Background and aims: Total enteral nutrition (TEN) with a liquid formula can suppress gut inflammation and induce remission in active Crohn’s disease. The mechanism is obscure. Studies have suggested that long term n...Background and aims: Total enteral nutrition (TEN) with a liquid formula can suppress gut inflammation and induce remission in active Crohn’s disease. The mechanism is obscure. Studies have suggested that long term nutritional supplementation with a liquid formula (partial enteral nutrition (PEN)) may also suppress inflammation and prevent relapse. The aim of this study was to compare PEN with conventional TEN in active Crohn’s disease. Patients and methods: Fifty children with a paediatric Crohn’s disease activity index (PCDAI) > 20 were randomly assigned to receive 50% (PEN) or 100% (TEN) of their energy requirement as elemental formula for six weeks. The PEN group was encouraged to eat an unrestricted dietwhile those receiving TEN were not allowed to eat. The primary outcome was achievement of remission (PCDAI < 10). Secondary analyses of changes in erythrocyte sedimentation rate (ESR), C reactive protein, albumin, and platelets were performed to look for evidence of anti-inflammatory effects. Results: Remission rate with PEN was lower than with TEN (15% v 42% ; p = 0.035). Although PCDAI fell in both groups (p = 0.001 for both), the reduction was greater with TEN (p = 0.005). Moreover, the fall in PCDAI with PEN was due to symptomatic and nutritional benefits. With both treatments there were significant improvements in relation to abdominal pain, “ sense of wellbeing", and nutritional status. However, only TEN led to a reduction in diarrhoea (p = 0.02), an increase in haemoglobin and albumin, and a fall in platelets and ESR. Conclusions: TEN suppresses inflammation in activeCrohn’s disease but PEN does not. This suggests that long term nutritional supplementation, although beneficial to some patients, is unlikely to suppress inflammation and so prevent disease relapse.展开更多
目的探讨重型颅脑损伤早期应用肠内营养(EN)的重要性及效果。方法对脑外伤患者按格拉斯哥昏迷评分(Glasgow coma scale,GCS)挑选80例重型颅脑损伤的患者，并将其按肠内营养给入时间随机分为四组，设立对照组。结果对患者进行营养指标评...目的探讨重型颅脑损伤早期应用肠内营养(EN)的重要性及效果。方法对脑外伤患者按格拉斯哥昏迷评分(Glasgow coma scale,GCS)挑选80例重型颅脑损伤的患者，并将其按肠内营养给入时间随机分为四组，设立对照组。结果对患者进行营养指标评定，应用t检验，两者有非常显著的差异。说明早期(伤后48小时)肠内营养后患者的营养状况明显优于晚期(伤后48小时后)给入。结论对于重型颅脑损伤患者，早期进行肠内营养是非常有效的营养支持治疗。展开更多
文摘Background and aims: Total enteral nutrition (TEN) with a liquid formula can suppress gut inflammation and induce remission in active Crohn’s disease. The mechanism is obscure. Studies have suggested that long term nutritional supplementation with a liquid formula (partial enteral nutrition (PEN)) may also suppress inflammation and prevent relapse. The aim of this study was to compare PEN with conventional TEN in active Crohn’s disease. Patients and methods: Fifty children with a paediatric Crohn’s disease activity index (PCDAI) > 20 were randomly assigned to receive 50% (PEN) or 100% (TEN) of their energy requirement as elemental formula for six weeks. The PEN group was encouraged to eat an unrestricted dietwhile those receiving TEN were not allowed to eat. The primary outcome was achievement of remission (PCDAI < 10). Secondary analyses of changes in erythrocyte sedimentation rate (ESR), C reactive protein, albumin, and platelets were performed to look for evidence of anti-inflammatory effects. Results: Remission rate with PEN was lower than with TEN (15% v 42% ; p = 0.035). Although PCDAI fell in both groups (p = 0.001 for both), the reduction was greater with TEN (p = 0.005). Moreover, the fall in PCDAI with PEN was due to symptomatic and nutritional benefits. With both treatments there were significant improvements in relation to abdominal pain, “ sense of wellbeing", and nutritional status. However, only TEN led to a reduction in diarrhoea (p = 0.02), an increase in haemoglobin and albumin, and a fall in platelets and ESR. Conclusions: TEN suppresses inflammation in activeCrohn’s disease but PEN does not. This suggests that long term nutritional supplementation, although beneficial to some patients, is unlikely to suppress inflammation and so prevent disease relapse.
文摘目的探讨重型颅脑损伤早期应用肠内营养(EN)的重要性及效果。方法对脑外伤患者按格拉斯哥昏迷评分(Glasgow coma scale,GCS)挑选80例重型颅脑损伤的患者，并将其按肠内营养给入时间随机分为四组，设立对照组。结果对患者进行营养指标评定，应用t检验，两者有非常显著的差异。说明早期(伤后48小时)肠内营养后患者的营养状况明显优于晚期(伤后48小时后)给入。结论对于重型颅脑损伤患者，早期进行肠内营养是非常有效的营养支持治疗。
