Wu Zhendong, Ni Chuyan, Ye Zhen, Xia Zhongsheng, Li Li, Yu Zhong, Tang Song, Lin Ying, Zhong Wa
Department of Gastroenterology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
Department of Gastroenterology, Dongguan Songshan Lake Tungwah Hospital, Dongguan, Guangdong, China.
Front Pharmacol. 2025 Apr 22;16:1544981. doi: 10.3389/fphar.2025.1544981. eCollection 2025.
Aminosalicylates have been used for the prevention and treatment of radiation enteritis (RE) for more than 50 years. However, their effectiveness in acute radiation enteritis (ARE) has been controversial. We conducted a meta-analysis to clarify the clinical efficacy of aminosalicylates in controlling the symptoms of ARE.
We searched PubMed, Cochrane Library, Embase, and Web of Science for studies published before January 2020. Eligible randomized controlled trials (RCTs) comparing the incidence of diarrhea, abdominal pain, constipation, tenesmus, and hematochezia between the aminosalicylates and control groups were included. Subgroup analyses were conducted based on different drugs and doses. Publication bias was assessed using funnel plots.
Seven RCTs with 613 patients were included. Aminosalicylates reduced the incidence of mild to moderate diarrhea (P < 0.05), while total diarrhea, severe diarrhea, abdominal pain, hematochezia, tenesmus, and constipation showed no significant differences from the control group. Subgroup analysis showed that sulfasalazine (SASP) reduced mild to moderate diarrhea (P < 0.05), whereas 5-aminosalicylic acid (5-ASA) increased total and severe diarrhea (P < 0.05). Additionally, when aminosalicylate doses exceeded 2 g/d, diarrhea incidence increased (P < 0.05).
SASP is a safe and effective treatment for mild to moderate diarrhea, while 5-ASA may increase diarrhea incidence in ARE patients. Aminosalicylates at ≤2 g/d are safe for ARE, but higher doses may worsen diarrhea.
氨基水杨酸类药物用于预防和治疗放射性肠炎（RE）已有50多年历史。然而，其在急性放射性肠炎（ARE）中的疗效一直存在争议。我们进行了一项荟萃分析，以阐明氨基水杨酸类药物在控制ARE症状方面的临床疗效。
我们检索了PubMed、Cochrane图书馆、Embase和科学网，查找2020年1月之前发表的研究。纳入符合条件的随机对照试验（RCT），比较氨基水杨酸类药物组和对照组之间腹泻、腹痛、便秘、里急后重和便血的发生率。根据不同药物和剂量进行亚组分析。使用漏斗图评估发表偏倚。
纳入了7项RCT，共613例患者。氨基水杨酸类药物降低了轻度至中度腹泻的发生率（P<0.05），而总腹泻、重度腹泻、腹痛、便血、里急后重和便秘与对照组相比无显著差异。亚组分析显示，柳氮磺胺吡啶（SASP）降低了轻度至中度腹泻（P<0.05），而5-氨基水杨酸（5-ASA）增加了总腹泻和重度腹泻的发生率（P<0.05）。此外，当氨基水杨酸类药物剂量超过2g/d时，腹泻发生率增加（P<0.05）。
SASP是治疗轻度至中度腹泻的安全有效药物，而5-ASA可能会增加ARE患者的腹泻发生率。≤2g/d的氨基水杨酸类药物对ARE是安全的，但更高剂量可能会加重腹泻。
