| Background:Crohns disease(CD)patients suffer from malnutrition due to intestinal lesion affecting the intake and absorption of nutrients.Malnutrition can affect disease progression,prognosis and clinical treatment.The nutritional status of the patients with Crohn’s disease can be well evaluated by the mini nutritional assessment(MNA),patient-generated subjective global assessment(PG-SGA)and the general nutritional indicators,so as to evaluate the severity of disease progression,prognosis and predict clinical treatment effect,indicate clinical treatment decision.However,there is still a lack of nutritional assessment for CD patients when received drug treatment(5-ASA,glucocorticoids,immunosuppressants,and biological agents),which is not help to dynamic conduct nutrition intake,affects the prognosis of the disease,increases the cost of medical treatment and patient pain.Objective:To analysis the effects of MNA and PG-SGA on the total medical cost,the number of hospitalization,the incidence of complications and the severity of disease of the CD patients Which had received drug treatment.To analysis the significance of the nutritional assessment in CD treatment.Method:The patients with CD who were hospitalized in Gastroenterology clinic or Gastroenterology ward of First Affiliated Hospital of Nanchang University from Mar.2016 to Mar.2017 that had not received medical treatment,and the general date,CDAI scores has been collected.The CD patients were randomly divided into experimental group and control group.During the period of drug treatment and follow-up,The MNA and PG-SGA nutrition was routinely evaluated in the experimental group,and Nutrition Risk Screening 2002 and general nutrition indicators was evauated in control group.Boths groups were dynamically conduct patients’ nutrition intake and adjust the nutrition treatment according to assess result.The total treatment cost,the times of hospitalization,the incidence of complicationsand the severtity of disease were collected during the one year in two groups,and the differences between the two groups were compared and analyzed.Result:(1)In experimental group,The malnutrition rate were assessed by MNA was18.2%,and malnutrition or potential malnutrition rate was 90.9% in CD patients.The rate of PG-SGA assessment that need for drug intervention or nutritional support(i.e.,PG-SGA score more than 4 points)was 77.3%.In control group,The malnutrition rate was 82%.(2)The average times of hospitalization in the experimental group was 0.45+ 0.63 times,While that in the control group was 0.76 + 0.69 times.The average hospitalization times of the experimental groups were lower compared to the control group(P < 0.05).(3)The average medical cost in the experimental group was2.44±2.34 ten thousand yuan in 1 years,while the control group was 2.93±2.15 ten thousand yuan.Comparing the average medical cost in 1 years between two group,there was no significance(P < 0.05).(4)During the one year,the number of complications in the experimental group was 3(3/44),while that in the control group was 7(7/50).There was no significant differences between the two groups(P <0.05).(5)In the experimental group,the severity of the disease was evaluated one years later: among them,10 were mild(22.7%),3 were moderate(6.8%)and 31 were in the remission(70.5%).In the control group the severity of the disease: 6 were mild(12%),12 were moderate(24%),and 32 were in remission(64%).The experimental group,Which the severity of disease was more slighter than that in the control group(P < 0.05).Conclusion:During the drug treatment in CD patients,Giving MNA and PG-SGA nutritional assessment in order to nutritional intervention may play a synergistic role in drug therapy. |
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