维生素 D 补充剂治疗肠易激综合征的疗效：系统评价与荟萃分析。
The efficacy of vitamin D supplementation for irritable bowel syndrome: a systematic review with meta-analysis.
机构信息
Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, 310003, Hangzhou, China.
Department of Gastroenterology, Haining Branch of the First Affiliated Hospital, Zhejiang University School of Medicine, 314499, Haining, China.
出版信息
Nutr J. 2022 May 5;21(1):24. doi: 10.1186/s12937-022-00777-x.
BACKGROUND
Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder involving gut-brain interactions with limited effective treatment options. Vitamin D deficiency is commonly observed in patients with IBS, but whether vitamin D supplementation ameliorates IBS is controversial in randomized controlled trials. The present systematic review and meta-analysis explored the efficacy of vitamin D supplementation in patients with IBS.
METHODS
We performed a systematic search of potentially relevant publications from PubMed, EMBASE, the Cochrane Central Register of Controlled Studies and the Web of Science up until January 2022. We assessed the weighted mean difference (WMD) and 95% confidence interval (95% CI) of the IBS severity scoring system (IBS-SSS), IBS quality of life (IBS-QoL) and IBS total score (IBS-TS) before and after vitamin D supplementation intervention.
RESULTS
We included four randomized, placebo-controlled trials involving 335 participants. The differences in IBS-SSS score between participants in the intervention group and the placebo group increased after intervention (WMD: -55.55, 95% CI: -70.22 to -40.87, I = 53.7%, after intervention; WMD: -3.17, 95% CI: -18.15 to 11.81, I = 0.0%, before intervention). Participants receiving vitamin D supplementation showed greater improvement in IBS-SSS after intervention than participants receiving placebo treatment (WMD: -84.21, 95% CI: -111.38 to -57.05, I = 73.2%; WMD: -28.29, 95% CI: -49.95 to -6.62, I = 46.6%, respectively). Vitamin D supplementation was also superior to placebo in IBS-QoL improvement (WMD: 14.98, 95% CI: 12.06 to 17.90, I = 0.0%; WMD: 6.55, 95% CI: -2.23 to 15.33, I = 82.7%, respectively). Sensitivity analyses revealed an unstable pooled effect on IBS-TS in participants receiving vitamin D supplementation. Therefore, we did not evaluate the efficacy of vitamin D intervention in IBS-TS.
CONCLUSIONS
This systematic review and meta-analysis suggested that vitamin D supplementation was superior to placebo for IBS treatment.
背景
肠易激综合征（IBS）是一种涉及肠道-大脑相互作用的慢性胃肠道疾病，其治疗方法有限。IBS 患者常存在维生素 D 缺乏，但维生素 D 补充是否能改善 IBS 在随机对照试验中存在争议。本系统评价和荟萃分析探讨了维生素 D 补充治疗 IBS 的疗效。
方法
我们对 PubMed、EMBASE、Cochrane 对照试验中心注册库和 Web of Science 中可能相关的文献进行了系统检索，检索截至 2022 年 1 月。我们评估了维生素 D 补充干预前后 IBS 严重程度评分系统（IBS-SSS）、IBS 生活质量（IBS-QoL）和 IBS 总分（IBS-TS）的加权均数差（WMD）和 95%置信区间（95%CI）。
结果
我们纳入了四项随机、安慰剂对照试验，共 335 名参与者。干预组和安慰剂组参与者的 IBS-SSS 评分在干预后有所增加（WMD：-55.55，95%CI：-70.22 至-40.87，I=53.7%，干预后；WMD：-3.17，95%CI：-18.15 至 11.81，I=0.0%，干预前）。与接受安慰剂治疗的参与者相比，接受维生素 D 补充的参与者的 IBS-SSS 改善更大（WMD：-84.21，95%CI：-111.38 至-57.05，I=73.2%；WMD：-28.29，95%CI：-49.95 至-6.62，I=46.6%，分别）。在 IBS-QoL 改善方面，维生素 D 补充也优于安慰剂（WMD：14.98，95%CI：12.06 至 17.90，I=0.0%；WMD：6.55，95%CI：-2.23 至 15.33，I=82.7%，分别）。敏感性分析显示，接受维生素 D 补充的参与者的 IBS-TS 汇总效应不稳定。因此，我们未评估维生素 D 干预对 IBS-TS 的疗效。
结论
本系统评价和荟萃分析提示，维生素 D 补充治疗 IBS 优于安慰剂。
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