食物不耐受检测血清特异性IgG结果的饮食指导对溃疡性结肠炎临床疗效影响的Meta分析
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摘要
[目的]综合评价食物不耐受血清特异性IgG抗体检测结果的饮食指导对溃疡性结肠炎疗效的影响,量化该类饮食指导的效果。[方法]检索中外数据库中公开发表的基于食物不耐受血清特异性IgG抗体检测结果的饮食指导在溃疡性结肠炎患者中应用的文献资料。采用Cochrane Handbook(5.1.0)对文献质量进行评价,RevMan5.3软件对资料进行Meta分析。[结果]最终纳入文献7篇,共计519例患者。Meta分析结果显示,基于食物不耐受检测血清特异性IgG结果的饮食指导临床有效率(RR=1.41,95%CI:1.16、1.72,P<0.05)优于常规饮食指导,疾病活动指数(WMD=-1.24,95%CI:-1.66、-0.83,P<0.01)低于对照组,差异均有统计学意义。[结论]基于食物不耐受血清特异性IgG抗体检测结果的饮食指导,可以提高溃疡性结肠炎患者的临床疗效。但是由于纳入文献数量及质量限制,可能影响本次Meta分析结果的可靠性和论证强度。
[Objective]To evaluate the efficacy of clinical improvements of ulcerative colitis by dietary interventions based on the results of food specific IgG antibody testing,and to quantify the effect of diet interventions.[Methods]Dietary interventions for UC patients based on the results of food specific IgG antibody testing were retrieved from Chinese and foreign databases,and some other related papers were manually checked.The quality of included studies were assessed according to Cochrane Handbook,then the Meta-analysis was performed by RevMan 5.3 software.[Results]At last,7 articles including 519 patients were involved.Meta-analysis showed that the clinical efficacy was significantly higher in the intervention group than the control group(RR= 1.41;95%CI:1.16,1.72;P<0.05).Disease activity index(WMD=-1.24;95%CI:-1.66,-0.83;P<0.01)was significantly lower than control group.[Conclusion]The dietary in-terventions based on the results of food specific IgG antibody testing can improve the efficacy of clinical efficacy and reduce disease activity index.However due to the quantity and quality of the included literature,it may affect the reliability of the meta-analysis results.
[Objective]To evaluate the efficacy of clinical improvements of ulcerative colitis by dietary interventions based on the results of food specific IgG antibody testing,and to quantify the effect of diet interventions.[Methods]Dietary interventions for UC patients based on the results of food specific IgG antibody testing were retrieved from Chinese and foreign databases,and some other related papers were manually checked.The quality of included studies were assessed according to Cochrane Handbook,then the Meta-analysis was performed by RevMan 5.3 software.[Results]At last,7 articles including 519 patients were involved.Meta-analysis showed that the clinical efficacy was significantly higher in the intervention group than the control group(RR= 1.41;95%CI:1.16,1.72;P<0.05).Disease activity index(WMD=-1.24;95%CI:-1.66,-0.83;P<0.01)was significantly lower than control group.[Conclusion]The dietary in-terventions based on the results of food specific IgG antibody testing can improve the efficacy of clinical efficacy and reduce disease activity index.However due to the quantity and quality of the included literature,it may affect the reliability of the meta-analysis results.
引文
[1]中华医学会消化病学分会炎症性肠病学组.炎症性肠病诊断与治疗的共识意见(2012年·广州)[J].胃肠病学,2012,51(12):763-781.
[2]MEKKEL G,BARTA Z,RESS Z,et al.Increased IgEtype antibody response to food allergens in irritable bowel syndrome and inflammatory bowel diseases[J].Orvosi Hetilap,2005,146:797-802.
[3]韦卉,胡海滨,莫善颖.消化系统疾病患者食物不耐受检测结果分析[J].吉林医学,2009,30(19):2258-2260.
[4]LEUNG J,CROWE S E.Food allergy and food intolerance[J].World Rev Nut Diet,2014,111:76-81.
[5]杨旭,章金春,李梅,等.食物不耐受与炎症性肠病[J].世界华人消化杂志,2011,19(30):3182-3185.
[6]KNIGHT-SEPULVEDA K,KAIS S,SANTAOLALLA R,et al.Diet and inflammatory bowel disease[J].Gastroenterol Hepatol,2015,11:511-520.
[7]FERGUSON L R,SHELLING A N,BROWNING B L,et al.Genes,diet and inflammatory bowel disease[J].Mutat Res,2007,622:70-83.
