本文選題：酒精性肝病 + 營養(yǎng)治療��； 參考：《暨南大學》2014年碩士論文

【摘要】：目的：評價營養(yǎng)治療對酒精性肝�。ˋLD）的療效與安全性。 方法：檢索Pubmed、Embase、Web of Science、The Cochrane Central Register of ControlledTrials、相關(guān)期刊論文、中國科技期刊數(shù)據(jù)庫（維普）、萬方數(shù)字化期刊全文數(shù)據(jù)庫等有關(guān)營養(yǎng)治療酒精性肝病的臨床隨機對照試驗，采用RevMan5.1.0軟件對入選試驗進行Meta分析。 結(jié)果：共13項隨機對照試驗（RCT）包含590名ALD患者符合入選標準。Meta分析結(jié)果顯示：①與對照組相比，營養(yǎng)治療可以更有效地降低ALD患者血清總膽紅素（P=0.04）、堿性磷酸酶（ALP）（P=0.04）以及升高血清轉(zhuǎn)鐵蛋白（P＜0.00001），但在其他肝功能及ALD并發(fā)癥等其他指標方面兩種治療方法無顯著統(tǒng)計學差異；②營養(yǎng)治療組的短期及長期死亡率與對照組相比無顯著統(tǒng)計學差異，RR值分別為1.09（95%CI：0.80~1.47，P=0.59）及0.75（95%CI：0.55~1.01，P=0.06）；③營養(yǎng)治療與對照組相比，總不良反應發(fā)生率及感染發(fā)生率均無顯著統(tǒng)計學差異（RR1.64，P=0.11；RR0.99，P=0.97）；④根據(jù)營養(yǎng)方式不同，將13個RCT分為腸內(nèi)營養(yǎng)亞組（9個RCT）和腸外營養(yǎng)亞組（4個RCT），，Meta分析結(jié)果顯示：與對照組相比，腸外營養(yǎng)能更加明顯降低ALD患者血清總膽紅素（P＜0.00001），而腸內(nèi)營養(yǎng)與對照組相比在降低血清總膽紅素的療效方面無顯著統(tǒng)計學差異（P=0.84）；其它療效指標如ALP、短期及長期死亡率等亞組分析結(jié)果與上述未分組時的結(jié)果一致。 結(jié)論：營養(yǎng)治療可以明顯改善ALD患者的血清膽紅素、堿性磷酸酶、轉(zhuǎn)鐵蛋白等部分肝功能指標，但不能改善其短期或長期生存率、其他肝功能及ALD并發(fā)癥等指標，不良反應較少，可以作為ALD患者的常規(guī)治療方法。
[Abstract]:Objective: to evaluate the efficacy and safety of nutritional therapy in patients with alcoholic liver disease (ALD). Methods: a randomized controlled clinical trial on nutritional therapy of alcoholic liver disease was conducted in Pubmedus Embase of Science and Technology (Cochrane Central Register of ControlledTrials,), Chinese Journal of Science and Technology (WYPU), Chinese Science and Technology Journals (WYPX), and the Chinese Journal of Science and Technology (Cochrane Central Register of ControlledTrials,). RevMan5.1.0 software was used to analyze the selected test by Meta. Results: a total of 13 randomized controlled trials (RCTs) included 590 ALD patients who met the inclusion criteria. Meta-analysis showed that: 1 was compared with the control group. Nutritional therapy could effectively reduce serum total bilirubin, alkaline phosphatase (ALP) and elevated serum transferrin (P < 0.00001) in patients with ALD, but there was no significant difference in other indexes such as liver function and ALD complications. 2There was no significant difference in the short-term and long-term mortality rates between the nutrition treatment group and the control group. The RR values were 1.09 / 95, respectively (CI: 0.80 / 1.47) (0.59) and 0.75 ~ 95% (CI: 0.551.01) and 0.06% (P < 0.05), respectively, compared with those in the control group, and there was no significant difference between the nutrition treatment group and the control group. There was no significant difference in the incidence of total adverse reactions and the incidence of infection. According to the different nutrition patterns, 13 RCT were divided into enteral nutrition subgroup (9 RCT) and parenteral nutrition subgroup (4 RCTs). The results of meta-analysis showed that: compared with the control group, 13 RCT were divided into two groups: compared with the control group, 13 RCT were divided into enteral nutrition subgroup (9 RCTs) and parenteral nutrition subgroup (4 RCTs). Parenteral nutrition significantly decreased serum total bilirubin in patients with ALD (P < 0.00001), but there was no significant difference in the efficacy of enteral nutrition in reducing serum total bilirubin compared with control group. The results of subgroup analysis were consistent with those of the ungrouped group. Conclusion: nutritional therapy can obviously improve some liver function indexes such as serum bilirubin, alkaline phosphatase and transferrin in ALD patients, but can not improve short-term or long-term survival rate, other liver function and ALD complications. There are few adverse reactions and can be used as a routine therapy for ALD patients.
【學位授予單位】：暨南大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R575.5

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相關(guān)期刊論文 前2條

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