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补充维生素D治疗肠易激综合征:一项系统评价与荟萃分析。

Vitamin D supplementation for irritable bowel syndrome: A systematic review and meta-analysis.

作者信息

Chong Ryan Ian Houe, Yaow Clyve Yu Leon, Loh Caitlin Yuen Ling, Teoh Seth En, Masuda Yoshio, Ng Wee Khoon, Lim Yu Liang, Ng Qin Xiang

机构信息

Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Department of Gastroenterology and Hepatology, Tan Tock Seng Hospital, Singapore.

出版信息

J Gastroenterol Hepatol. 2022 Jun;37(6):993-1003. doi: 10.1111/jgh.15852. Epub 2022 Apr 20.

Abstract

BACKGROUND AND AIM

Irritable bowel syndrome (IBS) is a prevalent and complex gastrointestinal disorder characterized by chronic abdominal pain and altered bowel habits. Observational studies have suggested a relationship between serum vitamin D levels and IBS symptoms. This systematic review and meta-analysis aimed to investigate the clinical effects of vitamin D supplementation on IBS symptom severity and quality of life (QoL) measures.

METHODS

Medline, Embase, Scopus, Web of Science, and The Cochrane Library databases were systematically searched. Data abstraction and quality assessment were conducted by four authors independently, and discrepancies were resolved through consensus from the senior author. Continuous data were pooled with standardized mean difference (SMD) using the DerSimonian and Laird's random-effects model. Sensitivity analysis by risk of bias and potentially "predatory" publication were performed as well.

RESULTS

A total of 685 patients across eight studies were included in the meta-analysis. Vitamin D supplementation significantly improved IBS symptom severity scale scores, with a SMD of -0.77 (95% confidence interval [CI] -1.47 to -0.07, P = 0.04, I  = 91%). Improvements in IBS-QoL scores were also observed, albeit not statistically significant (SMD 0.54; 95% CI -0.34 to 1.41, P = 0.15, I  = 87%). However, small sample sizes, a relatively young study population, limited ethnicities, and varied vitamin D dosing strategies across the studies were notable limitations.

CONCLUSIONS

Vitamin D supplementation could be part of our clinical armamentarium when managing IBS patients due to the potential efficacy and good safety profile. Further randomized, controlled trials are required to confirm the therapeutic effects.

摘要

背景与目的

肠易激综合征(IBS)是一种常见且复杂的胃肠道疾病,其特征为慢性腹痛和排便习惯改变。观察性研究表明血清维生素D水平与IBS症状之间存在关联。本系统评价和荟萃分析旨在探讨补充维生素D对IBS症状严重程度和生活质量(QoL)指标的临床效果。

方法

系统检索了Medline、Embase、Scopus、Web of Science和Cochrane图书馆数据库。由四位作者独立进行数据提取和质量评估,分歧由资深作者通过协商解决。连续数据采用DerSimonian和Laird随机效应模型合并标准化均数差(SMD)。还进行了偏倚风险和潜在“掠夺性”发表的敏感性分析。

结果

荟萃分析共纳入八项研究中的685例患者。补充维生素D显著改善了IBS症状严重程度量表评分,SMD为-0.77(95%置信区间[CI]-1.47至-0.07,P = 0.04,I² = 91%)。IBS-QoL评分也有改善,尽管无统计学意义(SMD 0.54;95% CI -0.34至1.41,P = 0.15,I² = 87%)。然而,样本量小、研究人群相对年轻、种族有限以及各研究中维生素D给药策略不同是显著局限性。

结论

由于潜在疗效和良好的安全性,补充维生素D可作为管理IBS患者时临床手段的一部分。需要进一步的随机对照试验来证实其治疗效果。

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