基于低FODMAP饮食联合灸法的整体护理模式在肠易激综合征患者护理中的应用研究

Application of low FODMAP diet-based holistic nursing model combined with moxibustion in patients with irritable bowel syndrome

背景由于肠易激综合征腹泻型(irritable bowel syndrome diarrhea type,IBS-D)严重影响患者生活质量,常规饮食指导及常规护理效果不佳,因此寻找一种安全有效的护理模式对于缓解病情,提升患者生活质量具有重要意义.目的分析基于低可发酵低聚糖,二糖,单糖,多元醇(fermentable oligosaccharides,disaccharides,monosaccharides,polyols,FODMAP)饮食联合灸法的整体护理模式在IBS-D患者护理中的应用效果.方法选择2018-09/2020-06我院住院部收治的100例IBS-D患者,按随机数表法分组,对照组(50例)接受经典肠易激综合征(irritable bowel syndrome,IBS)饮食指导与常规护理,研究组实施基于低FODMAP饮食联合灸法的整体护理模式.观察两组干预前后主要症状评分、IBS病情严重程度量表(IBS-SSS)评分、IBS相关生活质量量表(IBS-QOL)评分、Bristol粪便性状量表评分、血清脑肠肽水平[血管活性肠肽(vasoactive intestinal peptide,VIP)、5-羟色胺(5-hydroxytryptamine,5-HT)、P物质(substance P,SP)]、肠道主要菌群变化.结果研究组干预后主要症状评分、IBS-SSS评分、Bristol粪便性状量表评分比对照组低,BS-QOL评分比对照组高(P<0.05);研究组干预后血清VIP、5-HT、SP水平比对照组低(P<0.05);研究组干预后双歧杆菌、乳酸杆菌、大肠杆菌数量相比对照组,差异无统计学意义.研究组饮食总依从率(96.00%)比对照组(82.00%)高(P<0.05).结论基于低FODMAP饮食联合灸法的整体护理模式在IBS-D患者护理中具有一定可行性,可减轻临床症状,提升饮食依从性,改善生活质量,调节血清脑肠肽水平,且对肠道主要菌群无明显影响.

BACKGROUND Irritable bowel syndrome(IBS)is a common functional gastrointestinal disease.Although traditional diet therapy can relieve clinical symptoms,it has little effect in improving the quality of life and intestinal function.In recent years,studies have found that short-chain carbohydrates that are difficult to absorb,such as oligosaccharides,disaccharides,monosaccharides,and polyols(FODMAP),can increase the amount of fluid in the intestinal cavity and the production of intestinal gas,and induce intestinal barrier dysfunction,which exacerbates the symptoms of IBS.Thus,restricting FODMAP intake is particularly important in alleviating the condition of IBS.This study explored the feasibility of the holistic nursing model based on low FODMAP diet combined with moxibustion in the care of IBS patients,with an aim to find an effective of nursing care model,improve the quality of life of patients,and reduce the severity of IBS.AIM To analyze the application effect of the holistic nursing model based on low FODMAP diet combined with moxibustion in the care of patients with IBS.METHODS We selected 100 patients with IBS who were treated at our hospital from September 2018 to June 2020.The patients were randomly divided into either a control group(50 cases)to receive classic IBS diet guidance and routine care,or a study group to receive the holistic nursing model based on low FODMAP diet combined with moxibustion.Main symptom scores,IBS severity scale(IBS-SSS)scores,IBS-related quality of life scale(IBS-QOL)scores,Bristol stool trait scale scores,serum Brain-gut peptide levels[vasoactive intestinal peptide(VIP),5-hydroxytryptamine(5-HT),and substance P(SP)],and changes in main intestinal flora species were compared between the two groups.RESULTS The main symptom scores,IBS-SSS scores,and Bristol stool trait scale scores of the study group after intervention were lower than those of the control group,and the BS-QOL scores were higher than those of the control group(P<0.05).Serum levels of VIP,5-HT,and SP in the study group after intervention were significantly lower than those of the control group(P<0.05).The numbers of bifidobacteria,lactobacilli,and E.coli in the study group after intervention were comparable to those of the control group(P>0.05).CONCLUSION The holistic nursing model based on low FODMAP diet combined with moxibustion is feasible in the care of IBS patients,and it can reduce clinical symptoms,improve quality of life,and regulate serum brain-gut peptide levels,with no significant impact on main intestinal flora species.