Efficacy And Safety Of Nutrition Therapy In The Patients With Alcoholic Liver Diseases

Objective: To evaluate the efficacy and safety of nutrition therapy in the treatment of alcoholicliver diseases.Methods: Data were retrieved form Pubmed, Embase, Web of Science, The Cochrane CentralRegister of Controlled Trials, Chinese Journals Full-text Database, ChineseBiomedical Database and Wan Fang Digital Journal Full-text database to collectclinical randomized controlled trials regarding the treatment of alcoholic liverdiseases by nutrition therapy. Statistical analysis was performed by Meta-analysisusing Review Manager5.1.0.Results:13randomized controlled trials including590cases met the inclusion criteria.Meta-analysis showed that:①Compared with conventional therapy, nutrition therapywas more effective in reducing the serum total bilirubin (P=0.04) and ALP (P=0.04),and increasing serum transferring (P＜0.00001). But there were no statisticallysignificant differences between the two groups in the prothrombin time, serumalbumin, remission rate of hepatic encephalopathy or ascites.②There were nostatistically significant differences between the nutrition therapy group and controlgroup in the short-term and long-term mortality of alcoholic liver diseases (RR1.09,95%CI0.80~1.47, P=0.59and RR0.75,95%CI0.55~1.01, P=0.06, respectively).③Adverse events in the patients treated with nutrition therapy was no more than controlgroup, and there was no statistically significant difference in the incidence ofinfection (RR:0.99,95%CI:0.67-1.47, P=0.97).④According to the different waysof nutrition therapy,13RCTs were divided into two subgroups, such as enteralnutrition subgroup and parenteral nutrition subgroup, Subgroup analysis found thatparenteral nutrition therapy was more effective in reducing the serum total bilirubin(P＜0.00001) than control group, but there was no statistically significant differencebetween the enteral nutrition therapy subgroup and control group in serum totalbilirubin. Subgroup analysis also found the same outcome of other indexes as theresult of original analysis.Conclusion: Nutrition therapy can improve serological index of ALD, such as serum totalbilirubin, ALP, transferring, but it can’t improve the short-term and long-termmortality of alcoholic liver diseases. And the adverse event was no more thanconventional therapy. So the nutrition therapy can be recommended as the regulartreatment of alcoholic liver diseases.