Viall C, Porcelli K, Teran J C, Varma R N, Steffee W P
Clinical Nutrition Center, Saint Vincent Charity Hospital, Cleveland, Ohio.
JPEN J Parenter Enteral Nutr. 1990 May-Jun;14(3):265-9. doi: 10.1177/0148607190014003265.
Adequate enteral nutritional support is often limited by gastrointestinal (GI) side effects. In this pilot clinical trial we compared an enteral nutrition formula based on soy hydrolysate (study formula, SF) against a widely used intact casein formula (control formula, CF) for the incidence of GI side effects in a completely randomized double blind design. Twenty-three nonsurgical hospitalized patients requiring enteral nutritional support and free of GI symptoms were randomly assigned to receive either the CF or the SF for 6 days continuously. Both formulas were isotonic, low in residue, lactose free and isocaloric, but differed in the type and concentration of protein and the concentration of medium-chain triglycerides. After randomization both groups were comparable in demographic characteristics, and nutritional status, but there were more patients on antibiotics in the CF group. The amount of formula infused per day and the route of administration were equivalent. The number of bowel movements per day was 1.0 +/- 0.5 for the CF group and 0.6 +/- 0.3 for the SF group (p less than 0.05). The incidence of diarrhea was 10.8% days for the CF group and 6.2% for the SF group (p = NS). High gastric residuals occurred in 16.9% of days in the CF group and 3.3% in the SF group (p less than 0.05). Vomiting incidence was 10.8% in the CF group and 1.5% in the SF group (p less than 0.05). After adjustment for the use of antibiotics as a covariate, the differences in number of bowel movements, vomiting and incidence of high residuals became less significant (p less than 0.10).(ABSTRACT TRUNCATED AT 250 WORDS)
充足的肠内营养支持常常受到胃肠道副作用的限制。在这项初步临床试验中,我们采用完全随机双盲设计,比较了一种基于大豆水解物的肠内营养配方(研究配方,SF)与一种广泛使用的完整酪蛋白配方(对照配方,CF)的胃肠道副作用发生率。23名需要肠内营养支持且无胃肠道症状的非手术住院患者被随机分配,连续6天接受CF或SF。两种配方均为等渗、低残渣、无乳糖且等热量,但在蛋白质类型和浓度以及中链甘油三酯浓度方面有所不同。随机分组后,两组在人口统计学特征和营养状况方面具有可比性,但CF组使用抗生素的患者更多。每日输注的配方量和给药途径相同。CF组每日排便次数为1.0±0.5次,SF组为0.6±0.3次(p<0.05)。CF组腹泻发生率为10.8%日,SF组为6.2%(p=无统计学意义)。CF组16.9%的天数出现高胃残余量,SF组为3.3%(p<0.05)。CF组呕吐发生率为10.8%,SF组为1.5%(p<0.05)。将抗生素的使用作为协变量进行调整后,排便次数、呕吐和高残余量发生率的差异变得不那么显著(p<0.10)。(摘要截短至250字)