摘要
背景克罗恩病(Crohn’s disease,CD)常伴肠屏障损害与营养不良.本研究基于循证营养理念,假设个体化肠内营养能通过减轻抗原负荷、调节菌群,较常规支持更有效地改善疾病活动度、修复肠屏障功能并减轻炎症反应.目的基于循证营养学理念的CD肠内营养治疗对其肠道屏障功能、营养指标及临床疗效的影响.方法选取2023-01/2025-06南昌大学第二附属医院收治的120例CD患者,采用随机数字表法分为两组各60例.对照组采用常规营养支持治疗,观察组采用基于循证营养学理念的肠内营养治疗.比较两组的临床疗效、克罗恩病疾病活动指(Crohn’s disease activity index,CDAI)评分、克罗恩病评分系统(Crohn’s disease scoring system,SES-CD)评分、肠道屏障功能[内毒素(endotoxin,ET)、二胺氧化酶(diamine oxidase,DAO)、D-乳酸水平]、营养指标[白蛋白(albumin,ALB)、前白蛋白(prealbumin,PA)、总蛋白(total protein,TP)水平]及炎症指标[C反应蛋白(C-reactive protein,CRP)、红细胞沉降率(erythrocyte sedimentation rate,ESR)水平].结果观察组临床疗效总有效率为96.67%(58/60)高于对照组78.33%(47/60)(P<0.05).治疗后,两组CDAI、SES-CD评分均较治疗前下降,且观察组较对照组更低(均P<0.05).两组ET、DAO、D-乳酸水平均较治疗前下降,且观察组较对照组更低(均P<0.05).两组ALB、PA、TP水平均较治疗前增加,且观察组较对照组更高(均P<0.05).两组CRP、ESR水平均较治疗前下降,且观察组较对照组更低(均P<0.05).结论循证肠内营养治疗可提高CD患者的临床疗效,改善肠道状况,修复其肠道屏障功能,改善营养状况,降低炎症水平.
BACKGROUND Crohn’s disease(CD)often involves intestinal barrier impairment and malnutrition.Based on evidence-based nutrition,this study hypothesizes that individualized enteral nutrition can more effectively improve disease activity,restore barrier function,and reduce inflammation than conventional support by lowering antigen load and modulating microbiota.AIM To explore the effects of evidence-based enteral nutrition therapy on intestinal barrier function,nutritional indicators,and clinical efficacy in patients with CD.METHODS One hundred and twenty CD patients admitted to our hospital from January 2023 to June 2025 were selected and randomly divided into either a control group or an observation group(n=60 each)using the random number table method.The control group received conventional nutritional support treatment,while the observation group received evidence-based enteral nutrition treatment.Clinical efficacy,Crohn’s disease activity index(CDAI)score,Crohn’s disease scoring system(SES-CD)score,intestinal barrier function[endotoxin(ET),diamine oxidase(DAO),and D-lactate],nutritional indicators[albumin(ALB),prealbumin(PA),and total protein(TP)],and inflammatory indicators[C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)]were compared between the two groups.RESULTS The total effective rate in the observation group was 96.67%(58/60),which was higher than that of the control group(78.33%,47/60)(P<0.05).After treatment,the CDAI and SES-CD scores of both groups decreased compared to those before treatment,with the observation group showing a more significant decrease than the control group(P<0.05).The levels of ET,DAO,and D-lactate in both groups decreased compared to those before treatment,and the observation group had a more significant decrease than the control group(P<0.05).The levels of ALB,PA,and TP in both groups increased compared to those before treatment,and the observation group had a more significant increase than the control group(P<0.05).The levels of CRP and ESR in both groups decreased compared to those before treatment,with the observation group showing a more significant decrease than the control group(P<0.05).CONCLUSION Evidence-based enteral nutrition therapy serves as a key therapy for CD,with benefits including improved clinical efficacy,restored intestinal barrier integrity,better nutritional status,and reduced inflammatory levels.
作者
付珊
翟慧兰
徐双双
李雪芹
Shan Fu;Hui-Lan Zhai;Shuang-Shuang Xu;Xue-Qin Li(Department of Gastroenterology,Second Affiliated Hospital of Nanchang University,Nanchang 330000,Jiangxi Province,China)
出处
《世界华人消化杂志》
2025年第11期918-925,共8页
World Chinese Journal of Digestology
基金
江西省中医药管理局科技计划项目,No.2024B0137.
关键词
循证营养学理念
肠内营养治疗
克罗恩病
肠道屏障功能
炎症指标
Evidence-based nutrition
Enteral nutrition therapy
Crohn’s disease
Intestinal barrier function
Inflammatory indicators
