低FODMAP饮食对肝硬化患者胃肠道症状的影响

Effect of low FODMAP diet on gastrointestinal symptoms in patients with liver cirrhosis

目的探究低可发酵低聚糖、二糖、单糖、多元醇(FODMAP)饮食对肝硬化且小肠细菌过度生长(SIBO)阳性患者胃肠道症状的影响。方法收集2019年1月至2019年12月郑州人民医院就诊的73例具有胃肠道症状的肝硬化且SIBO阳性患者为研究对象,依据肝功能Child-Pugh分级采用系统分层抽样法分为观察组(n=37)、对照组(n=36)。在维持原有治疗不变的基础上,对照组患者给予正常饮食,观察组患者给予低FODMAP饮食,两组均持续治疗6周。对比两组的IBS症状严重程度量表(IBS-SSS)、胃肠生活质量指数(GIQLI)、产氢值(PH 2)及体质量指数(BMI)的变化。结果饮食干预6周后,观察组IBS-SSS评分明显低于同期对照组[(86.77±67.82)分vs(130.74±73.97)分],差异有统计学意义(t=2.599,P=0.011);观察组GIQLI评分明显高于同期对照组[(100.89±10.71)分vs(85.86±9.27)分],差异有统计学意义(t=6.275,P<0.001);观察组PH 2较同期对照组略有下降[(39.83±15.94)ppm vs(48.66±16.13)ppm],差异有统计学意义(t=2.303,P=0.024);观察组BMI与同期对照组相比[(23.88±3.02)kg/m 2 vs(23.42±3.01)kg/m 2],差异无统计学意义(t=0.640,P=0.524)。结论低FODMAP饮食可有效改善肝硬化且SIBO阳性患者短期内的胃肠道症状。

Objective To investigate the effect of low fermentable oligosaccharide,disaccharide,monosaccharide and polyol(FODMAP)diet on gastrointestinal symptoms of patients with liver cirrhosis and small intestinal bacterial overgrowth(SIBO)positive.Methods 73 liver cirrhosis patients which SIBO positive with gastrointestinal symptoms in People’s Hospital of Zhengzhou from Jan.2019 to Dec.2019 were divided into observation group(n=37)and control group(n=36)according to Child-Pugh classification of liver function.On the basis of maintaining the original treatment,the patients in the control group were given a normal diet,while the patients in the observation group were given a low-FODMAP diet.Both groups were treated continuously for 6 weeks.The changes of irritable bowel syndrome severity scoring system(IBS-SSS),gastrointestinal quality of life index(GIQLI),hydrogen production(PH 2)value and body mass index(BMI)were compared between the two groups.Results After 6 weeks of diet intervention,the IBS-SSS score of the observation group was significantly lower than that of the control group[(86.77±67.82)scores vs(130.74±73.97)scores]and the difference was statistically significant(t=2.599,P=0.011);the GIQLI score of the observation group was significantly higher than that of the control group[(100.89±10.71)scores vs(85.86±9.27)scores]and the difference was statistically significant(t=6.275,P<0.001);the PH 2 of the observation group was mildly lower than that of the control group in the same period[(39.83±15.94)ppm vs(48.66±16.13)ppm],and the difference was statistically significant(t=2.303,P=0.024);but there was no significant difference in BMI between the observation group and the control group[(23.88±3.02)kg/m 2 vs(23.42±3.01)kg/m 2,t=0.640,P=0.524].Conclusion Low FODMAP diet effectively improve gastrointestinal symptoms in patients with liver cirrhosis and SIBO positive in a short time.