[8]MARESCA M,FANTINI J.Some food-associated mycotoxins as potential risk factors in humans predisposed to chronic intestinal inflammatory diseases[J].Toxicon,2010,56:282-282.
[9]HOLT D Q,STRAUSS B J,MOORE G T.Patients with inflammatory bowel disease and their treating clinicians have different views regarding diet[J].J Hum Nutr Diet,2017,30:66-72.
[10]施文陆.溃疡性结肠炎患者膳食质量现状及其影响因素的研究[D].南京中医药大学,2016.
[11]李艳龙.炎症性肠病营养不良的原因与膳食治疗[J].河北中医,2012,34(8):1268-1269.
[12]中华医学会消化病学分会炎症性肠病协作组,欧阳钦,胡品津,等.对我国炎症性肠病诊断治疗规范的共识意见(2007年,济南)[J].中华消化杂志,2007,27(8):545
[13]张以霞,刘玲,王伯芳.个体化饮食护理在缓解溃疡性结肠炎病人临床症状中的应用效果[J].护理研究,2015,29(6):736-738.
[14]黄晓峰.溃疡性结肠炎患者食物不耐受分析和剔除不耐受食物后临床疗效观察[D].福建医科大学,2012.
[15]马铭泽,张安忠,蒯景华,等.溃疡性结肠炎患者食物特异性抗体的检测和剔除过敏食物对临床疗效的影响[J].山东大学学报(医学版),2011,49(1):86-89.
[16]何建伟,夏小丽,王昌泉.食物不耐受溃疡性结肠炎患者饮食管理方案研究[J].现代中西医结合杂志,2014,23(32):3571-3573.
[17]卞玉花,张苏闽.基于特异性IgG检测的饮食护理在轻-中度溃疡性结肠炎中的应用[J].现代中西医结合杂志,2015,26(27):3052-3054.
[18]沙夕华,吴元祥,刘建,等.基于血清IgG检测的饮食疗法对溃疡性结肠炎患者的疗效分析[J].现代消化及介入诊疗,2014,19(4):254-256.
[19]王学艳,姜国俊,石海云,等.食物特异性抗体IgG检测在溃疡性结肠炎中的临床意义[J].标记免疫分析与临床,2008,15(6):357-358.
[20]黄洁明,钟冕.食物不耐受检测意义及饮食指导的临床研究[J].重庆医学,2015,44(20):2835-2837.
[21]杨旭,周惠芬,张苏闽,等.基于食物特异性IgG检测的溃疡性结肠炎患者个体化饮食健康管理方案研究[J].中国全科医学,2012,15(20):2319-2322.
[22]苏清伦,汪洪燕,吴叶荣,等.慢性疲劳综合征患者食物不耐受检测的临床意义[J].中国临床保健杂志,2010,5(20):472-473.
[23]CASANOVA M J,CHAPARRO M,MOLINA B,et al.Prevalence of malnutrition and nutritional characteristics of patients with inflammatory bowel disease[J].J Crohns Colitis,2016,150:S89-89.
[24]INNS S J,EMMANUEL A V.Survey of UK and New Zealand gastroenterologists’practice regarding dietary advice and food exclusion in irritable bowel syndrome and inflammatory bowel disease[J].Frontline Gastroenterol,2013,4:44-50.
[25]BENTZ S,HAUSMANN M,PIBERGER H,et al.Clinical relevance of IgG antibodies against food antigens in Crohn’s disease:a double-blind cross-over diet intervention study[J].Digestion,2010,81:252-264.
[26]RAJENDRAN N,KUMAR D.Food-specific IgG4-guided exclusion diets improve symptoms in Crohn’s disease:apilot study[J].Colorectal Dis,2011,13:1009-1013.
[27]熊双双,王晓蕾,江春华,等.炎症性肠病患者食物不耐受检测的调查研究[J].国际消化病杂志,2017,27(5):311-315.
[28]KONIJETI G G,KIM N,LEWIS J D,et al.Efficacy of the autoimmune protocol diet for inflammatory bowel disease[J].Inflamm Bowel Dis,2017,11:2054-2060.
[2]MEKKEL G,BARTA Z,RESS Z,et al.Increased IgEtype antibody response to food allergens in irritable bowel syndrome and inflammatory bowel diseases[J].Orvosi Hetilap,2005,146:797-802.
[3]韦卉,胡海滨,莫善颖.消化系统疾病患者食物不耐受检测结果分析[J].吉林医学,2009,30(19):2258-2260.
[4]LEUNG J,CROWE S E.Food allergy and food intolerance[J].World Rev Nut Diet,2014,111:76-81.
