炎症性肠病特殊营养素的补充
陈焰, 浙江大学医学院附属二院消化科 浙江省杭州市 310009
姒健敏,浙江大学医学院附属邵逸夫医院胃肠疾病研究所 浙江省杭州市 310016
通讯作者:姒健敏,310016, 浙江省杭州市,浙江大学医学院附属邵逸夫医院胃肠疾病研究所. sijm@163.com
电话: 0571-86090073-2005
收稿日期:2005-04-04 接受日期:2005-04-09
摘要炎症性肠病(inflammatorybowel disease，IBD)与营养关系密切，一些特殊的营养素如短链脂肪酸、鱼油、谷氨酰胺、益生菌、益生素可以维持肠道适当的免疫应答，减轻炎症反应，对炎症性肠病的治疗有一定作用.
, 百拇医药
陈焰, 姒健敏.炎症性肠病特殊营养素的补充.世界华人消化杂志 2005;13(13):1577-1580
Breuer RI, Soergel KH, Lashner BA, Christ ML, Hanauer SB, VanagunasA, Harig JM, Keshavarzian A, Robinson M,Sellin JH, Weinberg D, Vidican DE, FlemalKL, Rademaker AW. Short-chain fatty acid rectal irrigation for leftsided
ulcerative colitis: A randomized,placebo-controlled trail. Gut 1997;40:485-491
2 Vernia P, Cittadini M, Caprilli R, Torsoli A. Topical treatment ofrefractory distal ulcerative colitis with 5-ASA and
, 百拇医药
sodium butyrate. Dig Dis Sci 1995;40:305-307
3 Vernia P, Annese V, Bresci G, d'AlbasioG, D'Inca R, Giaccari S, Ingrosso M, Mansi C, Riegler G, Valpiani D, Caprilli
R;Gruppo Italiano per lo Studio del Colon and del Retto. Topicalbutyrate improves efficacy of 5 ASA in refractory
distal ulcrtative colitis: result of a multicentre trial. Eur J ClinInvest 2003;33:244-248
, 百拇医药
4 Venkatraman A, Ramakrishna BS, Shaji RV, Kumar NS, Pulimood A,Patra S. Amelioration of dextran sulfate
colitis by butyrate: role of heat shock protein 70 and NF-kappaB. AmJ Physiol Gastrointest Liver Physiol
2003;285:G177-G184
5 Hallert C, Bjorck I, Nyman M, Pousette A, Granno C, SvenssonH. Increasing fecal butyrate in ulcerative colitis
patients by diet: controlled pilot study. Inflamm Bowel Dis 2003;9:116-121
, http://www.100md.com
6 Aslan A, Triadafilopoulos G. Fish oil fatty acid supplementation inactive ulcerative colitis: a double-blind, placebo
controlled, crossover study. Am J Gastroenterol 1992;87:432-437
7 McCall TB, O'LearyD, Bloomfield J, O'MorainCA. Therapeutic potential of fish oil in the treatment of ulcerative
colitis.Aliment Pharmacol Ther 1989;3:415-424
8 Hawthorne AB, Daneshmend TK, Hawkey CJ, Belluzzi A, Everitt SJ,Holmes GK, Malkinson C, Shaheen MZ, Willars JE.
, 百拇医药
Treatmentof ulcerative colitis with fish oil supplementation:a prospective 12 monthrandomized controlled trial.
Gut 1992;33:922-928
9 Stenson WF, Cort D, Rodgers J, Burakoff R, DeSchryver-Kecskemeti K,Gramlich TL, Beeken W. Dietary
supplementationwith fish oil in ulcerative colitis. Ann Intern Med 1992;116:609-614
10 Loeschke K, Ueberschaer B, Pietsch A, Gruber E, Ewe K, Wiebecke B,Heldwein W, Lorenz R. n-3 fatty acid onlydelay
, 百拇医药
earlyrelapse in ulcerative colitis in remission. Dig Dis Sci 1996;41:2087-2094
11 Almallah YZ, Ewen SW, El-Tahir A, Mowat NA, Brunt PW, Sinclair TS,Heys SD, Eremin O. Distal proctocolitis and
n-3polyunsaturated fatty acids (n-3 PUFAs): the mucosal effect in situ. JClin Immunol 2000;20:68-76
12 Almallah YZ, El-Tahir A, Heys SD, Richardson S, Eremin O. Distal procto-colitis and n-3 polyunsaturated fatty acids:
, 百拇医药
themechanism (s) of natural cytotoxicity inhibition. Eur J Clin Invest 2000;30:58-65
13 Belluzzi A. N-3 fatty acids for the treatment of inflammatory boweldiseases. Proc Nutr Soc 2002;61:391-395
14 Lorenz-Meyer H, Bauer P, Nicolay C, Schulz B, Purrmann J, Fleig WE,Scheurlen C, Koop I, Pudel V, Carr L. Omega-3
fattyacids and law carbohydrate dietfor maintenance of remission in Crohn's disease. Scand JGastroemterology
, 百拇医药
1996;31:778-785
15 Ameho CK, Adjei AA, Harrison EK, Takeshita K, Morioka T, Arakaki Y,Ito E, Suzuki I, Kulkarni AD, Kawajiri A,YamamotoS. Prophylactic effect of dietary glutamine supplementation on interleukin8 and tumor necrosis factor
alphaproduction in trinitrobenene sulphonic acid induced colitis. Gut 1997;41:487-493
