完全肠内营养和部分肠内营养疗法对克罗恩病患者的缓解作用及生存质量影响分析

Analysis of effects of complete enteral nutrition and partial enteral nutrition on mitigation and quality of life in patients with Crohn′s disease

目的探讨完全肠内营养(EEN)和部分肠内营养(PEN)疗法对活动期克罗恩病(CD)患者的缓解作用及生存质量影响。方法根据自愿原则将64例活动期CD患者分为PEN组(32例)和EEN组(32例),分别采用PEN和EEN疗法,两组的肠内营养制剂均包括百普力和能全力两种。另选择20例未采用肠内营养疗法的活动期CD患者作为对照组。治疗6周后统计各组的各项指标,复查内镜并计算克罗恩病内镜严重程度指数(CDEIS),进行炎症性肠病问卷(IBDQ)评分以评估患者的生存质量。结果治疗6周后,EEN组的临床缓解率(96.88%)显著高于PEN组(75.00%),且EEN组的内镜下缓解率(90.63%)远高于PEN组(65.63%),两组差异均有统计学意义(P<0.05)。两组临床缓解率及内镜下缓解率均显著高于对照组(P>0.05),两组中分别使用百普力和能全力的患者的临床缓解率及内镜下缓解率差异均无统计学意义(P均>0.05)。PEN组和EEN组治疗6周的克罗恩病活动性指数(CDAI)评分、CDEIS指数和C反应蛋白(CRP)水平均低于治疗前,且EEN组治疗6周的上述指标显著低于PEN组(P<0.05)。EEN组患者治疗后的体质指数(BMI)显著高于治疗前,且明显高于PEN组治疗后的BMI(P均<0.05)。PEN组和EEN组的IBDQ评分差异无统计学意义(P>0.05)。结论百普力和能全力的疗效相似。EEN和PEN疗法均能提高CD患者的缓解率,且EEN优于PEN。两种疗法对于CD患者的生存质量影响总体上无明显差异。

Objective An attempt was made in this paper to investigate the effects of complete enteral nutrition(EEN) and partial enteral nutrition(PEN) on the mitigation and quality of life of patients with active Crohn′s disease(CD). Methods According to the voluntary principle, 64 patients with active CD were divided into the PEN group(32 cases) and the EEN group(32 cases), respectively, which were given the PEN and EEN therapy. The enteral nutrition in each group includes two kinds, Peptison Liquid and Nutrison Fiber. Meanwhile, 20 patients with active CD who did not use enteral nutrition were selected as the control group. After 6 weeks of treatment, the indexes of each group were counted, endoscopy was performed, the CD endoscopy severity index(CDEIS) was calculated, and the inflammatory bowel disease questionnaire(IBDQ) score was used to evaluate the quality of life of the patients. Results After 6 weeks of treatment, the clinical remission rate(96.88%) was significantly higher in the EEN group than that in the PEN group(75.00%), and the endoscopic remission rate(90.63%) in the EEN group was much higher than that in the PEN group(65.63%). The differences were statistically significant(P<0.05). The clinical remission rate and the endoscopic remission rate were significantly higher in the two groups than in the control group(P<0.05). There was no significant difference in the clinical remission rate and the endoscopy remission rate in the two groups with different enteral nutrient solutions(P>0.05). The CDAI score, the CDEIS index, and the CRP of patients in the PEN group and the EEN group were lower than those before treatment. Besides, the CDAI score, the CDEIS index, and the CRP of the EEN group were significantly lower than those of the PEN group(P<0.05). The BMI value of the EEN group after treatment was significantly higher than that before treatment, and was significantly higher than that of the PEN group after treatment(BMI)(P<0.05). There was no significant difference in the IBDQ score between the PEN group and the EEN group(P>0.05). Conclusions The efficacy of Peptison Liquid and Nutrison Fiber is similar. Both the EEN and the PEN therapy improve the remission rates in patients with CD, and EEN is superior to PEN. There is no significant difference in the quality of life of the two patients with CD.