Jelalian E, Stark L J, Reynolds L, Seifer R
Brown University School of Medicine, Providence, Rhode Island, USA.
J Pediatr. 1998 Mar;132(3 Pt 1):486-92. doi: 10.1016/s0022-3476(98)70025-3.
A meta analysis of the literature on treatment approaches to malnutrition in cystic fibrosis (CF) was conducted to evaluate the effectiveness of oral supplementation, enteral nutrition, parenteral nutrition, and behavioral intervention on weight gain before and after treatment.
Eighteen studies were reviewed: four behavioral, six supplement, five enteral nutrition, and three parenteral nutrition.
The weighted effect size for weight gain was large for each intervention: 1.51 behavioral, 1.62 oral, 1.78 enteral, and 2.20 parenteral intervention. All interventions produced a large effect for weight gain in patients with CF. A univariate analysis of variance indicated no significant difference among the four interventions, F(3, 17) = 0.87, p > 0.05. Effect size for calorie intake was also evaluated when data were available (N = 7 studies), yielding a sample size of three behavioral, two enteral, and two oral supplement studies. Analysis of variance indicated a significant effect for treatment, F(2,4) = 13.34, p < 0.05, with post hoc analysis indicating that the behavioral intervention had a greater effect size for calorie intake than oral supplement.
All interventions were effective in producing weight gain in patients with CF. Behavioral intervention appeared to be as effective in improving weight gain in patients with CF as more invasive medical procedures. These findings support continued research on nutrition intervention with patients with CF including controlled clinical trials of the interventions and long-term follow-up on the impact of nutrition on disease progression.
对囊性纤维化（CF）营养不良治疗方法的文献进行荟萃分析，以评估口服补充、肠内营养、肠外营养和行为干预对治疗前后体重增加的有效性。
回顾了18项研究：4项行为研究、6项补充剂研究、5项肠内营养研究和3项肠外营养研究。
每种干预措施的体重增加加权效应量都很大：行为干预为1.51，口服为1.62，肠内为1.78，肠外干预为2.20。所有干预措施对CF患者的体重增加都有显著效果。单因素方差分析表明，四种干预措施之间无显著差异，F(3, 17) = 0.87，p > 0.05。当有数据可用时（N = 7项研究），还评估了卡路里摄入量的效应量，产生了三项行为研究、两项肠内研究和两项口服补充剂研究的样本量。方差分析表明治疗有显著效果，F(2,4) = 13.34，p < 0.05，事后分析表明行为干预对卡路里摄入量的效应量大于口服补充剂。
所有干预措施对CF患者的体重增加均有效。行为干预在改善CF患者体重增加方面似乎与侵入性更强的医疗程序一样有效。这些发现支持对CF患者进行营养干预的持续研究，包括对干预措施的对照临床试验以及对营养对疾病进展影响的长期随访。
