The question of the link between pregnancy and eating disorders is an important question. At the moment, there are few concrete answers for these patients. Despite common fertility challenges, patients who suffer from...The question of the link between pregnancy and eating disorders is an important question. At the moment, there are few concrete answers for these patients. Despite common fertility challenges, patients who suffer from ED are able to access maternity. ED and pregnancy can either have an easy evolution or experience a lot of trouble. Many studies describe obstetrical and foetal complications (low birthweight, inadequate intra-uterine growth, small head circumference, miscarriage, caesarean section). Those patients are frequently reluctant to address their disease with their specialist, who also often doesn’t know how to screen the signs. The lack of official data to train the specialists further increases these difficulties. However, ED are frequent in the general population and young patients are likely to eventually want to become mothers. It is thus essential to know how to screen those patients early and accurately to improve their treatment and care. Eating disorders impact the pregnancy, the delivery and the postpartum as well as the growth of the baby. It is an important public health problem. The evolution from being a woman to becoming a mother is a difficult one, and even more so when the women is suffering from ED. Those patients must handle their nutritional fears, the anxiety about their body changing with pregnancy and the daily challenges. The early interactions with their baby have consequences on their development. It seems necessary to evaluate how to improve the screening and the patient care in ED patients. Screening should begin from the pregnancy desire to the postpartum. This patient care should be based on a multidisciplinary care team.展开更多
Background:Liu-Jun-Zi decoction(LJZD),a classical nourishing formula in China,has been proven to be effective in treating chemotherapy-induced anorexia.In this study,the mechanism of LJZD in alleviating chemotherapy-i...Background:Liu-Jun-Zi decoction(LJZD),a classical nourishing formula in China,has been proven to be effective in treating chemotherapy-induced anorexia.In this study,the mechanism of LJZD in alleviating chemotherapy-induced anorexia was discussed from the aspects of regulating gut microbiota,repairing intestinal barrier injury and inhibiting inflammatory pathways.Methods:A rat model of chemotherapy-induced anorexia was established using cisplatin.The study evaluated the therapeutic effects of LJZD by observing the weight,food intake,and intestinal pathology of rats.The impact of LJZD on gut microbiota and metabolites,specifically short-chain fatty acids,was investigated through gut microbiota analysis and targeted metabolomics.The anti-inflammatory and intestinal protective effects of LJZD were assessed by examining the expression of intestinal tight junction proteins associated with the inflammatory pathway.Results:LJZD alleviated cisplatin-induced inflammation and intestinal barrier disruption,as evidenced by upregulated expression of tight junction protein 1(TJ-1)and occludin,along with reduced serum levels of interleukin 6(IL-6),interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),and lipopolysaccharide.Additionally,LJZD alleviated microbiota imbalance and regulated the levels of short-chain fatty acids,especially increased the relative abundance of Coriobacteriales Incertae Sedis,Lactabacillus johnsonii F19785,Parasutterella,and reduced the Tyzzerella.In the hypothalamus,LJZD exerts suppressive effects on the toll-like receptor 4(TLR4)/myeloid differentiation factor 88(MyD88)/nuclear factor-κB(NF-κB)p65 signaling pathway,leading to a downregulation in the transcriptional activity of IL-6 and IL-1β,as well as Interleukin 6 receptors(IL-6R)and Interleukin-1βreceptors(IL-1R1)mRNA expression levels.Conclusion:In summary,LJZD alleviate chemotherapy-induced anorexia by modulating the gut microbiota,repairing the intestinal mechanical barriers,and suppressing the TLR4/MyD88/NF-κB p65 signaling pathway.展开更多
