ABSTRACT
INTRODUCTION: Nausea and vomiting (NV) affect up to 85% of pregnant women, which has multiple effects on pregnancy outcome. The truth etiology of nausea and vomiting in pregnancy (NVP) is still unknown. Considering the potential teratogenic effect in fetus due to chemical drugs, ginger can be used to treat nausea and vomiting during pregnancy. Reports have shown that ginger can reduce the severity of NV, however, these results are controversial. Therefore, this meta-analysis aims to explore the effect of ginger in the treatment of nausea and vomiting during pregnancy compared with placebo and vitamin B6. METHODS: The randomized control trials (RCTs) on the association with ginger and pregnancy-related nausea and vomiting were searched and identified in two databases Web of Science and PubMed (up to April 2019). Stata software was used to conduct meta-analysis. In addition, the source of heterogeneity explored by metaregression, sensitivity analysis, subgroup analyses, the publication bias were assessed by Egger's tests and Funnel plot, p < .05 was considered to be significant. RESULTS: Thirteen studies involving 1174 subjects were included in this meta-analysis. The result demonstrated that ginger intervention has significant effect in improving general symptom of NVP [OR = 7.475, 95% CI = (4.133, 13.520), I2 = 30.1%], relieving severity of nausea [SMD = 0.821, 95% CI = (0.585, 1.056), I2 = 38.9%], but not significant in reducing vomiting [SMD = 0.549, 95% CI = (-0.268, 1.365), I2 = 91.4%], compared with placebo. Besides, ginger intervention has no significant effect on improving general symptom of NVP [OR = 1.239, 95% CI = (0.495, 3.102), I2 = 57.3%], relieving severity of nausea [SMD = 0.199, 95% CI = (-0.102, 0.500), I2 = 65.7%], reducing vomiting [SMD = 0.331, 95% CI = (-0.145, 0.808), I2 = 85.9%], compared with vitamin B6. CONCLUSIONS: Ginger supplementation significantly relieve general NVP symptom and nausea compared with placebo, but no significant effect on vomiting. Moreover, ginger is more effective than vitamin B6 in treating NVP, although, there were no significant differences. Further, rigidly designed RCTs with larger sample sizes are needed to verify the effectiveness of ginger supplementation for treatment NVP compared with vitamin B6.
Subject(s)
Antiemetics , Pregnancy Complications , Zingiber officinale , Antiemetics/therapeutic use , Female , Humans , Nausea/drug therapy , Phytotherapy , Pregnancy , Pregnancy Complications/drug therapy , Pregnancy Outcome , Vitamin B 6/therapeutic use , Vomiting/drug therapyABSTRACT
OBJECTIVES: Malnutrition is the most common complication of patients with esophageal cancer and can lead to poor prognosis and death. Good nutritional status has been shown to help improve patient outcomes and reduce complications. In the absence of specific evidence on the effect of nutrition in patients with esophageal cancer, the purpose of this study was to investigate the effect of whole-course nutrition management on the prognosis and complications of chemoradiotherapy in patients with esophageal cancer through a randomized controlled trial. METHODS: A total of 96 patients with esophageal cancer treated with concurrent chemoradiation were randomized to an intervention group (treated with whole-course nutrition management from the Nutrition Support Team) and a control group (treated with the general nutritional method) for approximately 6 wk. Dietary surveys and body measurements were conducted at baseline and every day thereafter. Patient-generated Subjective Global Assessment score, blood index, quality of life, and psychological condition were assessed at baseline and every week before discharge. Complications (e.g., radiation esophagitis, myelosuppression, and skin symptoms), completion rates of therapy, short-term efficacy evaluation, as well as clinical outcomes were measured. RESULTS: A total of 85 patients completed the study (intervention groupâ¯=â¯45; control groupâ¯=â¯40). There were significant differences in the changes of serum albumin and total protein between the two groups throughout the trial (P < 0.05). Complications (e.g., radioactive esophagitis, skin symptom of complications) and quality of life were statistically different before and after the intervention (P < 0.05). The difference in the change of other indicators was not statistically significant. CONCLUSIONS: Whole-course nutrition management can improve the nutritional status of patients with esophageal cancer treated with concurrent chemoradiotherapy, reduce the severity of radiation esophagitis and radiation skin reactions, improve the quality of life, and relieve depressive symptoms.