Peptic ulcer disease is a multifactorial and complex disease involving gastric and duodenal ulcers.Despite medical advances,the management of peptic ulcer and its complications remains a challenge,with high morbidity ...Peptic ulcer disease is a multifactorial and complex disease involving gastric and duodenal ulcers.Despite medical advances,the management of peptic ulcer and its complications remains a challenge,with high morbidity and death rates for the disease.An accumulating body of evidence suggests that,among a broad reach of natural molecules,dietary polyphenols with multiple biological mechanisms of action play a pivotal part in the management of gastric and duodenal ulcers.The current review confirmed that dietary polyphenols possess protective and therapeutic potential in peptic ulcer mediated by:improving cytoprotection,re-epithelialization,neovascularization,and angiogenesis; up-regulating tissue growth factors and prostaglandins; down-regulating anti-angiogenic factors; enhancing endothelial nitric oxide synthasederived NO; suppressing oxidative mucosal damage; amplifying antioxidant performance,antacid,and antisecretory activity; increasing endogenous mucosal defensive agents; and blocking Helicobacter pylori colonization associated gastric morphological changes and gastroduodenal inflammation and ulceration.In addition,anti-inflammatory activity due to downregulation of proinflammatory cytokines and cellular and int e r c e llular adhe s ion age nt s,s uppr e s s ing leukocyte-endothelium interaction,inhibiting nuclear signaling pathways of inflammatory process,and modulating intracellular transduction and transcription pathways have key roles in the anti-ulcer action of dietary polyphenols.In conclusion,administration of a significant amount of dietary polyphenols in the human diet or as part of dietary supplementation along with conventional treatment can result in perfect security and treatment of peptic ulcer.Further welldesigned preclinical and clinical tests are recommended in order to recognize higher levels of evidence for the confirmation of bioefficacy and safety of dietary polyphenols in the management of peptic ulcer.展开更多
目的系统评价肠内营养预防和辅助治疗压疮的效果,为指导压疮患者合理补充营养提供循证依据。方法计算机检索Cochrane图书馆(2014年第1期)、CINAHL、MEDLINE、EMbase、CBMdisc、CNKI和万方数据库中符合纳入标准的随机对照试验。由3名研...目的系统评价肠内营养预防和辅助治疗压疮的效果,为指导压疮患者合理补充营养提供循证依据。方法计算机检索Cochrane图书馆(2014年第1期)、CINAHL、MEDLINE、EMbase、CBMdisc、CNKI和万方数据库中符合纳入标准的随机对照试验。由3名研究者按纳入和排除标准独立筛选文献并对其质量进行评价及提取资料,对符合质量标准的随机对照试验采用Rev Man 5.0统计软件包进行Meta分析。结果纳入14篇随机对照试验共计1 851例患者,6篇涉及肠内营养预防压疮的研究,11篇涉及肠内营养辅助治疗压疮的研究,其中3篇随机对照试验均涉及到压疮的预防和治疗。Meta分析结果显示,肠内营养可明显降低压疮发生率(RR=0.84,P=0.006),缩小压疮面积(SMD=-1.23,P=0.000),不增加压疮患者的不良反应发生率(RR=0.82,P=0.69);但不能提高压疮治愈率(RR=1.46,P=0.05)及不能降低压疮患者的病死率(RR=1.57,P=0.06)。结论肠内营养能降低压疮发生率、收缩压疮面积,对压疮愈合有促进作用,但不能提高压疮治愈率及降低病死率。展开更多
基金Supported by National Elites Foundation of Iran(partly)
文摘Peptic ulcer disease is a multifactorial and complex disease involving gastric and duodenal ulcers.Despite medical advances,the management of peptic ulcer and its complications remains a challenge,with high morbidity and death rates for the disease.An accumulating body of evidence suggests that,among a broad reach of natural molecules,dietary polyphenols with multiple biological mechanisms of action play a pivotal part in the management of gastric and duodenal ulcers.The current review confirmed that dietary polyphenols possess protective and therapeutic potential in peptic ulcer mediated by:improving cytoprotection,re-epithelialization,neovascularization,and angiogenesis; up-regulating tissue growth factors and prostaglandins; down-regulating anti-angiogenic factors; enhancing endothelial nitric oxide synthasederived NO; suppressing oxidative mucosal damage; amplifying antioxidant performance,antacid,and antisecretory activity; increasing endogenous mucosal defensive agents; and blocking Helicobacter pylori colonization associated gastric morphological changes and gastroduodenal inflammation and ulceration.In addition,anti-inflammatory activity due to downregulation of proinflammatory cytokines and cellular and int e r c e llular adhe s ion age nt s,s uppr e s s ing leukocyte-endothelium interaction,inhibiting nuclear signaling pathways of inflammatory process,and modulating intracellular transduction and transcription pathways have key roles in the anti-ulcer action of dietary polyphenols.In conclusion,administration of a significant amount of dietary polyphenols in the human diet or as part of dietary supplementation along with conventional treatment can result in perfect security and treatment of peptic ulcer.Further welldesigned preclinical and clinical tests are recommended in order to recognize higher levels of evidence for the confirmation of bioefficacy and safety of dietary polyphenols in the management of peptic ulcer.
文摘目的系统评价肠内营养预防和辅助治疗压疮的效果,为指导压疮患者合理补充营养提供循证依据。方法计算机检索Cochrane图书馆(2014年第1期)、CINAHL、MEDLINE、EMbase、CBMdisc、CNKI和万方数据库中符合纳入标准的随机对照试验。由3名研究者按纳入和排除标准独立筛选文献并对其质量进行评价及提取资料,对符合质量标准的随机对照试验采用Rev Man 5.0统计软件包进行Meta分析。结果纳入14篇随机对照试验共计1 851例患者,6篇涉及肠内营养预防压疮的研究,11篇涉及肠内营养辅助治疗压疮的研究,其中3篇随机对照试验均涉及到压疮的预防和治疗。Meta分析结果显示,肠内营养可明显降低压疮发生率(RR=0.84,P=0.006),缩小压疮面积(SMD=-1.23,P=0.000),不增加压疮患者的不良反应发生率(RR=0.82,P=0.69);但不能提高压疮治愈率(RR=1.46,P=0.05)及不能降低压疮患者的病死率(RR=1.57,P=0.06)。结论肠内营养能降低压疮发生率、收缩压疮面积,对压疮愈合有促进作用,但不能提高压疮治愈率及降低病死率。
