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用于治疗克罗恩病的克罗恩病排除饮食:来自三级医疗中心的真实世界经验。

Crohn's Disease Exclusion Diet for the Treatment of Crohn's Disease: Real-World Experience from a Tertiary Center.

作者信息

Fliss-Isakov Naomi, Aviv Cohen Nathaniel, Bromberg Ahuva, Elbert Gal, Anbar Ronit, Ron Yulia, Hirsch Ayal, Thurm Tamar, Maharshak Nitsan

机构信息

Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.

Department of Gastroenterology and Liver Diseases, Tel Aviv Medical Center, Tel Aviv 6423906, Israel.

出版信息

J Clin Med. 2023 Aug 21;12(16):5428. doi: 10.3390/jcm12165428.

Abstract

The Crohn's Disease (CD) exclusion diet (CDED) has been shown to induce remission in pediatric and adult patients with CD. In this retrospective cohort study, we describe our real-world experience with the CDED at the inflammatory bowel disease (IBD) unit of the Tel Aviv Medical Center between 2018-2021. CD patients with multiple clinical presentations and disease phenotypes who initiated the diet were included. Indications for treatment, medical and nutritional data were collected from dietician clinic visits and medical records. Clinical and biomarker responses were determined. The CDED was recommended to 220 CD patients. Seventy-two patients were included in the analysis for a clinically active disease (n = 48) or for remission maintenance (n = 24). Among patients with a clinically active disease, 62.5% of patients achieved clinical remission at week 6 and at week 12. A positive association between high adherence to the CDED and clinical remission at week 12 was observed (adjusted OR = 7.6, 95% CI 1.07-55.2, = 0.043). Among patients treated for remission maintenance, remission at week 12 was maintained among 83.3% of patients. We conclude that the CDED may be a promising intervention for multiple CD presentations and indications. These findings should be further validated in larger, prospective, controlled studies.

摘要

克罗恩病(CD)排除饮食(CDED)已被证明可诱导儿童和成年CD患者缓解。在这项回顾性队列研究中,我们描述了2018年至2021年期间,我们在特拉维夫医疗中心炎症性肠病(IBD)科使用CDED的实际经验。纳入了开始该饮食的具有多种临床表现和疾病表型的CD患者。从营养师门诊就诊和病历中收集治疗指征、医学和营养数据。确定临床和生物标志物反应。向220例CD患者推荐了CDED。72例患者纳入分析,其中48例为临床活动期疾病患者,24例为缓解期维持治疗患者。在临床活动期疾病患者中,62.5%的患者在第6周和第12周实现临床缓解。观察到CDED高依从性与第12周临床缓解之间存在正相关(调整后的OR = 7.6,95%CI 1.07 - 55.2,P = 0.043)。在接受缓解期维持治疗的患者中,83.3%的患者在第12周维持缓解。我们得出结论,CDED可能是针对多种CD表现和指征的一种有前景的干预措施。这些发现应在更大规模的前瞻性对照研究中进一步验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53ff/10455757/7c433ea71110/jcm-12-05428-g001.jpg

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