Richard K Russell, Andrew Fagbemi, Jalil Benyacoub, Maria E Capobianco, Laura E Wells, Rita Shergill-Bonner, Preeti Sharma, Minal Patel
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引用次数: 0
摘要
本系统文献综述（SLR）旨在比较专业和标准营养配方治疗轻度至中度儿童克罗恩病的临床、人文和经济结果。方法：检索策略应用于MEDLINE、Cochrane和Web of Science（2000年1月- 2023年10月）和最近的国会会议论文集（2021年1月- 2023年10月）。遵循PRISMA-P指南。质量评价评价偏倚风险。结果：23项独特的研究符合纳入标准。19项研究（754例患者）评估了专业配方，10项研究（246例患者）评估了标准配方。粘膜愈合（7项研究）、诱导（20项研究）和维持缓解（9项研究）在不同的时间框架内进行了报道。接受专门配方治疗的患者粘膜愈合的比例较高（63-89%，8周）；10周25-74%)，缓解（8周50-100%）。特殊配方持续缓解（6个月34-62.5%，1年24-87.5%）。由于研究方法、患者群体和缓解定义的显著异质性，结果不能与标准公式直接比较。结论：证据主要支持专用配方在诱导粘膜愈合、缓解和维持多个时间点的积极结果方面的益处。需要对营养干预措施进行直接比较，以进一步支持该SLR的研究结果。协议注册：PROSPERO CRD42023472370。
Specialized and standard nutritional formulas for the dietary management of pediatric patients with Crohn's disease: a systematic literature review.
Introduction: This systematic literature review (SLR) aims to compare the clinical, humanistic, and economic outcomes associated with specialized and standard nutritional formulas for the treatment of mild-to-moderate pediatric Crohn's disease.
Methods: Search strategies were applied across MEDLINE, Cochrane and Web of Science (January 2000-October 2023) and recent congress proceedings (January 2021-October 2023). PRISMA-P guidelines were followed. Quality assessment evaluated risk of bias.
Results: Twenty-three unique studies met the inclusion criteria. Nineteen studies (754 patients) evaluated specialized formula, 10 assessed standard formula (246 patients). Mucosal healing (7 studies), induction (20 studies) and maintenance of remission (9 studies) were reported over various timeframes. High proportions of patients who received specialized formula achieved mucosal healing (63-89% 8 weeks; 25-74% 10 weeks), and remission (50-100% 8 weeks). Specialized formula sustained remission (34-62.5% 6 months and 24-87.5% 1 year). Results were not directly comparable with standard formula due to significant heterogeneity in study methodology, patient populations, and remission definition.
Conclusions: The evidence predominantly supports the benefits of specialized formula in inducing mucosal healing, remission, and sustaining positive outcomes across multiple timepoints. Direct comparison of nutritional interventions is required to further support the findings of this SLR.Protocol registration: PROSPERO CRD42023472370.
期刊介绍：
The enormous health and economic burden of gastrointestinal disease worldwide warrants a sharp focus on the etiology, epidemiology, prevention, diagnosis, treatment and development of new therapies. By the end of the last century we had seen enormous advances, both in technologies to visualize disease and in curative therapies in areas such as gastric ulcer, with the advent first of the H2-antagonists and then the proton pump inhibitors - clear examples of how advances in medicine can massively benefit the patient. Nevertheless, specialists face ongoing challenges from a wide array of diseases of diverse etiology.
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