INTRODUCTION Administration of butyrate enemas might improve the health status of patients with inflammatory bowel disease (IBD). However, the results seem equivocal. Therefore, this systematic review aimed to assess the effect of sodium butyrate enemas on disease activity index (DAI), endoscopic scores, as well as histological and inflammatory parameters in IBD patients. METHODS The PubMed, Scopus, Web of Science, and Cochrane databases were searched. Randomised controlled trials published in English that assessed the effect of butyrate enemas on DAI, clinical symptoms, inflammatory markers, as well as histological and endoscopic scores in patients with Crohn's disease (CD) and ulcerative colitis (UC) were included in the analysis. RESULTS Eight studies involving 227 UC patients were included in this analysis. Only one study reported significant differences in DAI between groups. Besides, butyrate treatment groups did not differ significantly from controls concerning the effect on endoscopic and histological scores. Moreover, butyrate enemas exerted a significant effect on few inflammatory parameters measured in colonic mucosal biopsies. CONCLUSION The current evidence is limited and does not support the application of butyrate enemas in UC. There are no reliable data regarding the efficacy of butyrate enemas in CD. The systematic review protocol was registered in the PROSPERO database (CRD42020163654).

中文翻译：

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丁酸钠灌肠剂与安慰剂相比对炎症性肠病的疾病活动、内窥镜评分以及组织学和炎症参数的影响：随机对照试验的系统评价

简介 丁酸盐灌肠剂可能会改善炎症性肠病 (IBD) 患者的健康状况。然而，结果似乎模棱两可。因此，本系统评价旨在评估丁酸钠灌肠剂对 IBD 患者疾病活动指数 (DAI)、内镜评分以及组织学和炎症参数的影响。方法 检索 PubMed、Scopus、Web of Science 和 Cochrane 数据库。以英文发表的随机对照试验评估了丁酸盐灌肠剂对克罗恩病 (CD) 和溃疡性结肠炎 (UC) 患者的 DAI、临床症状、炎症标志物以及组织学和内窥镜评分的影响，这些试验被纳入分析。结果 该分析包括八项研究，涉及 227 名 UC 患者。只有一项研究报告了组间 DAI 的显着差异。此外，丁酸盐治疗组与对照组在对内镜和组织学评分的影响方面没有显着差异。此外，丁酸盐灌肠剂对结肠粘膜活检中测量的少数炎症参数产生了显着影响。结论 目前的证据有限，不支持丁酸盐灌肠剂在 UC 中的应用。没有关于丁酸盐灌肠对 CD 疗效的可靠数据。系统评价方案已在 PROSPERO 数据库 (CRD42020163654) 中注册。丁酸盐灌肠对结肠粘膜活检中测量的少数炎症参数产生了显着影响。结论 目前的证据有限，不支持丁酸盐灌肠剂在 UC 中的应用。没有关于丁酸盐灌肠对 CD 疗效的可靠数据。系统评价方案已在 PROSPERO 数据库 (CRD42020163654) 中注册。丁酸盐灌肠对结肠粘膜活检中测量的少数炎症参数产生了显着影响。结论 目前的证据有限，不支持丁酸盐灌肠剂在 UC 中的应用。没有关于丁酸盐灌肠对 CD 疗效的可靠数据。系统评价方案已在 PROSPERO 数据库 (CRD42020163654) 中注册。