基于DII的膳食营养干预在肠癌术后化疗患者中的应用观察-现代医学

基于DII的膳食营养干预在肠癌术后化疗患者中的应用观察

单位：上海中医药大学附属曙光医院胃肠外科, 上海 201203

分类号：R735.3

出版年·卷·期（页码）：2025·44·第六期（927-935）

摘要：

目的： 探讨基于膳食炎症指数(DII)的膳食营养干预在肠癌术后化疗患者中的应用效果。方法： 回顾性选取2023年12月至2024年11月本院肠癌术后化疗患者103例，接受常规饮食干预的51例为常规组，接受基于DII的膳食营养干预的52例为研究组。统计两组干预前及干预3个、6个化疗周期后的效果变化。比较干预前后营养状况[白蛋白(Alb)、血红蛋白(Hb)、前白蛋白(PA)、握力状况、整体营养状况主观评定法(PG-SGA)评分]、肠道菌群数量(双歧杆菌、乳杆菌、大肠杆菌)、肠黏膜屏障功能[血浆D乳酸、二胺氧化酶(DAO)]、炎症反应指标[血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)]、安德森癌症症状评估量表-胃肠道肿瘤模块(MDASI-GI)评分，并统计毒副反应发生情况。结果： 研究组干预3个、6个化疗周期后的Alb、Hb、PA高于常规组，PG-SGA得分低于常规组，且研究组干预6个化疗周期的握力高于常规组(P＜0.05)。研究组干预6个化疗周期后的双歧杆菌、乳杆菌数量高于常规组，大肠杆菌数量低于常规组(P＜0.05)。研究组干预3个、6个化疗周期后的血浆D乳酸、DAO及血清CRP、TNF-α、IL-6水平低于常规组(P＜0.05)。研究组干预6个化疗周期的MDASI-GI核心症状严重程度、症状困扰生活程度评分低于常规组(P＜0.05)。研究组恶心呕吐发生率低于常规组(P＜0.05)。结论： 基于DII的膳食营养干预应用于肠癌术后化疗患者，可纠正肠道菌群紊乱，调节炎症反应，有助于降低相关毒副反应发生风险。

Objective: To investigate the effects of dietary inflammatory index(DII)-based nutritional intervention in colorectal cancer patients undergoing postoperative chemotherapy. Methods: A retrospective study included 103 postoperative colorectal cancer patients receiving chemotherapy at our hospital from December 2023 to November 2024. Fifty-one patients receiving conventional dietary intervention were assigned to the control group, while 52 patients receiving DII-based nutritional intervention comprised the study group. Intervention outcomes were assessed at baseline, after 3 chemotherapy cycles, and after 6 chemotherapy cycles. Evaluated parameters included nutritional status [albumin(Alb), hemoglobin(Hb), prealbumin(PA), grip strength, Patient-Generated Subjective Global Assessment(PG-SGA) score], gut microbiota composition(Bifidobacterium, Lactobacillus, Escherichia coli counts), intestinal barrier function [plasma D-lactate, diamine oxidase(DAO)], inflammatory markers [C-reactive protein(CRP), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6)], and MD Anderson Symptom Inventory-Gastrointestinal Cancer module(MDASI-GI) scores. Adverse effects were monitored.Results: The study group showed significantly higher Alb, Hb, and PA levels along with lower PG-SGA scores than the control group after both 3 and 6 chemotherapy cycles(P<0.05). Superior grip strength emerged in the study group after 6 chemotherapy cycles(P<0.05). Following 6 chemotherapy cycles, Bifidobacterium and Lactobacillus counts were higher respectively in the study group, while Escherichia coli decreased compared to controls(P<0.05). The study group demonstrated lower plasma D-lactate and DAO levels across both timepoints(P<0.05). Inflammatory markers(CRP, TNF-α, IL-6) were reduced in the study group versus controls(P<0.05). MDASI-GI core symptom severity and symptom interference scores decreased respectively after 6 chemotherapy cycles(P<0.05). The study group exhibited lower incidence of chemotherapy-induced vomiting(P<0.05). Conclusion: DII-based nutritional intervention in post-operative colorectal cancer patients improves gut microbiota balance, enhances intestinal barrier function, modulates inflammatory responses, and reduces chemotherapy-related adverse effects.

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