Non-absorbable disaccharides for hepatic encephalopathy: systematic review of randomised trials

作者: Bodil Als-Nielsen , Lise L Gluud , Christian Gluud

DOI: 10.1136/BMJ.38048.506134.EE

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摘要: Objective To assess the effects of non-absorbable disaccharides (lactulose and lactitol) in patients with hepatic encephalopathy. Data sources Cochrane Hepato-Biliary Group controlled trials register, Library, Medline, Embase until March 2003; reference lists relevant articles; authors pharmaceutical companies. Review methods Randomised that compared placebo, no intervention, or antibiotics for encephalopathy were included. The primary outcome measures improvement all cause mortality. Results 22 Compared placebo seemed to reduce risk (relative 0.62, 95% confidence interval 0.46 0.84, six trials). However, high quality found significant effect (0.92, 0.42 2.04, two had on mortality (0.41, 0.02 8.68, four Non-absorbable inferior reducing (1.24, 1.02 1.50, 10 trials) lowering blood ammonia concentration (weighted mean difference 2.35 μmol/l, 0.06 μmol/l 13.45 There was (0.90, 0.48 1.67, five trials). Conclusions is insufficient evidence support refute use encephalopathy. Antibiotics superior improving encephalopathy, but it unclear whether this clinically important. should not serve as comparator randomised

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