Gogou Maria, Kolios George
2nd Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, University General Hospital AHEPA, Thessaloniki, Greece.
Laboratory of Pharmacology, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.
Brain Dev. 2017 Sep;39(8):656-664. doi: 10.1016/j.braindev.2017.03.029. Epub 2017 Apr 21.
Autism spectrum disorder is associated with significant social and financial burden and no definite treatment for this entity has been identified, yet. In recent years there has been an increasing interest in the use of dietary interventions as a complementary therapeutic option for these patients.
The aim of this systematic review is to provide high evidence level literature data about the effect of dietary supplements on clinical aspects of children with autism.
A comprehensive literature search was conducted using Pubmed as the medical database source. Randomized controlled trials conducted in pediatric populations and including measures of clinical outcomes were considered.
A total of 17 eligible prospective studies were selected. Types of dietary supplements evaluated in these studies included amino acids, fatty acids and vitamins/minerals. N-acetylcysteine was shown to exert a beneficial effect on symptoms of irritability. On the other hand, literature data about the efficacy of d-cycloserine and pyridoxine-magnesium supplements was controversial. No significant effect was identified for fatty acids, N,N-dimethylglycine and inositol. Literature data about ascorbic acid and methyl B12 was few, although some encouraging results were found. No serious adverse events were reported in the vast majority of the studies, while the prevalence of adverse reactions was similar between treatment and placebo groups.
The use of dietary supplements in children with autism seems to be a safe practice with encouraging data about their clinical efficacy. More studies are needed to further investigate this issue.
自闭症谱系障碍会带来巨大的社会和经济负担，目前尚未确定针对该病症的明确治疗方法。近年来，人们越来越关注将饮食干预作为这些患者的一种辅助治疗选择。
本系统评价的目的是提供关于膳食补充剂对自闭症儿童临床方面影响的高证据水平文献数据。
以PubMed作为医学数据库来源进行全面的文献检索。纳入在儿科人群中进行的、包括临床结局测量的随机对照试验。
共筛选出17项符合条件的前瞻性研究。这些研究中评估的膳食补充剂类型包括氨基酸、脂肪酸和维生素/矿物质。N-乙酰半胱氨酸对易怒症状显示出有益作用。另一方面，关于d-环丝氨酸和吡哆醇-镁补充剂疗效的文献数据存在争议。未发现脂肪酸、N,N-二甲基甘氨酸和肌醇有显著作用。关于抗坏血酸和甲基维生素B12的文献数据较少，不过发现了一些令人鼓舞的结果。绝大多数研究中未报告严重不良事件，治疗组和安慰剂组不良反应的发生率相似。
对自闭症儿童使用膳食补充剂似乎是一种安全的做法，关于其临床疗效的数据令人鼓舞。需要更多研究来进一步调查这个问题。
