| Objective To evaluate the impact of the glutamine enhanced enteral nutrition on immune function for the gastric cancer.Methods The published studies were searched in Cochrane Library, PubMed, Embase, CNKI, WanFang Database and CBM from inception to Feb 2,2014, and other relevant references of the included literature were also searched to collect all the randomized controlled trials. Studyies were screened according to the inclusion and exclusion criteria, data were extracted, the methodological quality of the included studies was assessed, and meta-analyses were performed with RevMan 5.3 software.Results A total of eight randomized controlled trials involving 459 patients were included in the study. The results of meta—analysis showed:1) There was no statistical significant difference in CD4+ of preoperative 1 day between two groups, but the glutamine enhanced enteral nutrition were significantly higher than conventional enteral nutrition in CD4+after 1 to 3、7 to 10 days of gastric surgery.2) There was no statistical significant difference in CD8+ of preoperative 1 day、after 1 to 3 days of gastric surgery between two groups, the glutamine enhanced enteral nutrition were significantly higher than conventional enteral nutrition in CD8+ after 7 to 10 days of gastric surgery.3) The glutamine enhanced enteral nutrition were significantly higher than conventional enteral nutrition in CD4+/CD8+ preoperative 1 day, after 1 to 3、7 to 10 days of gastric surgery.4) There was no statistical significant difference in IgG of preoperative 1 day、after 1 to 3 days of gastric surgery between two groups, the glutamine enhanced enteral nutrition were significantly higher than conventional enteral nutrition in IgG after 7 to 10 days of gastric surgery. 5) There was no statistical significant difference in IgM of preoperative 1 day、after 1 to 3 days of gastric surgery between two groups, the glutamine enhanced enteral nutrition were significantly higher than conventional enteral nutrition in IgM after 7 to 10 days of gastric surgery.6) There was no statistical significant difference in IgA of preoperative 1 day、after 1 to 3 days of gastric surgery between two groups, the glutamine enhanced enteral nutrition were significantly higher than conventional enteral nutrition in IgA after 7 to 10 days of gastric surgery.7) The postoperative complications and the time to first flatus showed no significant difference between the glutamine enhanced enteral nutrition and the conventional enteral nutrition, but the hospital stay of glutamine enhanced enteral nutrition were significantly lower than conventional enteral nutrition.Conclusion Glutamine in enteral nutrition for patients with gastric cancer can improve and enhance the immune function, and also can short the hospital time and reduce the economic burden. |
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