临床与病理杂志
臨床與病理雜誌
림상여병리잡지
International Journal of Pathology and Clinical Medicine
2015年
z1期
10-17
,共8页
蒋大平%张常华%朱锦涛%夏光概%向臻%蔡世荣%何裕隆
蔣大平%張常華%硃錦濤%夏光概%嚮臻%蔡世榮%何裕隆
장대평%장상화%주금도%하광개%향진%채세영%하유륭
胃肠道肿瘤%化疗%营养支持%meta分析
胃腸道腫瘤%化療%營養支持%meta分析
위장도종류%화료%영양지지%meta분석
gastrointestinal cancer%chemotherapy%nutritional support%meta analysis
目的：通过meta分析研究营养支持对胃肠道肿瘤患者营养状况和化疗不良反应的影响。方法：应用Pubmed、Scopus、CNKI和万方数据知识服务平台数据库检索1990至2014年发表的关于胃肠道肿瘤患者化疗期间行营养支持与单纯化疗对比的随机对照研究(randomized clinical trials，RCT)，进行meta分析。结果：检索出相关文献922篇，纳入17篇。共纳入患者955例，实验组486例，对照组479例。结果显示化疗期间营养支持对转铁蛋白改善明显(SMD=0.61，95% CI,0.40~0.82；P<0.05)，对免疫指标IgG(SMD=0.65，95% CI,0.45~0.84；P<0.05)和IgA(SMD=0.62，95% CI,0.10~1.13；P<0.05)改善显著。在副作用方面白细胞减少(RR=0.57，95% CI,0.39~0.82；P<0.05)、恶心呕吐(RR=0.54，95% CI,0.40~0.72；P<0.05)和纳差(RR=0.50，95% CI,0.30~0.83；P<0.05)均明显改善。结论：胃肠道肿瘤患者在化疗期间给予营养支持治疗可以在一定程度上改善患者的营养状况、增强免疫力，降低不良反应发生风险，具有临床推广的意义。
目的：通過meta分析研究營養支持對胃腸道腫瘤患者營養狀況和化療不良反應的影響。方法：應用Pubmed、Scopus、CNKI和萬方數據知識服務平檯數據庫檢索1990至2014年髮錶的關于胃腸道腫瘤患者化療期間行營養支持與單純化療對比的隨機對照研究(randomized clinical trials，RCT)，進行meta分析。結果：檢索齣相關文獻922篇，納入17篇。共納入患者955例，實驗組486例，對照組479例。結果顯示化療期間營養支持對轉鐵蛋白改善明顯(SMD=0.61，95% CI,0.40~0.82；P<0.05)，對免疫指標IgG(SMD=0.65，95% CI,0.45~0.84；P<0.05)和IgA(SMD=0.62，95% CI,0.10~1.13；P<0.05)改善顯著。在副作用方麵白細胞減少(RR=0.57，95% CI,0.39~0.82；P<0.05)、噁心嘔吐(RR=0.54，95% CI,0.40~0.72；P<0.05)和納差(RR=0.50，95% CI,0.30~0.83；P<0.05)均明顯改善。結論：胃腸道腫瘤患者在化療期間給予營養支持治療可以在一定程度上改善患者的營養狀況、增彊免疫力，降低不良反應髮生風險，具有臨床推廣的意義。
목적：통과meta분석연구영양지지대위장도종류환자영양상황화화료불량반응적영향。방법：응용Pubmed、Scopus、CNKI화만방수거지식복무평태수거고검색1990지2014년발표적관우위장도종류환자화료기간행영양지지여단순화료대비적수궤대조연구(randomized clinical trials，RCT)，진행meta분석。결과：검색출상관문헌922편，납입17편。공납입환자955례，실험조486례，대조조479례。결과현시화료기간영양지지대전철단백개선명현(SMD=0.61，95% CI,0.40~0.82；P<0.05)，대면역지표IgG(SMD=0.65，95% CI,0.45~0.84；P<0.05)화IgA(SMD=0.62，95% CI,0.10~1.13；P<0.05)개선현저。재부작용방면백세포감소(RR=0.57，95% CI,0.39~0.82；P<0.05)、악심구토(RR=0.54，95% CI,0.40~0.72；P<0.05)화납차(RR=0.50，95% CI,0.30~0.83；P<0.05)균명현개선。결론：위장도종류환자재화료기간급여영양지지치료가이재일정정도상개선환자적영양상황、증강면역력，강저불량반응발생풍험，구유림상추엄적의의。
Objective: To assess the effect of nutritional support on nutrition and chemotherapy-related side effects in GI cancer patients undergoing chemotherapy.Methods:Randomized clinical trials (RCTs) on comparison of nutrition, immunity and chemotherapy-related side effects between the GI cancer patients with or without additional nutritional support were searched through Pubmed, Scopus, CNKI and WANFANG databases. Qualified trials published from 1990 to 2014 were included in the study. Meta-analysis was used to compare nutrition, immunity and chemotherapy-related side effects between the two groups.Results: Finally 17 RCTs with 955 patients were included in the study. Among them, 486 patients received chemotherapy plus nutritional support and 492 patients received chemotherapy only. The patients who received nutritional support had significant improvement in transferring (SMD=0.61, 95% CI, 0.40~0.82,P<0.05), IgG (SMD=0.65, 95% CI, 0.45~0.84,P<0.05) and IgA (SMD=0.62, 95% CI, 0.10~1.13,P<0.05). The incidences of side-effects related to chemotherapy including leukopenia (RR=0.57, 95% CI, 0.39~0.82,P<0.05), nausea and vomiting (RR=0.54, 95% CI, 0.40~0.72,P<0.05) and anorexia (RR=0.50, 95% CI, 0.30~0.83,P<0.05) were significantly decreased in the patients with nutritional support.Conclusion:Nutritional intervention can improve nutritional status and immunity and decrease incidence of chemotherapy-related side-effects in GI cancer patients undergoing chemotherapy.
