Ishige Takashi, Tomomasa Takeshi, Tajiri Hitoshi, Yoden Atsushi
Department of Pediatrics, Gunma University Graduate School of Medicine, Maebashi, Japan.
PAL Children's Clinic, Isesaki, Japan.
Intest Res. 2017 Jul;15(3):345-351. doi: 10.5217/ir.2017.15.3.345. Epub 2017 Jun 12.
BACKGROUND/AIMS: Enteral nutrition (EN) is recommended for the treatment of pediatric Crohn's disease (CD) in Japan. However, the indications and treatment protocols for EN vary among hospitals. In the present study, we aimed to determine how EN was administered to pediatric patients and whether physicians followed treatment guidelines in their practices.
Two types of questionnaires were administered to 32 physicians who were involved in the treatment of pediatric CD. The consensus questionnaire evaluated the physicians' attitudes towards EN, whereas the efficacy questionnaire collected data on patients with CD, aged <17 years, who had undergone induction therapy between 2006 and 2011.
A total of 23 physicians responded to the questionnaires. The results of the consensus questionnaire indicated that 82% and 59% of study participants recommended EN treatment for all newly diagnosed pediatric patients with CD and all relapsed patients, respectively. Exclusive EN (EEN) and elemental formula were recommended by 84% and 85% of physicians, respectively. The efficacy questionnaire revealed that 57 of the 58 patients received EN. Elemental formula was used in 39 of 40 patients who were treated with EEN. Of these 40 patients, 27 were treated with EEN alone; of these, 22 (81%) achieved remission without any other treatment. The mean duration of EEN was 15.9 days.
EN is widely recommended by physicians treating pediatric CD in Japan. In contrast to Western countries, clinicians used elemental formula more often and with a shorter EEN treatment duration.
背景/目的：在日本，肠内营养（EN）被推荐用于治疗儿童克罗恩病（CD）。然而，各医院对于EN的适应证和治疗方案存在差异。在本研究中，我们旨在确定儿科患者接受EN治疗的方式，以及医生在实际操作中是否遵循治疗指南。
向32名参与儿童CD治疗的医生发放了两种问卷。共识问卷评估医生对EN的态度，而疗效问卷收集了2006年至2011年间接受诱导治疗的17岁以下CD患者的数据。
共有23名医生回复了问卷。共识问卷结果显示，分别有82%和59%的研究参与者建议对所有新诊断的儿童CD患者和所有复发患者进行EN治疗。分别有84%和85%的医生推荐采用全肠内营养（EEN）和要素配方。疗效问卷显示，58例患者中有57例接受了EN治疗。在40例接受EEN治疗的患者中，39例使用了要素配方。在这40例患者中，27例仅接受EEN治疗；其中22例（81%）未接受任何其他治疗即实现缓解。EEN的平均持续时间为15.9天。
在日本，治疗儿童CD的医生广泛推荐EN治疗。与西方国家不同，临床医生更常使用要素配方，且EEN治疗持续时间较短。
