| Background and objective:Ulcerative colitis(UC) is a chronic nonspecific inflammatory disease of rectum and colon, which is not very clear. The lesions were mainly confined to the mucosa and submucosal layer. The clinical manifestations are diarrhea, bloody mucopurulent stool and abdominal pain. The severity of the disease is different, which is a chronic process of repeated attacks. In recent years, with the improvement of medical diagnosis and the change of people’s diet and living habits, the incidence of UC has increased year by year, especially in western countries, which may be related to the typical characterist ics of Western diet(high fat and refined carbohydrate and low fiber). Its complications are many. Weight loss and malnutrition are also common complications in UC patients. Malnutrition can lead to development dysplasia, Intestinal mucosal immune disorder, Intestinal flora imbalance, and repeated the course of disease, affecting the prognosis of the disease, may have malignant transformation. In addition, the drug effect is poor or the il ness is aggravating, which make the patient feel nervous, anxiety, insomnia, and so on, Seriously affecting the quality of life of patients. So nutritional support is needed to improve nutritional status of patients, the intestinal mucosal immune functio n and body resistance, inducing remission, improving the quality of life of patients. This study is to explore the effect of enteral nutrition on nutritional status, disease activit y index, intestinal mucosal immune function, clinical symptoms and quality of life in patients with ulcerative colitis and in order to evaluate the effect of enteral nutrition on patients with ulcerative colitis with different severity and extent of disease. Method:The research objects was selected from 2014 April to 2016 March in NO.1 Hospital of Jilin University, There all were a definite diagnosis of ulcerative colitis and in the active phase of disease.There were 52 patients in total, of which the clinical date was complete, including name, gender, age, and then according to the modified Truelove and Witts inflammation degree classification standard, they were divided into 3 types which were mild moderate and severe separately. According to lesion range, participants were divided into rectum and sigmoid colon type, left colon type, total colonic type. The 52 participants were randomly divided into two groups. Control group(traditional anti-inflammatory treatment + less residue diet) and the Experimental group(control group use drugs + Enteral Nutrition). Collect blood test results: hemoglobin(HB), total protein(TP), albumin(ALB), weight, Erythrocyte Sedimentat io n Rate(ESR), C-Reactive Protein(CRP); weight change, endoscopic performance; Follow up for clinical manifestations, adverse reactions, daily activities, mood changes before and after treatment, Using the SF-36 quality of life questionnaire, which was developed by the American Institute of health in Boston, to fill in the quality of life of patients and to assess the quality of life before and after treatment. Results:1、general situation:There were no significant difference in sex ratio, age, severity of disease, lesion type, lesion area between the two groups(P>0.05).2、nutritional index:There were no significant differences in ALB and TP, HB before treatment between the two groups(P>0.05). After treatment, the experimental group ALB and TP, HB, weight compared with before treatment had a significant increase, the differe nce was statistically significant(P<0.05).While the control group, the change of ALB and TP, HB, weight was not obvious compared with before treatment, the difference was not statistically significant(P>0.05). The ALB and TP, HB, weight were signific a nt differences between the two groups after treatment(P<0.05).3、inflammatory indicators:There were no significant differences in ALB and TP, HB before treatment between the two groups(P>0.05). There was a significant decrease in CRP and ESR compared with before treatment in experimental group, and the difference was statistically significant(P<0.05). While the change of CRP, ESR compared with before treatment was not obvious in the control group, the difference was not statistica l ly significant(P>0.05). The differences of CRP and ESR after treatment in the two groups were statistically significant(P<0.05).4、clinical effectsAfter treatment, experimental group curative effect total efficiency was better than the control group, the total efficiency was 88.9%, which was higher than that of the control group of 48%, the difference between the two groups had statistica l significance(P<0.05).4.1 clinical curative effect comparison(According to the severity)In the experimental group with mild UC patients clinical curative effect compared with the control group, the difference was not statistically signific a nt(P>0.05). The clinical curative effect of moderate to severe UC patients in experime nt a l group was better than that of the control group, the difference was statistica l ly significant(P<0.05).4.2 clinical curative effect comparison(According to the lesion range)There was no significant difference in clinical efficacy between the experimental group and the control group(P>0.05) in UC patients of the rectum and sigmoid colon, the left half colon type. The clinical efficacy of the experimental group of all colon type UC patients was significantly better than that of the control group, the difference was statistically significant(P<0.05).5、quality of life assessment:Before treatment, there was no significant difference in the scores of each dimension of the quality of life scale between two groups(P>0.05). After treatment, the quality of life scale of the 9 dimension scores were higher than before treatment both the 2 groups, the difference was statistically significant(P<0.05)。After treatment, there were statistically significant differences between the 2 groups(P<0.05). Conclusion:1、Adequate enteral nutrition support should be given to patients with multip le site lesions and moderate to severe ulcerative colitis, which has better clinical efficacy.2、Enteral nutritional support can be used as an adjuvant therapy for patients with UC in active stage3、Drug combined with enteral nutrition support has better clinical efficacy4、Enteral nutrition is beneficial to the recovery of malnutrition, effectively relieve the clinical symptoms and improve the immune function of intestinal mucosa, which can also improve the quality of life. |
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