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肠内和肠外营养的历史里程碑:从古代到 20 世纪。

Hallmarks in the history of enteral and parenteral nutrition: from antiquity to the 20th century.

机构信息

School of Dietetics & Human Nutrition, McGill University, Montreal, Canada.

出版信息

Nutr Clin Pract. 2013 Apr;28(2):209-17. doi: 10.1177/0884533612468602. Epub 2012 Dec 13.

Abstract

Parenteral nutrition (PN) and enteral nutrition (EN) have a very long history, emerging in the ancient world and developing throughout the common epoch. This history dates back as far as 3500 bc to the ancient Egyptians, Indians, and Chinese. Their medical practices were the first reports of enteral feeding therapy, provided via rectum with enemas of wine, milk, whey, wheat, and barley. Hippocrates and Plato, in ancient Greece, were the first personalities to emphasize the importance of diet on health. In the following centuries, Erasistratus and Herophilus described the first notion of the circulatory system, and Oribasius and Celsus described the role of nutrition and disease. There is a great historical gap between the times of Galen (2nd century), who elaborated on the circulatory system; Ibn Zuhr (12th century), who constructed the first model of PN; and Capivacceus (16th century), who placed the first tube for EN. The 17th-19th centuries showed major developments in modern nutrition elements. Steps toward artificial nutrition began in 1628 with the detailed description of blood circulation by William Harvey; however, most of the advances in enteral and parenteral feeding techniques, solutions, and formulas took place in the 20th century. Over the last decade of the 20th century, research focused on metabolic control, multitude formulas, timing and the combination of EN and PN for intensive care patients.

摘要

肠外营养(PN)和肠内营养(EN)有着非常悠久的历史,可以追溯到古代世界,并在整个共同时代发展。这段历史可以追溯到公元前 3500 年的古埃及、印度和中国。他们的医疗实践是最早的肠内喂养治疗报告,通过灌肠用酒、牛奶、乳清、小麦和大麦提供。古希腊的希波克拉底和柏拉图是最早强调饮食对健康重要性的人。在接下来的几个世纪里,埃拉西斯特拉图斯和赫罗菲卢斯描述了循环系统的第一个概念,奥里巴斯和塞尔苏斯描述了营养和疾病的作用。从盖伦(公元 2 世纪)详细阐述循环系统的时代,到伊本·祖赫尔(12 世纪)构建第一个 PN 模型,再到卡皮瓦库斯(16 世纪)放置第一个 EN 管,这之间存在着巨大的历史空白。17 至 19 世纪见证了现代营养元素的重大发展。人工营养的步骤始于 1628 年,威廉·哈维详细描述了血液循环;然而,肠内和肠外喂养技术、溶液和配方的大部分进展发生在 20 世纪。在 20 世纪最后十年,研究重点是代谢控制、多种配方、时机以及重症监护患者的 EN 和 PN 联合应用。

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