EN, TPN and bowel rest in terms of disease activity measures when compared to a standard oral diet. The results of this study also showed promising potential for the use of elimination diets in the outpatient setting with four studies finding a significant difference in disease activity measures between the intervention diet and control.
There is no strong evidence to support the use of any specific dietary prescription to improve clinical outcomes for individuals with active UC. A number of low quality studies suggest benefit of following an elimination diet, however, additional high quality studies are required before any more specific recommendations can be made.