[5]杨旭,章金春,李梅,等.食物不耐受与炎症性肠病[J].世界华人消化杂志,2011,19(30):3182-3185.
[6]KNIGHT-SEPULVEDA K,KAIS S,SANTAOLALLA R,et al.Diet and inflammatory bowel disease[J].Gastroenterol Hepatol,2015,11:511-520.
[7]FERGUSON L R,SHELLING A N,BROWNING B L,et al.Genes,diet and inflammatory bowel disease[J].Mutat Res,2007,622:70-83.
[8]MARESCA M,FANTINI J.Some food-associated mycotoxins as potential risk factors in humans predisposed to chronic intestinal inflammatory diseases[J].Toxicon,2010,56:282-282.
[9]HOLT D Q,STRAUSS B J,MOORE G T.Patients with inflammatory bowel disease and their treating clinicians have different views regarding diet[J].J Hum Nutr Diet,2017,30:66-72.
[10]施文陆.溃疡性结肠炎患者膳食质量现状及其影响因素的研究[D].南京中医药大学,2016.
[11]李艳龙.炎症性肠病营养不良的原因与膳食治疗[J].河北中医,2012,34(8):1268-1269.
[12]中华医学会消化病学分会炎症性肠病协作组,欧阳钦,胡品津,等.对我国炎症性肠病诊断治疗规范的共识意见(2007年,济南)[J].中华消化杂志,2007,27(8):545
[13]张以霞,刘玲,王伯芳.个体化饮食护理在缓解溃疡性结肠炎病人临床症状中的应用效果[J].护理研究,2015,29(6):736-738.
[14]黄晓峰.溃疡性结肠炎患者食物不耐受分析和剔除不耐受食物后临床疗效观察[D].福建医科大学,2012.
[15]马铭泽,张安忠,蒯景华,等.溃疡性结肠炎患者食物特异性抗体的检测和剔除过敏食物对临床疗效的影响[J].山东大学学报(医学版),2011,49(1):86-89.
[16]何建伟,夏小丽,王昌泉.食物不耐受溃疡性结肠炎患者饮食管理方案研究[J].现代中西医结合杂志,2014,23(32):3571-3573.
[17]卞玉花,张苏闽.基于特异性IgG检测的饮食护理在轻-中度溃疡性结肠炎中的应用[J].现代中西医结合杂志,2015,26(27):3052-3054.
[18]沙夕华,吴元祥,刘建,等.基于血清IgG检测的饮食疗法对溃疡性结肠炎患者的疗效分析[J].现代消化及介入诊疗,2014,19(4):254-256.
[19]王学艳,姜国俊,石海云,等.食物特异性抗体IgG检测在溃疡性结肠炎中的临床意义[J].标记免疫分析与临床,2008,15(6):357-358.
[20]黄洁明,钟冕.食物不耐受检测意义及饮食指导的临床研究[J].重庆医学,2015,44(20):2835-2837.
[21]杨旭,周惠芬,张苏闽,等.基于食物特异性IgG检测的溃疡性结肠炎患者个体化饮食健康管理方案研究[J].中国全科医学,2012,15(20):2319-2322.
[22]苏清伦,汪洪燕,吴叶荣,等.慢性疲劳综合征患者食物不耐受检测的临床意义[J].中国临床保健杂志,2010,5(20):472-473.
[23]CASANOVA M J,CHAPARRO M,MOLINA B,et al.Prevalence of malnutrition and nutritional characteristics of patients with inflammatory bowel disease[J].J Crohns Colitis,2016,150:S89-89.
[24]INNS S J,EMMANUEL A V.Survey of UK and New Zealand gastroenterologists’practice regarding dietary advice and food exclusion in irritable bowel syndrome and inflammatory bowel disease[J].Frontline Gastroenterol,2013,4:44-50.
[25]BENTZ S,HAUSMANN M,PIBERGER H,et al.Clinical relevance of IgG antibodies against food antigens in Crohn’s disease:a double-blind cross-over diet intervention study[J].Digestion,2010,81:252-264.
[26]RAJENDRAN N,KUMAR D.Food-specific IgG4-guided exclusion diets improve symptoms in Crohn’s disease:apilot study[J].Colorectal Dis,2011,13:1009-1013.
[27]熊双双,王晓蕾,江春华,等.炎症性肠病患者食物不耐受检测的调查研究[J].国际消化病杂志,2017,27(5):311-315.
[28]KONIJETI G G,KIM N,LEWIS J D,et al.Efficacy of the autoimmune protocol diet for inflammatory bowel disease[J].Inflamm Bowel Dis,2017,11:2054-2060.