低FODMAP饮食联合美沙拉嗪对溃疡性结肠炎患者的疗效及安全性评价

Efficacy and safety of low FODMAP diet combined with mesalazine in treatment of patients with mild to moderate ulcerative colitis

目的探讨低FODMAP饮食联合美沙拉嗪对溃疡性结肠炎(UC)患者的疗效及其安全性。方法选取2018年1月至2019年12月浙江医院消化内科收治的活动性轻中度UC患者129例,采用随机数字表法分为实验组(63例)和对照组(66例),两组患者均进行相同的临床治疗,在此基础上实验组患者予低FODMAP饮食,对照组患者予普通饮食,为期6周。测定并比较两组患者治疗前后营养状况指标、相关炎症因子指标、肝肾功能指标及临床疗效和生活质量指标。结果治疗后两组患者IL-17、IL-23、TNF-α水平均明显下降(均P<0.05),且实验组患者IL-17、IL-23、TNF-α水平均明显低于对照组(均P<0.05);白蛋白、前白蛋白、Hb、ALT、AST、GFR水平与治疗前比较差异均无统计学意义(均P>0.05),且组间比较差异均无统计学意义(均P>0.05);Southerland DAI评分、肠黏膜镜像评分均明显下降(均P<0.05),且实验组明显低于对照组(P<0.05);肠道症状、全身症状、情感功能、社会功能评分均明显上升(均P<0.05),且实验组均明显高于对照组(均P<0.05)。结论低FODMAP饮食联合美沙拉嗪可以显著降低轻中度UC患者的相关炎症因子水平,抑制肠道炎症,缓解患者的胃肠道症状,提高其生活质量,且安全性较好。

Objective To investigate the clinical efficacy and safety of low FODMAP diet combined with mesalazine in treatment of patients with mild to moderate ulcerative colitis(UC).Methods A total of 129 patients with mild to moderate ulcerative colitis treated in Department of Gastroenterology of Zhejiang Hospital from January 2018 to December 2019 were recruited and divided into two groups randomly.Patients in study group(n=63)were intervened by low FODMAP diet,and those in control group(n=66)were given ordinary diet,both groups were treated with mesalazine.Index of The nutritional indexes,inflammatory factors,liver and kidney function,clinical efficacy and quality of life were compared between two groups before intervention and after 6 weeks of intervention.Results After intervention,the Southerland DAI score,intestinal mucosal mirror score,quality of life,and inflammatory factor levels in both groups were significantly improved,compared to those before intervention,while the above indicators in the study group were significantly better than those in the control group(all P<0.05).After intervention,the nutritional status,liver and kidney function indicators in the two groups did not change significantly compared to those before intervention.Conclusion Low FODMAP diet combined with mesalazine can significantly ameliorate the symptoms and decrease the levels of inflammatory factors and improve the quality of life in patients with mild to moderate UC,and it has a certain degree of safety.