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目的:采用荟萃分析和系统评价的文献研究,探讨多不饱和脂肪酸(PUFA)治疗癌性恶病质的临床价值。方法:确定符合条件的研究,系统回顾1995年1月至2015年10月,搜索Pub Med/MEDLINE、EMBASE和Cochrane中心注册的随机对照试验,包括随机登记、各种进展期恶性肿瘤、肿瘤相关厌食症、恶病质综合征病人和评估PUFA的作用与安慰剂相比,其他药物或不同剂量的PUFA。目标结局是对食欲、C-反应蛋白、IL-6水平、瘦组织体重、生活质量和体重分析。结果:最终对16篇文献展开了研究。系统评价评估指标包括食欲(6篇)、C-反应蛋白(9篇)、IL-6(5篇)、瘦组织体重(7篇)、生活质量(7篇)。其中4篇文献研究结果提示PUFA干预显著改善食欲,PUFA降低C-反应蛋白血清水平的文献6篇,PUFA干预后IL-6水平下降、生活质量提升和瘦体重改善各3篇文献。纳入5篇文献进行Meta分析,其中3篇RCT研究,结果提示PUFA干预可有效地改善病人的体重。结论:PUFA可明显改善癌性恶病质病人的体重、食欲、炎性指标和生活质量,病人耐受性良好。
AIM: To investigate the clinical value of polyunsaturated fatty acids (PUFA) in the treatment of cancerous cachexia using meta-analysis and systematic reviews. METHODS: Identified eligible studies were systematically reviewed from January 1995 to October 2015 and searched for randomized controlled trials of Pub Med / MEDLINE, EMBASE and the Cochrane Central Register of Registration, including randomized enrollment, various advanced malignancies, tumor-associated anorexia Symptoms, cachexia syndrome patients and evaluation of the role of PUFA compared with placebo, other drugs or different doses of PUFA. The target outcome is appetite, C-reactive protein, IL-6 levels, body weight, quality of life and body weight analysis. Results: Finally, 16 articles were studied. Systematic reviews included appetite (6 articles), C-reactive protein (9 articles), IL-6 (5 articles), lean body weight (7 articles) and quality of life (7 articles). Four of the literature studies suggested that PUFA significantly improved appetite, decreased the serum level of C-reactive protein by PUFA, and three articles on the improvement of the quality of life and lean body mass after PUFA intervention. Five articles were included in the meta-analysis. Among the three RCTs, the results suggested that PUFA intervention could effectively improve the patient’s body weight. Conclusion: PUFA can significantly improve the body weight, appetite, inflammatory parameters and quality of life in patients with cancerous cachexia, and the patients are well tolerated.