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. 2002(3):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 searched 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 four 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.
Nine randomised controlled trials conducted between 1986 and 2001 satisfied the inclusion criteria. Seven were of parallel design and two were cross-over studies. Eight compared fish oil with placebo whilst one compared high dose vs low dose marine n-3 fatty acid supplementation. Two studies were conducted in children, whilst the remaining seven studies were conducted in adults. None of the included studies reported asthma exacerbations, health status or hospital admissions. There was no consistent effect on any of the analysable outcomes: FEV1, peak flow rate, asthma symptoms, asthma medication use or bronchial hyper reactivity. One of the studies performed in children which combined dietary manipulation with fish oil supplementation showed improved peak flow and reduced asthma medication use. There were no adverse events associated with fish oil supplements.
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性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。检索了检索到的试验的参考文献，并联系了鱼油制造商。
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四周。优先选择双盲试验，但也对单盲和开放试验进行了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。
唯一可能的比较是补充海洋n-3脂肪酸与安慰剂之间的比较。没有足够的试验来单独研究饮食干预。
1986年至2001年间进行的九项随机对照试验符合纳入标准。七项为平行设计，两项为交叉研究。八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。两项研究在儿童中进行，其余七项研究在成人中进行。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。在儿童中进行的一项将饮食干预与鱼油补充相结合的研究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。
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，也没有证据表明这样做会使他们面临风险。
