摘要
目的 探索生活方式指导联合膳食纤维补充对慢传输型便秘的改善效果。方法 前瞻性的纳入2015年10月至2016年11月期间在陆军军医大学大坪医院便秘门诊就诊的慢传输型便秘患者82例，调查患者膳食、运动及便秘情况，通过一对一的交谈进行生活方式指导，同时给予复合膳食纤维口服10d干预，每月定期电话督促其日常饮食与运动。随访治疗开始后一个月及六个月便秘改善情况，评价患者膳食、饮水量及运动变化，评价每周排便次数大便性状（Bristol评分），排便困难感觉评分及便秘症状评估量表评分等。结果 82例纳入患者7例失访，对最终纳入研究的75例慢传输型便秘患者数据进行分析，结果显示，治疗后饮食结构以荤素适宜为主，主食以精粮与杂粮混合为主，治疗后动物性食物每天摄入量100~150g、每日吃一份水果、每日饮水量1，500~2，000ml的患者比例以及每周规律锻炼的患者比例显著增加，其差异均有统计学意义。治疗前、治疗后1个月和6个月每周排便次数分别为（1.40±0.77）次，（3.67±1.20）次和（3.62±1.17）次，与治疗前比，P值均＜0.05。排便困难感觉评分下降，大便性状Bristol评分增加分别为（1.99±1.34）分，（3.89±0.95）分和（3.87±0.99）分，与治疗前比，P值均＜0.05；PAC-SYM评分下降，分别为（2.21±0.42）分，（1.43±0.57）分和（1.51±0.46）分，与治疗前比，P值均＜0.05。便秘改善临床有效率治疗后1个月及6个月分别为88.00%和86.67%，患者自我满意度分别为85.33%和80.00%。结论 应用生活方式指导联合膳食纤维补充能够有效改善慢性便秘患者症状及满意度，是一种有效的临床综合治疗措施。
Abstract
Objective To explore the effects of combined lifestyle guidance and early dietary fiber intervention on slow transit constipation. Methods 82 patients diagnosed with slow transit constipation at out-patient department of Daping Hospital， Army Medical University were prospectively included from October 2015 to November 2016. Dietary， exercise and constipation status were investigated. Lifestyle guidance was given via one-to-one interview. Oral intervention of dietary fiber complex was continuously given to each subject for 10days. Daily dietary intake and exercise amount of subjects were monitored by monthly telephone interview. One and six month after intervention beginning， follow-up was performed to evaluate constipation improvement， dietary intake， water consumption， exercise change， weekly stool frequency， stool consistency (Bristol Stool Score)， Patient Assessment of Constipation Symptoms score (PAC-SYM score). Results Among 82 patients， 7 subjects were lost to follow-up. Finally， data from 75 patients diagnosed with slow transit constipation was analyzed. The results showed that proportions of the following patient groups were elevated， including patients with balanced meat and vegetables， patients with combined whole grains and refined grains as their staple food， patients with 100-150g daily animal food consumption， patients with one share of daily fruit consumption， patients with 1，500-2，000ml daily water consumption and patients with regular exercise. Compared with baseline， the patient’s stool frequency increased significantly［(1.40±0.77) vs (3.67±1.20) vs (3.62±1.17)， both P<0.05］ at 1-mo and 6-mo. Meanwhile the defecate feeling demonstrated a significant reduction［(1.48±1.26) vs (1.13±1.24) vs (0.89±1.10) both P<0.05］ and Bristol scores increased remarkably［(1.99±1.34) vs (3.89±0.95) vs (3.87±0.99) both P<0.05］. The PAC-SYM scores had s significant reduction［(2.21±0.42) vs (1.43±0.57) vs (1.51±0.46) both P<0.05］. The clinical improvement rates reached 88.00% and 86.67%， respectively. Self-satisfaction rates were 85.33% and 80.00%， respectively. Conclusion As an integrative clinical measure， combined treatment with lifestyle guidance and early dietary fiber supplementation is effective to improve symptoms and satisfaction degree of patients with slow transit constipation.
关键词
生活方式 /
膳食纤维 /
膳食调查 /
运动 /
慢性传输型便秘 /
Bristol评分 /
PAC-SYM评分
Key words
Lifestyle /
Dietary fiber /
Diet surveys /
Exercise /
Slow transit constipation /
Bristol score /
PAC-SYM score
张玲，刘高磊，张梦媛，刘洁，郭静，林欣，许红霞，李春穴.
生活方式指导联合早期膳食纤维补充改善慢传输型便秘的自身对照研究[J]. 肿瘤代谢与营养电子杂志. 2019, 6(2): 190-195 https://doi.org/10.16689/j.cnki.cn11-9349/r.2019.02.007
ZHANG Ling， LIU Gao-lei， ZHANG Meng-yuan， LIU Jie，1UO Jing， LIN Xin， XU Hong-xia， LI Chun-xue.
Combined life style guidance and early dietary fiber supplementation to improve slow transit constipation: a self-controlled study[J]. Electronic Journal of Metabolism and Nutrition of Cancer. 2019, 6(2): 190-195 https://doi.org/10.16689/j.cnki.cn11-9349/r.2019.02.007
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基金
重庆市社会民生科技创新专项（cstc2015shmszx120109）；重庆市临床营养学医学重点建设学科（2012）
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