营养支持对胃肠道肿瘤化疗患者营养及不良反应影响的meta分析【已撤稿】
| 作者: |
1蒋大平,
2张常华,
2朱锦涛,
2夏光概,
2向臻,
2蔡世荣,
2何裕隆
1 皖南医学院弋矶山医院外科，安徽 芜湖 241000 2 中山大学附属第一院胃肠外科，广州 510080 |
| 通讯: |
张常华
Email: zhchangh@mail.sysu.edu.cn |
| DOI: | 10.3978/j.issn.2095-6959.2015.06.S003 |
摘要
【本文已撤稿，请勿继续引用】目的：通过meta分析研究营养支持对胃肠道肿瘤患者营养状况和化疗不良反应的影响。方法：应用Pubmed、Scopus、CNKI和万方数据知识服务平台数据库检索1990至2014年发表的关于胃肠道肿瘤患者化疗期间行营养支持与单纯化疗对比的随机对照研究(randomized clinical trials，RCT)，进行meta分析。结果：检索出相关文献922篇，纳入17篇。共纳入患者955例，实验组486例，对照组479例。结果显示化疗期间营养支持对转铁蛋白改善明显(SMD=0.61，95% CI, 0.40~0.82；P<0.05)，对免疫指标IgG(SMD=0.65，95% CI, 0.45~0.84；P<0.05)和IgA(SMD=0.62，95% CI,0.10~1.13；P<0.05)改善显著。在副作用方面白细胞减少(RR=0.57，95% CI, 0.39~0.82；P<0.05)、恶心呕吐(RR=0.54，95% CI, 0.40~0.72；P<0.05)和纳差(RR=0.50，95% CI, 0.30~0.83；P<0.05)均明显改善。结论：胃肠道肿瘤患者在化疗期间给予营养支持治疗可以在一定程度上改善患者的营养状况、增强免疫力，降低不良反应发生风险，具有临床推广的意义。
关键词：
胃肠道肿瘤
化疗
营养支持
meta分析
Meta-analysis of the effect of nutritional support on nutrition and chemotherapy-related side effects in GI cancer patients
DOI: 10.3978/j.issn.2095-6959.2015.06.S003
Abstract
Objective: To assess the effect of nutritional support on nutrition and chemotherapy-related side effects in GI cancer patients undergoing chemotherapy. Methods: Randomized clinical trials (RCTs) on comparison of nutrition, immunity and chemotherapy-related side effects between the GI cancer patients with or without additional nutritional support were searched through Pubmed, Scopus, CNKI and WANFANG databases. Qualified trials published from 1990 to 2014 were included in the study. Meta-analysis was used to compare nutrition, immunity and chemotherapy-related side effects between the two groups. Results: Finally 17 RCTs with 955 patients were included in the study. Among them, 486 patients received chemotherapy plus nutritional support and 492 patients received chemotherapy only. The patients who received nutritional support had significant improvement in transferring (SMD=0.61, 95% CI, 0.40~0.82, P<0.05), IgG (SMD=0.65, 95% CI, 0.45~0.84, P<0.05) and IgA (SMD=0.62, 95% CI, 0.10~1.13, P<0.05). The incidences of side-effects related to chemotherapy including leukopenia (RR=0.57, 95% CI, 0.39~0.82, P<0.05), nausea and vomiting (RR=0.54, 95% CI, 0.40~0.72, P<0.05) and anorexia (RR=0.50, 95% CI, 0.30~0.83, P<0.05) were significantly decreased in the patients with nutritional support. Conclusion: Nutritional intervention can improve nutritional status and immunity and decrease incidence of chemotherapy-related side-effects in GI cancer patients undergoing chemotherapy.