Woods R K, Thien F C, Abramson M J
Department of Epidemiolgy and Preventative Medicine, Monash Medical School, Alfred Hospital, Commercial Road, Prahran, Victoria, AUSTRALIA, 3181.
Cochrane Database Syst Rev. 2000;2000(4):CD001283. doi: 10.1002/14651858.CD001283.
Epidemiological studies suggest that a diet high in marine fatty acids (fish oil) may have beneficial effects on inflammatory conditions such as rheumatoid arthritis and possibly asthma.
The Cochrane Airways Review Group register was search using the terms: marine fatty acids OR diet OR nutrition OR fish oil OR eicosapentaenoic acid OR EPA. Bibliographies of retrieved trials were searched and fish oil manufacturers contacted.
Randomised controlled trials in patients with asthma more than two years of age were included. The study duration had to be in excess of 4 weeks. Double blind trials were preferred, but single-blind and open trials were also reviewed for possible inclusion. Three reviewers read each paper, blind to its identity. Decisions concerning inclusion were made by simple majority. Quality assessment was performed by all three reviewers independently.
The only comparison possible was between marine n-3 fatty acid supplementation and placebo. There were insufficient trials to examine dietary manipulation alone.
Eight randomised controlled trials conducted between 1986 and 1998 satisfied the inclusion criteria. Six were of parallel design and two were cross-over studies. Seven compared fish oil with placebo whilst one compared high dose vs low dose marine n-3 fatty acid supplementation. None of the included studies reported asthma exacerbations, health status or hospital admissions. There was no consistent effect on any of the analyzable outcomes: FEV1, peak flow rate, asthma symptoms, asthma medication use or bronchial hyper reactivity. The single study performed in children also combined dietary manipulation with fish oil supplementation and showed improved peak flow and reduced asthma medication use. There were no adverse events associated with fish oil supplements. Updated Search conducted August 2000. No new trials were found.
REVIEWER'S CONCLUSIONS: There is little evidence to recommend that people with asthma supplement or modify their dietary intake of marine n-3 fatty acids (fish oil) in order to improve their asthma control. Equally, there is no evidence that they are at risk if they do so.
流行病学研究表明，富含海洋脂肪酸（鱼油）的饮食可能对类风湿关节炎等炎症性疾病以及可能对哮喘具有有益作用。
使用以下术语检索Cochrane气道综述小组登记册：海洋脂肪酸或饮食或营养或鱼油或二十碳五烯酸或EPA。检索所获试验的参考文献并联系鱼油制造商。
纳入年龄超过两岁的哮喘患者的随机对照试验。研究持续时间必须超过4周。优先选择双盲试验，但也对单盲和开放试验进行审查以确定是否可能纳入。三位审阅者阅读每篇论文，对其身份保密。关于纳入的决定以简单多数做出。由所有三位审阅者独立进行质量评估。
唯一可行的比较是海洋n-3脂肪酸补充剂与安慰剂之间的比较。没有足够的试验单独研究饮食干预。
1986年至1998年间进行的八项随机对照试验符合纳入标准。六项为平行设计，两项为交叉研究。七项将鱼油与安慰剂进行比较，而一项比较高剂量与低剂量海洋n-3脂肪酸补充剂。纳入的研究均未报告哮喘加重、健康状况或住院情况。对任何可分析的结果（第一秒用力呼气量、峰值流速、哮喘症状、哮喘药物使用或支气管高反应性）均无一致影响。在儿童中进行的单项研究还将饮食干预与鱼油补充相结合，结果显示峰值流速有所改善且哮喘药物使用减少。没有与鱼油补充剂相关的不良事件。2000年8月进行了更新检索。未发现新的试验。
几乎没有证据建议哮喘患者补充或改变其饮食中海洋n-3脂肪酸（鱼油）的摄入量以改善哮喘控制。同样，也没有证据表明他们这样做会有风险。
