排除ダイエットによるクローン病の治療:イースト・アングリアの多センター制御試験
A M Riordan1, J O Hunter, R E Cowan
1Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, UK.
Lancet (London, England)
|November 6, 1993
まとめ
クローン氏病 (CD) の患者で寛解を維持するために,食事の変更はコルチコステロイドよりも効果的です. この研究は,ダイエットが寛解を長く維持し,CD患者の再発率を低減することを示しています.
科学分野:
- 胃腸内科 胃腸内科
- クリニカル・ニュートリション
- 免疫学 免疫学とは
背景:
- エレメンタルダイエットは,コルチコステロイドに匹敵するクローン病 (CD) の寛解を効果的に誘導します.
- 基本的ダイエット療法の後,通常の食事を再開した後,再発は一般的です.
研究 の 目的:
- CD寛解を維持するために,経口用コルチコステロイドと比べ,食事の変更の有効性を調査する.
- ダイエット介入とコルチコステロイド治療の寛解期間と再発率を比較する.
主な方法:
- エレメンタルダイエットで開始された136人のCD患者を含む多センター試験.
- 寛解した患者は,コルチコステロイド (n=38) または食事の変更 (n=40) を受けるようにランダムに割り当てられました.
- 評価されたアウトカムには,2年間にわたる寛解の長さと再発率が含まれていました.
主要な成果:
- 食事の変化により,寛解期間の中央値は7.5ヶ月で,コルチコステロイドは3.8ヶ月でした.
- 2年後の再発率は,ダイエットグループでは62%,コルチコステロイドグループでは79% (p=0.048) でした.
- ダイエットグループにおける臨床改善は,アルバミン,アルファ1-アンチキモトリプシン,ESRの変化と相関していた.
結論:
- 食事の変更は,クローン病の寛解を維持するための有効な戦略です.
- 食物不耐症 (穀物,乳製品,酵母) を特定し排除することは,持続的な寛解の鍵となる可能性があります.
- 食事療法による介入は,クローン病の管理のための治療的代替案を提供します.
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