Chiba Mitsuro, Nakane Kunio, Tsuji Tsuyotoshi, Tsuda Satoko, Ishii Hajime, Ohno Hideo, Watanabe Kenta, Ito Mai, Komatsu Masafumi, Yamada Koko, Sugawara Takeshi
Chief of the Inflammatory Bowel Disease Section at Akita City Hospital in Japan.
Chief of the Gastroenterology Division at Akita City Hospital in Japan.
Perm J. 2018;22:17-167. doi: 10.7812/TPP/17-167.
No known published study has focused on a plant-based diet (PBD) in the treatment of ulcerative colitis (UC).
To investigate relapse prevention in UC after consumption of a PBD during educational hospitalization in Japan.
Prospective study of patients with mild UC or UC in remission who did not need immediate treatment. A PBD and dietary guidance were provided during a two-week hospitalization.
The primary end point was relapse (a flare-up that required more aggressive treatment) during the follow-up period. Kaplan-Meier analysis was used to calculate the cumulative relapse rate. Secondary end points were immediate improvement in symptoms or laboratory data during hospitalization and a chronologic change in the PBD score, which evaluated adherence to the PBD.
Sixty cases were studied: 29 initial episode cases and 31 relapse cases. Of these, 31 involved proctitis; 7, left-sided colitis; and 22, extensive colitis. Thirty-seven patients were receiving medication; 23 were not. The median age was 34 years; median follow-up was 3 years 6 months. Eight cases relapsed during follow-up. The cumulative relapse rates at 1, 2, 3, 4, and 5 years of follow-up were 2%, 4%, 7%, 19%, and 19%, respectively. Most patients (77%) experienced some improvement such as disappearance or decrease of bloody stool during hospitalization. The short- and long-term PBD scores after the hospitalization were higher than baseline PBD scores.
Relapse rates after educational hospitalization providing a PBD were far lower than those reported with medication. Educational hospitalization is effective at inducing habitual dietary changes.
尚无已知的已发表研究聚焦于植物性饮食（PBD）在溃疡性结肠炎（UC）治疗中的应用。
在日本，对接受教育性住院治疗期间食用PBD后的UC患者进行预防复发的研究。
对轻度UC或处于缓解期且无需立即治疗的UC患者进行前瞻性研究。在为期两周的住院期间提供PBD及饮食指导。
主要终点为随访期内的复发（病情突然加重，需要更积极的治疗）。采用Kaplan-Meier分析计算累积复发率。次要终点为住院期间症状或实验室数据的即刻改善以及PBD评分的时间变化，PBD评分用于评估对PBD的依从性。
共研究了60例患者：29例初发病例和31例复发病例。其中，31例为直肠炎；7例为左侧结肠炎；22例为广泛性结肠炎。37例患者正在接受药物治疗；23例未接受药物治疗。中位年龄为34岁；中位随访时间为3年6个月。随访期间有8例复发。随访1年、2年、3年、4年和5年时的累积复发率分别为2%、4%、7%、19%和19%。大多数患者（77%）在住院期间病情有所改善，如血便消失或减少。住院后短期和长期的PBD评分均高于基线PBD评分。
提供PBD的教育性住院治疗后的复发率远低于药物治疗报告的复发率。教育性住院治疗在促使饮食习惯改变方面是有效的。
