Kirchmann H M
Universitäts-Kinderklinik Frankfurt.
Monatsschr Kinderheilkd. 1987 Oct;135(10):666-71.
Aminoacid and oligopeptide formulas of low molecular weight have frequently been used in the past on an empirical basis for nutritional support of patients with Crohn's disease. Improvement of intestinal symptoms and laboratory parameters reflecting the inflammatory process have been demonstrated. Only a few controlled therapeutic trials have compared elemental diets with conventional drug therapy. In small bowel involvement, therapeutic efficiency in active disease is as good as salazosulfapyridine combined with corticosteroids. Elemental diet is less effective in large bowel disease. In the therapeutic application of elemental diets in active disease these formulas should be the only nutritional source for the patient. Particularly in small bowel disease the growth retarding side effects of corticosteroids can markedly be reduced by elemental diets. Children with moderate disease and additional growth retardation may benefit from either supplemental elemental diet and/or high molecular weight formula or from parenteral hyperalimentation. --Crohn-specific fistulas seem to close rarely on elemental diets while favourable results are seen in postoperative fistulas.
过去，低分子量氨基酸和寡肽配方常被经验性地用于克罗恩病患者的营养支持。已证实肠道症状有所改善，反映炎症过程的实验室指标也有所改善。仅有少数对照治疗试验比较了要素饮食与传统药物治疗。在小肠受累的情况下，要素饮食对活动性疾病的治疗效果与柳氮磺胺吡啶联合皮质类固醇相当。要素饮食在大肠疾病中的效果较差。在活动性疾病中应用要素饮食进行治疗时，这些配方应是患者唯一的营养来源。特别是在小肠疾病中，要素饮食可显著降低皮质类固醇对生长的抑制副作用。患有中度疾病且伴有生长发育迟缓的儿童可能从补充要素饮食和/或高分子量配方或肠外高营养中获益。——克罗恩病特异性瘘管在要素饮食治疗下很少闭合，而术后瘘管则有较好疗效。
