Underweight and specific nutrient deficiencies are frequent in adult patients with inflammatory bowel disease(IBD).In addition,a significant number of children with IBD,especially Crohn's disease(CD) have impaired...Underweight and specific nutrient deficiencies are frequent in adult patients with inflammatory bowel disease(IBD).In addition,a significant number of children with IBD,especially Crohn's disease(CD) have impaired linear growth.Nutrition has an important role in the management of IBD.In adults with CD,enteral nutrition(EN) is effective in inducing clinical remission of IBD,although it is less efficient than corticosteroids.Exclusive EN is an established primary therapy for pediatric CD.Limited data suggests that EN is as efficient as corticosteroids for induction of remission.Additional advantages of nutritional therapy are control of inflammation,mucosal healing,positive benefits to growth and overall nutritional status with minimal adverse effects.The available evidence suggests that supplementary EN may be effective also for maintenance of remission in CD.More studies are needed to confirm these findings.However,EN supplementation could be considered as an alternative or as an adjunct to maintenance drug therapy in CD.EN does not have a primary therapeutic role in ulcerative colitis.Specific compositions of enteral dietselemental diets or diets containing specific components-were not shown to have any advantage over standard polymeric diets and their place in the treatment of CD or UC need further evaluation.Recent theories suggest that diet may be implicated in the etiology of IBD,however there are no proven dietary approaches to reduce the risk of developing IBD.展开更多
背景冠心病并发失眠可称之为“双心疾病”,而失眠的持续存在又可诱发冠心病的发作或加重病情。近年来,不断有中医药治疗冠心病并发失眠的文献报道,但样本量较小,相关循证评价不足。目的系统评价中医药疗法及镇静安眠药物治疗冠心病并发...背景冠心病并发失眠可称之为“双心疾病”,而失眠的持续存在又可诱发冠心病的发作或加重病情。近年来,不断有中医药治疗冠心病并发失眠的文献报道,但样本量较小,相关循证评价不足。目的系统评价中医药疗法及镇静安眠药物治疗冠心病并发失眠的疗效。方法计算机检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据知识服务平台、维普网(VIP)、PubMed、Web of Science、EMBase、Cochrane Library数据库,检索时间为建库至2018年9月,搜集干预措施涉及中医药疗法,研究对象为冠心病并发失眠患者的临床随机对照试验(RCT)。由2位研究者独立筛选文献、提取数据和评价纳入研究的质量后,采用RevMan 5.3、Sta ta 15.1、ADDIS 1.16.8软件进行Meta分析。结果最终纳入21篇文献,共计2496例样本,涉及11种干预措施,其中中医药疗法9种。传统Meta分析结果显示:中成药+常规、中药复方+常规优于镇静安眠药物+常规(P<0.05)。网状Meta分析结果显示:按摩+五音+常规、中成药+常规、中药复方+常规、中药复方+按摩+五音+常规优于镇静安眠药物+常规(P<0.05)。艾灸+常规、八段锦+按摩+常规、按摩+五音+常规、指针+常规、中成药+常规、中药复方+常规、中药复方+按摩+五音+常规优于常规(P<0.05)。排序第1位的是中药复方+按摩+五音+常规,镇静安眠药物+常规在11项干预措施中排第10位,仅优于常规治疗。结论现有证据表明,中医药疗法对冠心病并发失眠的疗效均显示出一定优势,并且在常规治疗基础上联合中药复方+按摩+五音治疗冠心病并发失眠患者的疗效成为最优选择的可能最大。但受纳入文献数量和质量限制,本研究结论仍需更多高质量的多中心、大样本RCT予以证实。展开更多
文摘Underweight and specific nutrient deficiencies are frequent in adult patients with inflammatory bowel disease(IBD).In addition,a significant number of children with IBD,especially Crohn's disease(CD) have impaired linear growth.Nutrition has an important role in the management of IBD.In adults with CD,enteral nutrition(EN) is effective in inducing clinical remission of IBD,although it is less efficient than corticosteroids.Exclusive EN is an established primary therapy for pediatric CD.Limited data suggests that EN is as efficient as corticosteroids for induction of remission.Additional advantages of nutritional therapy are control of inflammation,mucosal healing,positive benefits to growth and overall nutritional status with minimal adverse effects.The available evidence suggests that supplementary EN may be effective also for maintenance of remission in CD.More studies are needed to confirm these findings.However,EN supplementation could be considered as an alternative or as an adjunct to maintenance drug therapy in CD.EN does not have a primary therapeutic role in ulcerative colitis.Specific compositions of enteral dietselemental diets or diets containing specific components-were not shown to have any advantage over standard polymeric diets and their place in the treatment of CD or UC need further evaluation.Recent theories suggest that diet may be implicated in the etiology of IBD,however there are no proven dietary approaches to reduce the risk of developing IBD.
文摘背景冠心病并发失眠可称之为“双心疾病”,而失眠的持续存在又可诱发冠心病的发作或加重病情。近年来,不断有中医药治疗冠心病并发失眠的文献报道,但样本量较小,相关循证评价不足。目的系统评价中医药疗法及镇静安眠药物治疗冠心病并发失眠的疗效。方法计算机检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据知识服务平台、维普网(VIP)、PubMed、Web of Science、EMBase、Cochrane Library数据库,检索时间为建库至2018年9月,搜集干预措施涉及中医药疗法,研究对象为冠心病并发失眠患者的临床随机对照试验(RCT)。由2位研究者独立筛选文献、提取数据和评价纳入研究的质量后,采用RevMan 5.3、Sta ta 15.1、ADDIS 1.16.8软件进行Meta分析。结果最终纳入21篇文献,共计2496例样本,涉及11种干预措施,其中中医药疗法9种。传统Meta分析结果显示:中成药+常规、中药复方+常规优于镇静安眠药物+常规(P<0.05)。网状Meta分析结果显示:按摩+五音+常规、中成药+常规、中药复方+常规、中药复方+按摩+五音+常规优于镇静安眠药物+常规(P<0.05)。艾灸+常规、八段锦+按摩+常规、按摩+五音+常规、指针+常规、中成药+常规、中药复方+常规、中药复方+按摩+五音+常规优于常规(P<0.05)。排序第1位的是中药复方+按摩+五音+常规,镇静安眠药物+常规在11项干预措施中排第10位,仅优于常规治疗。结论现有证据表明,中医药疗法对冠心病并发失眠的疗效均显示出一定优势,并且在常规治疗基础上联合中药复方+按摩+五音治疗冠心病并发失眠患者的疗效成为最优选择的可能最大。但受纳入文献数量和质量限制,本研究结论仍需更多高质量的多中心、大样本RCT予以证实。
