Gastrointestinal Unit for Translational Studies, Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand.
Biostatistics and Computational Biology Unit, University of Otago Christchurch, Christchurch, New Zealand.
Adv Nutr. 2022 Jun 1;13(3):846-856. doi: 10.1093/advances/nmac025.
Kiwifruit have known positive effects on digestion. During clinical intervention trials using kiwifruit to improve constipation, upper gastrointestinal (GI) symptoms such as abdominal discomfort and pain, indigestion, and reflux were also alleviated. We aimed to evaluate the evidence for upper GI symptom relief by kiwifruit in clinical trials on participants with functional constipation (FC), irritable bowel syndrome with constipation (IBS-C), and healthy participants, and to elucidate which symptoms may be relieved and whether a difference exists between the effects of gold and green kiwifruit. We executed a systematic scoping review of 3 electronic databases from 1947 through January 2021 to identify clinical trials that reported effects of green or gold kiwifruit or kiwifruit compounds on upper GI symptoms as secondary outcomes in healthy participants or participants with FC or IBS-C. Studies were divided into those using the Gastrointestinal Symptom Rating Scale (GSRS) and those using alternative measurement tools. GSRS outcomes were pooled and statistically analyzed; non-GSRS outcomes were summarized. We identified 12 clinical trials with a total of 661 participants (124 controls, 537 receiving intervention) providing evidence for symptom relief of upper GI symptoms by kiwifruit intake. Only 5 of the 12 clinical trials used the GSRS to assess upper GI symptom relief. We found good evidence that green kiwifruit may reduce abdominal discomfort and pain, and some evidence that kiwifruit consumption may attenuate indigestion. Pooled GSRS outcome analysis indicates an average reduction of -0.85 (95% CI: -1.1, -0.57; Z = 6.1) in abdominal pain scores and -0.33 (95% CI: -0.52, -0.15; Z = -3.5) in indigestion scores with habitual kiwifruit consumption. While the number of studies reporting on upper GI symptom relief with a comparable measurement is limited, there is consistent evidence for the efficacy of kiwifruit on upper GI symptom relief. More research to strengthen the evidence is recommended.
奇异果对消化有明显的积极作用。在使用奇异果改善便秘的临床干预试验中，腹部不适和疼痛、消化不良和反流等上胃肠道（GI）症状也得到了缓解。我们旨在评估奇异果对功能性便秘（FC）、便秘型肠易激综合征（IBS-C）和健康参与者的临床研究中缓解上 GI 症状的证据，并阐明哪些症状可能得到缓解，以及金奇异果和绿奇异果的效果是否存在差异。我们对三个电子数据库进行了系统的范围综述，从 1947 年到 2021 年 1 月，以确定报告绿奇异果或金奇异果或奇异果化合物对健康参与者或 FC 或 IBS-C 参与者上 GI 症状作为次要结局的临床研究。研究分为使用胃肠道症状评分量表（GSRS）和使用替代测量工具的研究。对 GSRS 结果进行了汇总和统计学分析；对非 GSRS 结果进行了总结。我们确定了 12 项共涉及 661 名参与者（124 名对照组，537 名接受干预）的临床试验，这些研究为奇异果摄入缓解上 GI 症状提供了证据。只有 12 项临床试验中的 5 项使用 GSRS 来评估上 GI 症状的缓解情况。我们发现，绿奇异果可能缓解腹部不适和疼痛的证据较好，而奇异果摄入可能减轻消化不良的证据较弱。GSRS 汇总结果分析表明，习惯性食用奇异果可使腹痛评分平均降低 -0.85（95%CI：-1.1，-0.57；Z=6.1），消化不良评分降低 -0.33（95%CI：-0.52，-0.15；Z=-3.5）。虽然报告具有可比测量值的上 GI 症状缓解的研究数量有限，但有一致的证据表明奇异果对上 GI 症状缓解有效。建议进行更多研究以加强证据。
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