摘要
目的探讨"三高"饮食(高热量、高蛋白质、高维生素)联合糖脂双能源肠内营养(EN)治疗肝硬化患者的效果。方法将肝硬化患者286例按随机数字表法分为治疗组143例和对照组143例。对两组患者进行保肝、利尿、抗感染等常规治疗。治疗组在常规治疗基础上加用"三高"饮食、糖脂双能源EN治疗,对照组给予常规饮食。观察治疗前后两组临床症状、肝功能、血氨、内毒素、糖脂代谢等变化。结果治疗组总有效率为90.91%,对照组为73.43%,治疗组临床疗效明显优于对照组(P<0.05)。治疗后治疗组AST、ALT、内毒素、餐后2h血糖、胰岛素水平明显低于对照组(P<0.05);血清白蛋白、胆碱酯酶、甘油三酯、总胆固醇、载脂蛋白A、载脂蛋白B、高密度脂蛋白胆固醇、极低密度脂蛋白胆固醇均明显高于对照组(P<0.05)。治疗后两组血氨和空腹血糖比较,差异无统计学意义(P>0.05)。结论 "三高"饮食、糖脂双能源EN有利于改善肝硬化患者临床症状、肝功能,减少内毒素,促进脂质、血糖代谢恢复。
Objective To explore the effect of′Three High′（ high calorie,high protein,high vitamin） diet combined with glycolipid dual energy enteral nutrition（EN） on the treatment of patients with cirrhosis.Methods Two hundred and eighty-six patients with cirrhosis were divided into treatment group（143 cases） and control group（143 cases） according to the random number table.The patients in the two groups received routine treatment including protecting liver therapy,diuresis therapy and anti-infection therapy.Based on the routine treatment, the treatment group was given′Three High′diet and glycolipid dual energy EN while the observation group was given routine diet.The changes in the clinical symptoms,liver function,blood ammonia,endotoxin,glucose and lipid metabolism indexes before and after treatment were observed in the two groups.Results The total effective rate was 90.91%in the treatment group,73.43%in the control group,the clinical effect of treatment group was significantly better than that of control group（P〈0.05）.After treatment,AST,ALT,endotoxin,2-hour postprandial blood glucose and insulin levels in the treatment group were significantly lower than those in the control group（P〈0.05）;Serum albumin,cholinesterase,TG, TC,apolipoprotein A, apolipoprotein B, HDL-C, very low density lipoprotein cholesterol levels in the treatment group were significantly higher than those in the control group（P〈0.05）.There was no significant difference in the blood ammonia or fasting blood glucose between two groups（P〉0.05）.Conclusion ′Three High′diet combined with glycolipid dual energy EN is beneficial to the improvement of clinical symptoms and liver function of patients with cirrhosis,which might reduce endotoxin and promote the recovery of lipid and glucose metabolism.
出处
《广西医学》
CAS
2015年第5期633-636,共4页
Guangxi Medical Journal
基金
广西科学研究与技术开发计划(桂科攻0632007-2)
全国临床医药研究专项基金(2011-J-34-01-L03)
关键词
肝硬化
肠内营养
糖脂双能源
高热量
高蛋白质
高维生素
膳食疗法
Cirrhosis
Enteral nutrition
Glycolipid dual energy
High calorie
High protein
High vitamin
Diet therapy
作者简介
E—mail：wangzhenchang924@163．com,王振常（1972～），男，硕士，主任医师，研究方向：肝病中西医结合规范化治疗。
