低FODMAP饮食指导的延续性护理对溃疡性结肠炎患者营养状况和肠道菌群的影响

Effect of continuous care with low FODMAP dietary guidance on nutritional status and intestinal flora in patients with ulcerative colitis

目的通过构建低量可发酵的低聚糖、双糖、单糖、多元醇(FODMAP)饮食指导的延续性护理方案,帮助溃疡性结肠炎患者改善营养状况和调节肠道菌群,实现护理质量的优化。方法选取2022年7月—2024年1月在杭州市中医院治疗的溃疡性结肠炎患者141例,采用随机数字表法分为对照组(71例)和试验组(70例),对照组给予常规延续性护理,试验组在上述基础上给予低FODMAP饮食指导的延续性护理,比较2组护理前后饮食依从性、改良Mayo评分、肠道菌群菌落数及营养状况。结果试验组护理12周后饮食相关知识、饮食管理行为评分均高于对照组(P<0.05);改良Mayo评分[(3.11±1.12)vs.(4.09±1.76)分]低于对照组(P<0.05);大肠埃希菌菌落数少于对照组(P<0.05),双歧杆菌及乳酸杆菌菌落数多于对照组(P<0.05);血清白蛋白[ALB,(32.09±8.03)vs.(30.56±7.24)g/L]、前白蛋白[PAB,(190.09±20.77)vs.(182.44±15.38)mg/L]及血红蛋白[HGB,(109.34±11.34)vs.(95.77±10.71)g/L]均高于对照组(P<0.05)。结论低FODMAP饮食指导的延续性护理既可提高溃疡性结肠炎患者饮食依从性,缓解临床症状,又有助于平衡肠道菌群,改善患者营养状况。

Objective Constructing a continuous nursing program guided by a low fermentable oligosaccharides,disaccharides,monosaccharides and polyols(FODMAP)diet to help patients with ulcerative colitis improve their nutritional status,regulate intestinal flora,and optimize the quality of care.Methods A total of 141 patients with ulcerative colitis treated in Hangzhou Hospital of Traditional Chinese Medicine from July 2022 to January 2024 were selected and divided into a control group(71 cases)and an experimental group(70 cases)by random number table method.The control group was given routine continuous care,and the experimental group was given continuous care with low FODMAP dietary guidance on the basis of the above.Dietary compliance,modified Mayo score,intestinal flora number,and nutritional status of the two groups were compared before and after care.Results After 12 weeks of nursing,the scores of diet-related knowledge and diet management behavior in the experimental group were higher than those of the control group(P<0.05);The modified Mayo score[(3.11±1.12)vs.(4.09±1.76)points]in the experimental group was lower than that of the control group(P<0.05).The number of Escherichia coli colonies in the experimental group was lower than that of the control group(P<0.05),and bifidobacterium and lactobacillus colonies in the experimental group were higher than those of the control group(P<0.05).Serum albumin[ALB,(32.09±8.03)vs.(30.56±7.24)g/L],prealbumin[PAB,(190.09±20.77)vs.(182.44±15.38)mg/L],and hemoglobin[HGB,(109.34±11.34)vs.(95.77±10.71)g/L]in the experimental group were higher than those in the control group(P<0.05).Conclusion The continuous nursing of low FODMAP dietary guidance can not only improve the dietary compliance of patients with ulcerative colitis,and relieve the clinical symptoms of patients,but also help balance the intestinal flora and improve the nutritional status of patients.