Rigaud Daniel, Brondel Laurent, Poupard Anne Thérèse, Talonneau Isabelle, Brun Jean Marcel
Service d'Endocrinologie et Nutrition, CHU Le Bocage, 21079, Dijon, France.
Clin Nutr. 2007 Aug;26(4):421-9. doi: 10.1016/j.clnu.2007.03.012. Epub 2007 May 17.
BACKGROUND & AIMS: Despite the high mortality rate in malnourished anorexia nervosa (AN) patients, very few trials have prospectively studied the efficacy of tube feeding.
This open prospective study was conducted in malnourished AN patients, who were randomized in tube feeding (n=41) or control (n=40) groups during a 2-month period. Thereafter, body weight, body mass gain, energy intake, eating behavior and relapse rates were compared during a 1-year follow-up, using paired Student t-test and ANOVA.
At the end of the 2-months period, weight gain was 39% higher in the tube feeding group than in the control group (194+/-14 vs 126+/-19g/day; P<0.01). The fat-free mass gain was greater in the tube-feeding group: 109+/-14 vs 61+/-17g/day (P<0.01). Energy intake was higher in the tube feeding group than in the control group (P<0.05), as well as the decrease in bingeing episodes (P<0.01). Most patients thought that CEN improved their eating disorder. After discharge, the relapse-free period was longer in the CEN group than in the control one: 34.3+/-8.2 weeks vs 26.8+/-7.5 weeks (P<0.05).
CEN is helpful in malnourished AN patients for weight restoration, without hindrance on the eating behavior therapy nor inducing a more rapid relapse.
尽管营养不良的神经性厌食症（AN）患者死亡率很高，但很少有试验对管饲的疗效进行前瞻性研究。
本开放性前瞻性研究针对营养不良的AN患者开展，在2个月期间将患者随机分为管饲组（n = 41）和对照组（n = 40）。此后，在1年的随访期间，使用配对学生t检验和方差分析比较体重、体重增加、能量摄入、饮食行为和复发率。
在2个月期末，管饲组的体重增加比对照组高39%（194±14 vs 126±19克/天；P<0.01）。管饲组的去脂体重增加更大：109±14 vs 61±17克/天（P<0.01）。管饲组的能量摄入高于对照组（P<0.05），暴饮暴食发作次数的减少也高于对照组（P<0.01）。大多数患者认为补充能量营养（CEN）改善了他们的饮食失调。出院后，CEN组的无复发期比对照组更长：34.3±8.2周 vs 26.8±7.5周（P<0.05）。
CEN有助于营养不良的AN患者恢复体重，对饮食行为治疗没有阻碍，也不会导致更快复发。
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