目的探究中医食疗联合营养治疗改善恶性肿瘤患者厌食症状的临床研究.方法选择2022年2月至2023年2月期间在河北工程大学附属医院被确诊的106例恶性肿瘤引发的厌食患者为研究对象,并采用随机数表法分为两组,每组各53例.对照组采用标准的...目的探究中医食疗联合营养治疗改善恶性肿瘤患者厌食症状的临床研究.方法选择2022年2月至2023年2月期间在河北工程大学附属医院被确诊的106例恶性肿瘤引发的厌食患者为研究对象,并采用随机数表法分为两组,每组各53例.对照组采用标准的营养疗法,观察组则采用中医食疗和营养疗法相结合的方式.对两组患者接受干预后食欲改善情况、干预前后食欲的视觉模拟评分(Visual Analogue Scale,VAS)、安德森症状评估量表评分、体重、血前白蛋白、血白蛋白及生存质量[生存质量卡氏评分(Karnofsky,KPS)、生活质量量表评分(Quality of Life Questionnaire-Core 30,QLQ-C30)]、治疗依从性(Frankl依从量表)进行研究,并监测期间不良事件发生情况.结果进行干预前,将两组患者一般资料(性别、年龄、病程及肿瘤类型)、食欲VAS评分、安德森症状评估量表评分、体重值、血前白蛋白值、血白蛋白值、KPS评分、QLQ-C30评分进行比较,差异均无统计学意义(P>0.05).干预后,观察组总有效率为94.34%(50/53),比对照组的75.47%(40/53)明显提高(P<0.05).观察组食欲VAS评分,两组安德森症状评估量表评分均较干预前降低,且干预后观察组食欲VAS评分、安德森症状评估量表评分均低于对照组,差异有统计学意义(P<0.05).观察组患者的体重值、血前白蛋白值、血白蛋白值均较干预前有所升高,且干预后观察组体重值、血前白蛋白值、血白蛋白值均明显高于对照组(P<0.05).观察组KPS评分较干预前升高、QLQ-C30评分均较干预前降低,且干预后观察组KPS评分高于对照组、QLQ-C30评分低于对照组,差异有统计学意义(P<0.05).观察组治疗依从性明显高于对照组(P<0.05).两组干预期间均未发生呕吐、恶心、大便糖稀等不良反应.结论中医食疗联合营养治疗有利于改善恶性肿瘤癌性厌食患者食欲,提高营养状况和体重,并改善生活质量.展开更多
目的系统评价扶正化瘀散结法联合西药治疗厌食-恶病质综合征的有效性。方法系统检索维普(VIP)、中国知网(CNKI)、万方数据知识服务平台(Wan Fang)、中国生物医学文献数据库(CBM)、PubMed、Web of Science、Embase数据库、Cochrane Libr...目的系统评价扶正化瘀散结法联合西药治疗厌食-恶病质综合征的有效性。方法系统检索维普(VIP)、中国知网(CNKI)、万方数据知识服务平台(Wan Fang)、中国生物医学文献数据库(CBM)、PubMed、Web of Science、Embase数据库、Cochrane Library数据库,利用Jadad、Cochrane协作网RCT质量评价标准对纳入文献的研究质量进行评价,Meta分析提取数据。结果1)共纳入17个随机对照研究(RCT),患者1423例,纳入研究质量一般;2)Meta分析合并RR值包括体重变化[RR=1.36,95%CI(1.08,1.71),P=0.009]、KPS评分变化[RR=1.44,95%CI(1.29,1.60),P<0.00001]、进食量变化[RR=1.33,95%CI(1.15,1.55),P=0.0002]、白蛋白变化[MD=3.01,95%CI(2.10,3.93),P<0.00001]以及血红蛋白变化[MD=10.74,95%CI(1.91,19.58),P=0.02]。结论本研究证实扶正化瘀散结法在厌食-恶病质综合征应用的有效性优于单纯西药治疗或结合营养支持治疗。展开更多
文摘The question of the link between pregnancy and eating disorders is an important question. At the moment, there are few concrete answers for these patients. Despite common fertility challenges, patients who suffer from ED are able to access maternity. ED and pregnancy can either have an easy evolution or experience a lot of trouble. Many studies describe obstetrical and foetal complications (low birthweight, inadequate intra-uterine growth, small head circumference, miscarriage, caesarean section). Those patients are frequently reluctant to address their disease with their specialist, who also often doesn’t know how to screen the signs. The lack of official data to train the specialists further increases these difficulties. However, ED are frequent in the general population and young patients are likely to eventually want to become mothers. It is thus essential to know how to screen those patients early and accurately to improve their treatment and care. Eating disorders impact the pregnancy, the delivery and the postpartum as well as the growth of the baby. It is an important public health problem. The evolution from being a woman to becoming a mother is a difficult one, and even more so when the women is suffering from ED. Those patients must handle their nutritional fears, the anxiety about their body changing with pregnancy and the daily challenges. The early interactions with their baby have consequences on their development. It seems necessary to evaluate how to improve the screening and the patient care in ED patients. Screening should begin from the pregnancy desire to the postpartum. This patient care should be based on a multidisciplinary care team.
基金National Natural Science Foundation of China(grant numbers 82174143)the Innovative Team Project of Ordinary Universities in Guangdong Province(grant numbers 2022KCXTD016).
