Song Guo-Min, Tian Xu, Ma Li, Yi Li-Juan, Shuai Ting, Zeng Zi, Zeng Xian-Tao
From the Department of Nursing, Tianjin Hospital, Tianjin, China (G-MS); Graduated College, Tianjin University of Traditional Chinese Medicine, Tianjin, China (XT, LM, L-JY, TS, ZZ); and Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China (XT, ZZ).
Medicine (Baltimore). 2016 Jan;95(1):e2432. doi: 10.1097/MD.0000000000002432.
Clear liquid diet (CLD) is used to perform bowel preparation before colonoscopy traditionally, but several clinical studies indicated that low-residue diet (LRD) generates equal effects to CLD and a conclusive conclusion has not yet been yielded. The systematic review was performed to address this conflict and facilitate informed decision-making eventually. To capture randomized controlled trials (RCTs) comparing LRD with CLD in terms of bowel preparation, a search was performed in PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Science Direct, recent conference abstracts, Google Scholar, and Clinicaltrials.gov through May 2015. We performed all meta-analyses based on fixed- or random-effects model, which is generated from clinical characteristics and methodology. Moreover, the G*Power software was adopted to achieve statistical power for each outcome. In total, we captured 109 potential citations at initial search stage and 2 topic-related articles were included through other sources. After critical appraisal, 7 RCTs were eligible for our inclusion criteria. Meta-analyses generated similar effects in bowel preparation quality, efficacy of colon cleansing, and compliance with recommended dietary regime when LRD versus CLD regime, but patients who were prescribed to receive LRD have slightly better tolerance (RR, 1.06; 95% CI, 1.02-1.11) and tended to repeat the same preparation regime in future (RR, 1.17; 95% CI, 1.09-1.26) relative to patients in CLD. Importantly, both regimes resulted in similar adverse events (AEs). With the best available evidence, LRD could be recommended to be as standard regime for bowel preparation prior to colonoscopy.
传统上，清流质饮食（CLD）用于结肠镜检查前的肠道准备，但多项临床研究表明，低渣饮食（LRD）产生的效果与CLD相同，尚未得出确凿结论。进行该系统评价以解决这一矛盾并最终促进明智的决策。为了获取比较LRD与CLD肠道准备情况的随机对照试验（RCT），截至2015年5月在PubMed、EMBASE、Cochrane对照试验中心注册库（CENTRAL）、Science Direct、近期会议摘要、谷歌学术和Clinicaltrials.gov中进行了检索。我们根据临床特征和方法学采用固定效应或随机效应模型进行所有荟萃分析。此外，采用G*Power软件计算每个结局的统计效能。在初始检索阶段共获取109条潜在引文，通过其他来源纳入2篇主题相关文章。经过严格评估，7项RCT符合纳入标准。荟萃分析显示，在肠道准备质量、结肠清洁效果和对推荐饮食方案的依从性方面，LRD与CLD方案产生的效果相似，但相对于CLD组患者，接受LRD治疗的患者耐受性略好（RR，1.06；95%CI，1.02-1.11），且未来倾向于重复相同的准备方案（RR，1.17；95%CI，1.09-1.26）。重要的是，两种方案导致的不良事件（AE）相似。基于现有最佳证据，可推荐LRD作为结肠镜检查前肠道准备的标准方案。
