家庭护士食疗方案在超重/肥胖代谢功能障碍相关性脂肪肝病人中的实证研究

Empirical research of family nurse diet scheme in overweight/obese patients with metabolic dysfunction⁃associated fatty liver

目的:探讨基于家庭护士食疗理论构建的家庭护士食疗方案在超重/肥胖代谢功能障碍相关性脂肪肝病人中的应用效果。方法:2022年10月31日—2022年11月17日在社区招募62例代谢功能障碍相关性脂肪肝病人,将其随机分为茶饮组与食疗组,各31例。茶饮组给予脂肪肝常规饮食指导以及每天冲泡代用茶2包饮用。食疗组在茶饮组的基础上给予家庭护士食疗方案。干预42 d后比较两组影像学检查、血脂、血糖代谢情况、人体测量学指标、肝肾功能。结果:1)干预42 d后,食疗组脂肪肝缓解率(48.4%)高于茶饮组(10.0%),差异有统计学意义(P<0.001)。2)人体测量学指标:干预42 d后,与干预前比较,茶饮组体重、腰围、臀围、体质指数无明显变化(P>0.05),食疗组体重、腰围、臀围、体质指数均有所改善(P<0.05);干预后,食疗组体重、腰围、臀围均低于茶饮组(P<0.05)。3)血脂:干预42 d后,与干预前比较,茶饮组总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇无明显变化(P>0.05),食疗组总胆固醇、三酰甘油、低密度脂蛋白胆固醇均有所改善(P<0.05);干预后,食疗组三酰甘油、低密度脂蛋白胆固醇低于茶饮组(P<0.05)。4)干预42 d后,与干预前比较,茶饮组空腹血糖无明显变化(P>0.05),食疗组空腹血糖有所改善(P<0.05);干预后,食疗组血糖低于茶饮组(P<0.05)。5)肝肾功能指标。干预42 d后,与干预前比较,食疗组丙氨酸氨基转移酶、天门冬酸氨基转移酶、尿酸有所下降(P<0.05),肌酐、尿素氮无明显变化(P>0.05),茶饮组天门冬酸氨基转移酶、血尿酸有所下降(P<0.05),丙氨酸氨基转移酶、肌酐、尿素氮无明显变化(P>0.05);干预42 d后,两组丙氨酸氨基转移酶、天门冬酸氨基转移酶、肌酐、尿素氮、血尿酸比较,差异无统计学意义(P>0.05)。结论:富含非营养素的家庭护士食疗方案较单纯茶饮效果更佳,可以改善代谢功能障碍相关性脂肪肝病人不良的饮食习惯,提升健康饮食的意识,培养正确的饮食方式,可在短期内改善脂肪肝分级程度,降低病人血脂、血糖以及转氨酶指数。

Objective:Exploring the application effect of a family nurse diet scheme based on the family nurse diet theory in overweight/obese patients with metabolic dysfunction⁃associated fatty liver.Method:From October 31,2022 to November 17,2022,62 patients with metabolic dysfunction⁃associated fatty liver were recruited and randomly divided into a tea drinking group and a dietary therapy group,with 31 patients in each group.The tea drinking group was given routine dietary guidance for fatty liver and 2 packs of bitter buckwheat tea were brewed daily for consumption.The food therapy group provides family nurse diet scheme.After 42 days of intervention,the imaging examing,blood lipid,blood glucose,anthropometry indicators,liver and kidney functions of the two groups were compared.Results:1)After 42 days of intervention,the remission rate of fatty liver in the dietary therapy group(48.4%)was higher than that in the tea drinking group(10.0%),with a statistically significant difference(P<0.001).2)Anthropometry indicators.42 days after the intervention,compared with the pre intervention,there was no significant change in weight,waist circumference,hip circumference,waist hip ratio and body mass index in the tea drinking group(P>0.05),while the weight,waist circumference,hip circumference,and body mass index in the dietary therapy group were improved(P<0.05);After intervention,the weight,waist circumference,and hip circumference of the dietary therapy group were lower than those of the tea drinking group(P<0.05).3)Blood lipid:after 42 days of intervention,compared with that before intervention,there was no significant change in total cholesterol,triglyceride,high⁃density lipoprotein cholesterol and low⁃density lipoprotein cholesterol in the tea drinking group(P>0.05),while in the diet therapy group,total cholesterol,triglyceride,and low⁃density lipoprotein cholesterol were all improved(P<0.05);After intervention,the dietary therapy group showed better levels of triglycerides and low⁃density lipoprotein cholesterol compared to the tea drinking group(P<0.05).4)Fasting blood glucose.After 42 days of intervention,compared with before intervention,there was no significant change in fasting blood glucose in the tea drinking group(P>0.05),while the fasting blood glucose in the dietary therapy group improved(P<0.05);After intervention,the blood glucose levels in the dietary therapy group were lower than those in the tea drinking group(P<0.05).5)Liver and kidney function indicators.After 42 days of intervention,compared with that before intervention,ALT,AST and uric acid in the diet therapy group decreased(P<0.05),creatinine and urea nitrogen did not change significantly(P>0.05),while AST,and urea nitrogen in the tea drinking group decreased(P<0.05),ALT,creatinine and urea nitrogen did not change significantly(P>0.05);After the intervention,there was no significant difference between the two groups(P>0.05).Conclusion:The family nurse diet scheme rich in non nutrients is more effective than simple tea drinking.It can improve the poor dietary habits of patients with metabolic dysfunction related fatty liver,enhance their awareness of healthy eating,cultivate correct dietary habits,and improve the grading of fatty liver in the short term,reduce patients′blood lipids,blood sugar,and liver enzyme index.