■憩室疾病(DD)是一种常见的胃肠道疾病,对全世界的医疗保健系统造成沉重负担。高度的不确定性围绕着有症状的无并发症憩室病(SUDD)患者的症状控制以及憩室炎的一级和二级预防及其后果的治疗方法。
■回顾当前的知识并讨论有关SUDD管理和预防急性憩室炎的未满足的需求。
■随机试验,观察性研究,以及关于生活方式/饮食干预和药物治疗的系统评价(利福昔明,美沙拉嗪,和益生菌)SUDD或预防急性憩室炎。
■文献检索从开始到2023年4月,没有语言限制,遵循经修改的系统评价和荟萃分析(PRISMA)报告指南的首选报告项目。检查所选论文的参考文献以识别潜在感兴趣的其他论文。最终的参考文献清单由专家小组评估,他们被要求检查是否缺乏相关研究。
■关于患者群体的信息,研究设计,干预,对照组,观察的持续时间,评估的结局由两名作者独立收集.
■该综述显示,治疗干预措施存在高度不确定性,饮食/生活方式和药理,在SUDD患者中,因为现有证据的稀缺和薄弱。现有的研究通常质量低,异质,和过时的,排除得出有力结论的可能性。同样,急性憩室炎的预防很少被研究,大量缺乏证据支持饮食/生活方式或药理学方法对降低憩室炎风险的作用.
关于SUDD患者胃肠道症状的治疗选择以及急性憩室炎的一级和二级预防,缺乏有力的证据仍然是DD管理中未满足的重要需求。
UNASSIGNED: Diverticular disease (DD) represents a common gastrointestinal condition that poses a heavy burden on healthcare systems worldwide. A high degree of uncertainty surrounds the therapeutic approaches for the control of symptoms in patients with symptomatic uncomplicated diverticular disease (SUDD) and primary and secondary prevention of diverticulitis and its consequences.
UNASSIGNED: To
review the current knowledge and discuss the unmet needs regarding the management of SUDD and the prevention of acute
diverticulitis.
UNASSIGNED: Randomized trials, observational studies, and systematic reviews on lifestyle/dietary interventions and medical treatment (rifaximin, mesalazine, and probiotics) of SUDD or prevention of acute diverticulitis.
UNASSIGNED: The literature search was performed from inception to April 2023, without language restriction, following the modified Preferred Reporting Items for Systematic
review and Meta-Analyses (PRISMA) reporting guidelines. References of the papers selected were checked to identify additional papers of potential interest. The final list of references was evaluated by a panel of experts, who were asked to check for any lack of relevant studies.
UNASSIGNED: Information on patient population, study design, intervention, control group, duration of the observation, and outcomes assessed was collected by two authors independently.
UNASSIGNED: The
review shows a high degree of uncertainty about therapeutic interventions, both dietary/lifestyle and pharmacological, in patients with SUDD, because of the scarcity and weakness of existing evidence. Available studies are generally of low quality, heterogeneous, and outdated, precluding the possibility to draw robust conclusions. Similarly, acute
diverticulitis prevention has been seldom investigated, and there is a substantial lack of evidence supporting the role of dietary/lifestyle or pharmacological approaches to reduce the risk of diverticulitis.
UNASSIGNED: The lack of robust evidence regarding therapeutic options for gastrointestinal symptoms in SUDD patients and for primary and secondary prevention of acute diverticulitis remains an important unmet need in the management of DD.