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生酮饮食在耐药性癫痫治疗中的地位:全面综述。

The place of a ketogenic diet in the treatment of resistant epilepsy: a comprehensive review.

机构信息

Ankara Medipol University, School of Health Sciences, Department of Nutrition and Dietetics, Ankara, Turkey.

出版信息

Nutr Neurosci. 2023 Sep;26(9):828-841. doi: 10.1080/1028415X.2022.2095819. Epub 2022 Jul 5.

Abstract

The ketogenic diet (KD) is a high-fat, adequate-protein, and low-carb diet. Ketone bodies increase in the blood due to low carbohydrate content and high-fat content in the diet. The most important feature of the ketogenic diet is that it causes the production of ketone bodies in the liver. Ketone bodies are an alternative fuel to glucose for the brain and form the structure necessary for the cell membrane and biosynthesis of triglycerides. The ketogenic diet provides evidence on seizure control with anticonvulsant effects. In this review, the positive/negative effects of KD on seizure control, place, importance, quality of life, cognition, and behavior in the treatment of resistant epilepsy were examined. Scientific information on the subject was obtained from the literature accessed through databases such as MEDLINE, Embase, Web of Science, Cochrane Central, www.ClinicalTrials.gov, PubMed, Science Direct, and Google Scholar. Although it has started to be used as a treatment method in many diseases today, the main area of effect of KD is drug-resistant epilepsy. In order for the ketogenic diet to be successful in these patients, it is necessary to choose the appropriate patient, medical treatment and diet plan, inform the patient sufficiently, and perform frequent monitoring in accordance with the follow-up criteria. It is argued that KD is one of the most effective treatments for epilepsy. The fact that KDs generally have a restricted diet pattern, the need for supplementation, biochemical findings and possible side effects raise the issue of diet sustainability. More clinical studies are needed to generalize.

摘要

生酮饮食(KD)是一种高脂肪、适量蛋白质和低碳水化合物的饮食。由于饮食中碳水化合物含量低,脂肪含量高,血液中的酮体增加。生酮饮食最重要的特点是它能在肝脏中产生酮体。酮体是大脑中葡萄糖的替代燃料,构成细胞膜和甘油三酯生物合成所必需的结构。生酮饮食在控制癫痫发作方面提供了抗惊厥作用的证据。在这篇综述中,检查了 KD 对控制癫痫发作、地位、重要性、生活质量、认知和行为的积极/消极影响,以及在耐药性癫痫的治疗中的作用。通过访问 MEDLINE、Embase、Web of Science、Cochrane Central、www.ClinicalTrials.gov、PubMed、Science Direct 和 Google Scholar 等数据库获得了关于该主题的科学信息。尽管生酮饮食今天已开始作为许多疾病的治疗方法,但 KD 的主要作用领域是耐药性癫痫。为了使生酮饮食在这些患者中取得成功,有必要选择合适的患者、医疗和饮食计划,充分告知患者,并根据随访标准进行频繁监测。有人认为 KD 是治疗癫痫最有效的方法之一。KD 通常具有限制饮食模式、需要补充、生化发现和可能的副作用等事实,这引发了饮食可持续性的问题。需要更多的临床研究来推广。

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