Adjuvant Efficacy of Nutrition Support During Pulmonary Tuberculosis Treating Course: Systematic Review and Meta-analysis.
Adjuvant Efficacy of Nutrition Support During Pulmonary Tuberculosis Treating Course: Systematic Review and Meta-analysis.
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DOI：
10.4103/0366-6999.170255
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发表时间：
2015-12-05
影响因子：
6.1
通讯作者：
Zhou YZ
中科院分区：
文献类型：
--
作者：
Si ZL;Kang LL;Shen XB;Zhou YZ
营养不良和结核病(TB)往往相互作用。结核病可能导致营养不足，反过来又会通过抑制免疫功能而推迟康复。营养支持可以促进正在接受结核病治疗的对象的康复。本研究的目的是评价营养支持在成人肺结核患者抗结核药物治疗中促进康复的效果。检索Cochrane对照试验注册数据库、PubMed、EMBASE、中国生物医学文献数据库、CNKI、维普、万方中文数据库。将接受抗结核治疗的结核病患者的营养支持(给予超过2周)与不进行营养干预、仅提供营养建议或安慰剂对照进行比较的随机对照试验包括在内。两名评审员进行数据提取，独立评估研究的质量，任何差异都由第三名评审员解决。用Revman 5.2软件进行数据录入和分析，并使用二分变量的风险比(RR)和连续变量的均值差(MD)进行Meta分析，可信区间(CI)为95%。共纳入19项研究(3681名参与者)。在结核病患者的营养支持中，与对照组相比，合并RR和95%CI分别为1.10(1.04，1.17)和1.22(1.08，1.39)，合并MD和95%CI分别为0.59(0.16，1.2)和−5.42(−7.93，−2.92)。干预组与对照组受累CXR区结局、TB评分、血清白蛋白、Hb差异无统计学意义(P分别为0.76、0.24、0.28、0.20)。没有记录到系统性不良事件。在抗结核治疗过程中，营养支持可提高痰培养转阴率和BMI，缩短痰转阴时间，有助于结核病患者的治疗。能否提高最终的临床疗效，还需要高水平的高质量研究在未来加以证实。
Malnutrition and tuberculosis (TB) tend to interact with each other. TB may lead to nutrition deficiencies that will conversely delay recovery by depressing immune functions. Nutrition support can promote recovery in the subject being treated for TB. The aim of this study was to evaluate the effectiveness of nutrition support on promoting the recovery of adult pulmonary TB patients with anti-TB drug therapy. English database of the Cochrane Controlled Trials Register, PubMed, EMBASE, and Chinese database of CBM, CNKI, VIP, and WANFANG were searched. Randomized controlled trials comparing nutrition support (given for more than 2 weeks) with no nutrition intervention, nutrition advice only, or placebo-control for TB patients being anti-TB treated were included. Two reviewers conducted data extraction, assessed the quality of the studies independently, and any discrepancies were solved by the third reviewer. Data were entered and analyzed by RevMan 5.2 software, and meta-analysis was done using risk ratios (RRs) for dichotomous variables and mean differences (MDs) for continuous variables with 95% confidence intervals (CIs). A total of 19 studies (3681 participants) were included. In nutritional support for TB patients, pooled RR and its 95% CI of sputum smears- or culture-negative conversion rate and chest X-ray (CXR) absorption rate were 1.10 (1.04, 1.17) and 1.22 (1.08, 1.39), respectively, the pooled MD and its 95% CI of body mass index (BMI) and time of sputum smears or culture negativity were 0.59 (0.16, 1.2) and − 5.42 (−7.93, −2.92), respectively, compared with the control group. The differences in outcomes of CXR zone affected, TB score, serum albumin, and hemoglobin were not statistically significant (P = 0.76, 0.24, 0.28, and 0.20, respectively) between the intervention group and the control group. No systemic adverse events were recorded. During anti-TB course, nutrition support may be helpful in treatment of TB patients by improving both sputum smears- or culture-negative conversion rate and BMI, shortening the time of sputum conversion negative. Whether it can improve the final clinical effect, there still needs high-level quality studies to confirm in the future.