Adjuvant Efficacy of Nutrition Support During Pulmonary Tuberculosis Treating Course： Systematic Review and Meta-analysis

• Published in: Chinese medical journal 2015-12, Vol.128 (23), p.3219-3230
• Main Authors: Si, Zhuang-Li, Kang, Ling-Ling, Shen, Xu-Bo, Zhou, Yuan-Zhong
• Format: Article
• Language: English
• Subjects: Analysis; Animals; Antitubercular agents; Antitubercular Agents - therapeutic use; Body mass index; Care and treatment; Chemotherapy; Developing countries; Diabetes; Drug resistance; Health aspects; HIV; Human immunodeficiency virus; Humans; Hygiene; Infections; Intervention; Intervention; Nutrition Support; Tuberculosis; LDCs; Malnutrition; Malnutrition - therapy; Meta Analysis; Nutrition; Nutritional Support; Proteins; Public health; PubMed; Pulmonary tuberculosis; Sputum - microbiology; Studies; Toxicology; Tuberculosis; Tuberculosis, Pulmonary - drug therapy; Tuberculosis, Pulmonary - therapy; 数据库管理; 系统; 肺结核; 药物治疗; 营养支持; 质量指数; 辅助疗效
• ISSN: 0366-6999; 2542-5641
• DOI: 10.4103/0366-6999.170255

Background： 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. Methods： English database of the Cocbrane Controlled Trials Register, PubMed, EMBASE, and Chinese database ofCBM, CNKI, VIE and WAN FANG were searched. Randomized controlled trials comparing nutrition support （given tbr 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 recta-analysis was done using risk ratios （RRs） for dichotomous variables and mean differences （MDs） for continuous variables with 95% confidence intervals （C/s）. Results： 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. Conclusions： 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 BM1, 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.