文摘Background:Liu-Jun-Zi decoction(LJZD),a classical nourishing formula in China,has been proven to be effective in treating chemotherapy-induced anorexia.In this study,the mechanism of LJZD in alleviating chemotherapy-induced anorexia was discussed from the aspects of regulating gut microbiota,repairing intestinal barrier injury and inhibiting inflammatory pathways.Methods:A rat model of chemotherapy-induced anorexia was established using cisplatin.The study evaluated the therapeutic effects of LJZD by observing the weight,food intake,and intestinal pathology of rats.The impact of LJZD on gut microbiota and metabolites,specifically short-chain fatty acids,was investigated through gut microbiota analysis and targeted metabolomics.The anti-inflammatory and intestinal protective effects of LJZD were assessed by examining the expression of intestinal tight junction proteins associated with the inflammatory pathway.Results:LJZD alleviated cisplatin-induced inflammation and intestinal barrier disruption,as evidenced by upregulated expression of tight junction protein 1(TJ-1)and occludin,along with reduced serum levels of interleukin 6(IL-6),interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),and lipopolysaccharide.Additionally,LJZD alleviated microbiota imbalance and regulated the levels of short-chain fatty acids,especially increased the relative abundance of Coriobacteriales Incertae Sedis,Lactabacillus johnsonii F19785,Parasutterella,and reduced the Tyzzerella.In the hypothalamus,LJZD exerts suppressive effects on the toll-like receptor 4(TLR4)/myeloid differentiation factor 88(MyD88)/nuclear factor-κB(NF-κB)p65 signaling pathway,leading to a downregulation in the transcriptional activity of IL-6 and IL-1β,as well as Interleukin 6 receptors(IL-6R)and Interleukin-1βreceptors(IL-1R1)mRNA expression levels.Conclusion:In summary,LJZD alleviate chemotherapy-induced anorexia by modulating the gut microbiota,repairing the intestinal mechanical barriers,and suppressing the TLR4/MyD88/NF-κB p65 signaling pathway.
文摘目的探究中医食疗联合营养治疗改善恶性肿瘤患者厌食症状的临床研究.方法选择2022年2月至2023年2月期间在河北工程大学附属医院被确诊的106例恶性肿瘤引发的厌食患者为研究对象,并采用随机数表法分为两组,每组各53例.对照组采用标准的营养疗法,观察组则采用中医食疗和营养疗法相结合的方式.对两组患者接受干预后食欲改善情况、干预前后食欲的视觉模拟评分(Visual Analogue Scale,VAS)、安德森症状评估量表评分、体重、血前白蛋白、血白蛋白及生存质量[生存质量卡氏评分(Karnofsky,KPS)、生活质量量表评分(Quality of Life Questionnaire-Core 30,QLQ-C30)]、治疗依从性(Frankl依从量表)进行研究,并监测期间不良事件发生情况.结果进行干预前,将两组患者一般资料(性别、年龄、病程及肿瘤类型)、食欲VAS评分、安德森症状评估量表评分、体重值、血前白蛋白值、血白蛋白值、KPS评分、QLQ-C30评分进行比较,差异均无统计学意义(P>0.05).干预后,观察组总有效率为94.34%(50/53),比对照组的75.47%(40/53)明显提高(P<0.05).观察组食欲VAS评分,两组安德森症状评估量表评分均较干预前降低,且干预后观察组食欲VAS评分、安德森症状评估量表评分均低于对照组,差异有统计学意义(P<0.05).观察组患者的体重值、血前白蛋白值、血白蛋白值均较干预前有所升高,且干预后观察组体重值、血前白蛋白值、血白蛋白值均明显高于对照组(P<0.05).观察组KPS评分较干预前升高、QLQ-C30评分均较干预前降低,且干预后观察组KPS评分高于对照组、QLQ-C30评分低于对照组,差异有统计学意义(P<0.05).观察组治疗依从性明显高于对照组(P<0.05).两组干预期间均未发生呕吐、恶心、大便糖稀等不良反应.结论中医食疗联合营养治疗有利于改善恶性肿瘤癌性厌食患者食欲,提高营养状况和体重,并改善生活质量.
文摘目的系统评价扶正化瘀散结法联合西药治疗厌食-恶病质综合征的有效性。方法系统检索维普(VIP)、中国知网(CNKI)、万方数据知识服务平台(Wan Fang)、中国生物医学文献数据库(CBM)、PubMed、Web of Science、Embase数据库、Cochrane Library数据库,利用Jadad、Cochrane协作网RCT质量评价标准对纳入文献的研究质量进行评价,Meta分析提取数据。结果1)共纳入17个随机对照研究(RCT),患者1423例,纳入研究质量一般;2)Meta分析合并RR值包括体重变化[RR=1.36,95%CI(1.08,1.71),P=0.009]、KPS评分变化[RR=1.44,95%CI(1.29,1.60),P<0.00001]、进食量变化[RR=1.33,95%CI(1.15,1.55),P=0.0002]、白蛋白变化[MD=3.01,95%CI(2.10,3.93),P<0.00001]以及血红蛋白变化[MD=10.74,95%CI(1.91,19.58),P=0.02]。结论本研究证实扶正化瘀散结法在厌食-恶病质综合征应用的有效性优于单纯西药治疗或结合营养支持治疗。
