Clinical evidence of nutritional rehabilitation for short bowel syndrome: a meta-analysis of clinical trials YAN Zhong-fang* , QI Yu-mei, LU Wei, et al. * Haihe Hospital of Tianjin, Tianjin Medical University, Tianjin 300350, China Corresponding author: QI Yu-mei, E-mail: qym0305@yahoo.com.cn Abstract Objective To assess the safety and efficacy of growth hormone (GH) and glutamine (GLN) combined with a modified (high-carbohydrate-low-fat, HCLF) diet in patients with short bowel syndrome. Methods A meta-analysis of all the relevant clinical trials was performed. Clinical trials were identified from the following electronic databases between January 1995 and March 2008: MEDLINE, EMBASE, the Cochrane Controlled Trials Register, Chinese Bio-medicine Database. The search was undertaken in May 2008. Language was restricted to Chinese and English. Literature references were checked at the same time. Clinical trials were extracted and evaluated by two reviewers independently of each other. The statistical analysis was performed by Rev Man4.2 software which was provided by the Cochrane Collaboration. The value of P <0.05 was considered statistically significant. Results Eleven trials involving 201 patients were included. The combined results showed that GH, GLN and HCLF diet had positive treatment effect on body weight, stool output, lean body mass, absorption of D-xylose, and IGF-1. But there were no improvements in fat mass, absorption of energy, absorption of carbohydrates, absorption of nitrogen and absorption of fat. Conclusion Treatment with a combination of low-dose GH, GLN and HCLF diet is effective without any major adverse effects in patients with short bowel syndrome. Further trials are required, especially in children, with sufficient size and rigorous design.