Efficacy of Dietary Treatment for Inducing Disease Remission in Eosinophilic Gastroenteritis
Efficacy of Dietary Treatment for Inducing Disease Remission in Eosinophilic Gastroenteritis
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DOI：
10.1097/mpg.0000000000000766
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发表时间：
2015-07-01
影响因子：
2.9
通讯作者：
Tenias, Jose M.
中科院分区：
文献类型：
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作者：
Lucendo, Alfredo J.;Serrano-Montalban, Beatriz;Tenias, Jose M.
目的：各种饮食干预措施已用于治疗嗜酸性胃肠炎(EGE)。然而，缺乏关于这种疗法在诱导疾病缓解方面的有效性的具体证据。本研究的目的是系统地评价饮食疗法在EGE缓解中的作用。方法：我们对MEDLINE、EMBASE和SCOPUS数据库进行了系统的搜索，以研究饮食干预(在组织学和症状缓解方面)对儿童和成人EGE和结肠炎的疗效。结果：共获得490篇参考文献，其中30篇纳入综述，这些参考文献大多是低质量的个案或短的病例系列。未发现显著的发表偏倚。儿童的基本饮食与75.8%的临床改善有关，但这些患者中很少有接受组织学评估的。过敏测试结果在EGE中很少使用。经验性地消除与过敏相关的食物是最常用的选择。然而，在症状缓解方面的不同结果几乎没有伴随着组织学证实。临床和方法的异质性阻碍了对饮食疗法在诱导疾病缓解方面疗效的定量总结的执行。结论：大多数现有文献报道的EGE饮食治疗的症状改善是值得怀疑的，因为缺乏对临床变化的客观评估，并且对组织学缓解的评估非常有限。由于相对缺乏精心设计的、高质量的研究，不能支持明确使用饮食治疗来治疗EGE和结肠炎患者。应该进行进一步的研究。
Objectives:Various dietary interventions have been used to treat patients with eosinophilic gastroenteritis (EGE). Concrete evidence as to the effectiveness of such treatments in inducing disease remission is, however, lacking. The aim of the study was to systematically review the efficacy of dietary therapies in inducing EGE remission.Methods:We performed a systematic search for the MEDLINE, EMBASE, and SCOPUS libraries for studies investigating the efficacy of dietary interventions (in both histological and symptomatic remission) for children and adults with EGE and colitis.Results:The search yielded 490 references; 30 were included in the review, with most of these references being low-quality individual cases or short case series. No significant publication bias was found. Elemental diets in children were linked to 75.8% of clinical improvement, but few of these patients underwent a histological evaluation. Allergy-testing results have been used scarcely in EGE. Empiric elimination of allergy-associated foods was the most commonly used option. The variable results in terms of symptom relief, however, were scarcely accompanied by histological confirmation. Clinical and methodological heterogeneity hindered the performance of quantitative summaries for the efficacy of dietary therapies in inducing disease remission.Conclusions:Symptomatic improvements reported for dietary treatment in EGE by most of the available literature are questionable because of the lack of objective evaluation of clinical changes and the very limited assessment of histological remission. Because of the relative lack of well-designed, high-quality studies, the unequivocal use of dietary treatment for patients with EGE and colitis cannot be supported. Further research should be undertaken.