Wu Yun, Jiang Zhenyu, Su Ri Gu Ge, Wang Lu, Tian Feilong, Liu Lin
Department of Gastroenterology, The Second Affiliated Hospital of Baotou Medical College, Baotou, Inner Mongolia, China.
Medicine (Baltimore). 2024 Dec 6;103(49):e40499. doi: 10.1097/MD.0000000000040499.
So far, there are still many difficulties in the treatment of inflammatory bowel disease (IBD), among which enteral nutrition (EN) is the most valuable and controversial treatment. Therefore, this study will compare the effectiveness of conventional medication with EN in the treatment of inflammatory bowel disease.
Searching the Pubmed, Embase, Web of Science, Cochrane Library, Clinical trial, CNKI, Chinese biomedical literature, VIP, and Wanfang databases, Randomized controlled trials and cohort studies on conventional drug + EN and conventional drug therapy for IBD were also retrieved, The data of their efficiency and nutritional status (hemoglobin, albumin, and body mass index) were extracted independently, After a qualitative evaluation of the included literature. The meta-analysis was performed using the RevMan5.3 software.
A total of 33 study articles were included, including 2466 IBD patients, 1248 patients in the test group (conventional drugs combined with EN), and 1218 patients in the control group (conventional drugs). The meta-analysis showed that the clinical response of conventional drugs with EN for IBD was higher than the conventional drug group (RR = 1.25, 95% CI: 1.17-1.34, Z = 6.37, P < .00001); incidence of total adverse effects: compared with the combination group (RR = 0.98, 95% CI: 0.64-1.48, Z = 0.11, P = .91). Nutritional status: hemoglobin, albumin, and body mass index in the combined EN group were significantly higher than those in the control group.
For IBD patients (including UC and CD), the combination of conventional drugs and EN was more effective than conventional drug treatment alone, hemoglobin, albumin and body mass index were significantly higher than conventional drug treatment alone, and the difference in adverse reactions was not significant. However, the current research evidence is not enough to fully prove the reliability of the combination therapy, and further studies need to be verified in the future.
迄今为止，炎症性肠病（IBD）的治疗仍存在诸多困难，其中肠内营养（EN）是最具价值且颇具争议的治疗方法。因此，本研究将比较传统药物治疗与肠内营养在炎症性肠病治疗中的有效性。
检索Pubmed、Embase、Web of Science、Cochrane图书馆、临床试验、中国知网、中国生物医学文献、维普和万方数据库，同时检索关于传统药物+肠内营养与传统药物疗法治疗IBD的随机对照试验和队列研究，独立提取其疗效及营养状况（血红蛋白、白蛋白和体重指数）的数据，对纳入文献进行定性评估后，使用RevMan5.3软件进行荟萃分析。
共纳入33篇研究文章，包括2466例IBD患者，试验组（传统药物联合肠内营养）1248例患者，对照组（传统药物）1218例患者。荟萃分析显示，传统药物联合肠内营养治疗IBD的临床缓解率高于传统药物组（RR = 1.25，95%CI：1.17 - 1.34，Z = 6.37，P <.00001）；总不良反应发生率：联合组与对照组相比（RR = 0.98，95%CI：0.64 - 1.48，Z = 0.11，P =.91）。营养状况：联合肠内营养组的血红蛋白、白蛋白和体重指数显著高于对照组。
对于IBD患者（包括溃疡性结肠炎和克罗恩病），传统药物与肠内营养联合治疗比单纯传统药物治疗更有效，血红蛋白、白蛋白和体重指数显著高于单纯传统药物治疗，且不良反应差异不显著。然而，目前的研究证据不足以充分证明联合治疗的可靠性，未来还需进一步研究验证。
