Effect Of Exclusive Enteral Nutrition On Intestinal Mucosal Repair In Children With Mild To Moderate Active Crohn’s Disease

Objectives: To investigate the effect of Exclusive enteral nutrition(EEN)on intestinal mucosal repair in children with mild to moderate active Crohn’s Disease(CD),and to evaluate the improvement of nutritional indicators,inflammatory indicators,Disease activity indicators,endoscopic score and other indexes after EEN treatment.And to analyze the effects of EEN combined with mesalazine and partial enteral nutrition on intestinal mucosal repair in children with mild to moderate active Crohn’s disease.Methods: Review the patients with mild to moderate CD who met the enrollment criteria and received enteral nutrition therapy at Shenzhen Children’s Hospital from August 2018 to February 2021,and recorded the children’s re-examination before enteral nutrition treatment and 8 weeks after treatment Clinical data.Including children’s Crohn’s disease activity index(PCDAI)score,body mass index(BMI),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),albumin(Albumin,ALB),Hematokrit(HCT),Simplified Endoscopic Score for Crohn’s Disease(SES-CD).The data were grouped according to whether to use EEN treatment and whether to use mesalazine drug treatment in combination,and further analyze the differences between the groups.Results: This study included a total of 20 patients with mild to moderate CD in the active phase who met the inclusion criteria.A total of 13 patients were treated with EEN,including 6 patients in the EEN alone group and 7 patients in the EEN combined with mesalazine group.The remaining 7 patients treated with PEN combined with mesalazine were grouped into one group.After 8 weeks of treatment,the levels of ESR,HCT,ALB,CRP,BMI,PCDAI and SES-CD in 13 patients treated with EEN were significantly improved(P< 0.05).The clinical remission rate of EEN alone group and EEN combined with mesalazine group was 100%,which was significantly higher than that of PEN combined with mesalazine group(71.4%),and the difference was not statistically significant(P > 0.05).The mucosal healing rate of EEN alone group(66.7%)and EEN combined with mesalazine group(57.1%)were both higher than that of PEN combined with mesalazine group(28.6%),and the difference was not statistically significant(P >0.05).This study also found that :1.Regardless of whether combined with mesalazine drug treatment,the indicators of children with mild to moderate active Crohn’s disease treated with complete enteral nutrition were significantly improved compared with those before treatment(P<0.05),but all indicators after treatment The difference between the groups is not statistically significant(P > 0.05).2.Most of the PEN with the salad oxazine therapy of children,after treatment was improved to a certain extent the evaluation indexes,and HCT,BMI,PCDAI difference has significant statistical significance(P< 0.05).Conclusion: 1.EEN treatment can effectively improve the nutritional status and disease activity of children with mild to moderate Crohn’s disease.2.The therapeutic effect of mesalazine on children with mild to moderate Crohn’s disease is not significant.3.The mucosal remission rate of children with mild to moderate Crohn’s disease treated with EEN is much higher than that of the PEN group.Although the difference is not statistically significant,the PCDAI score of the EEN group after treatment is significantly lower than that of the PEN group after treatment Considering that this result is related to the course of medication and anti-infective treatment of some children,and we still need further research and exploration.