16 Gismondo MR, Drago L, Fassina MC, Vaghi I, Abbiati R, Grossi E.Immunostimulating effect of oral glutamine.
, http://www.100md.com
DigDis Sci 1998;43:1752-1754
17 Kaya E, Gur ES, Ozguc H, Bayer A, Tokyay R. L-glutamine enemasattenuate mucosal injury in experimental colitis.
DisColon Rectum 1999;42:1209-1215
18 Kanauchi O, Iwanaga T, Mitsuyama K. Germinated barley foodstufffeeding. A novel nrutraceutical therapeutic strategy
forulcerative colotis. Digestion 2001;63(Suppl 1):60-67
, http://www.100md.com
19 Wischmeyer P, Pemberton JH, Phillips SF. Chronic pouchitis afterileal pouch-anal anastomosis: responses to butyrate
andglutamine suppositories in a pilot study. Mayo Clin Proc 1993;68:978-981
20 Akobeng AK, Miller V, Stanton J, Elbadri AM, Thomas AG.Double-blind randomized controlled trial of glutamine
-enrichedpolymeric diet in the treatment of active Crohn's disease. J PediatrGastroenterol Nutr 2000;30:78-84
, 百拇医药
21 Den Hond E, Hiele M, Peeters M, Ghoos Y, Rutgeerts P. Effect oflong-term oral glutamine supplement on small
intestinalpermeability in patients with Crohn'sdisease. J Parenter Enteral Nutr 1999;23:7-11
22 Gionchetti P, Rizzello F, Helwig U, Venturi A, Lammers KM, BrigidiP, Vitali B, Poggioli G, Miglioli M, Campieri M.
Prophylaxisof pouchitis onset with probiotic therapy: a double-blind,placebo-controlled trial. Gastroenterology
, http://www.100md.com
2003;124:1202-1209
23 Kruis W, Schutz E, Fric P, Fixa B, Judmaier G, Stolte M.Double-blind comparison of an oral Escherichia coli
preparationand mesalazine in maintaining remission of ulcerative colitis. AlimentPharmacol Ther 1997;11:853-858
24 Rembacken BJ, Snelling AM, Hawkey PM, Chalmers DM, Axon AT.Non-pathogenic Escherichia coli versus mesalazine
forthe treatment of ulcerative colitis: a randomised trial. Lancet 1999;354:635-639
, http://www.100md.com
25 Famularo G, Mosca L, Minisola G, Trinchieri V, De Simone C.Probiotic lactobacilli: a new perspective for the
treatmentof inflammatory bowel disease. Curr Pharm Des 2003;9:1973-1980
26 Steidler L, Hans W, Schotte L, Neirynck S, Obermeier F, Falk W,Fiers W, Remaut E. Treatment of murine colitis
byLactococcus lactis secreting interleukin-10. Science 2000;289:1352-1355
, http://www.100md.com
27 Vandenbroucke K, Hans W, Van Huysse J, Neirynck S, Demetter P,Remaut E, Rottiers P, Steidler L. Active delivery
oftrefoil factors by genetically modified Lactococcus lactis prevents andheals acute colitis in mice.
Gastroenterology 2004;127:502-513
28 Boudeau J, Glasser AL, Julien S, Colombel JF, Darfeuille-Michaud A.Inhibitory effect of probiotic Escherichia coli
, http://www.100md.com
strainNissle 1917 on adhesion to and invasion of intestinal epithelial cells byadherent-invasive E. coli strains isolated
frompatients with Crohn'sdisease. Aliment Pharmacol Ther 2003;18:45-56
29 Borruel N, Carol M, Casellas F, Antolin M, de Lara F, Espin E,Naval J, Guarner F, Malagelada JR. Increased mucosal
tumournecrosis factor alpha production in Crohn'sdisease can be downregulated ex vivo by probiotic bacteria.
, 百拇医药
Gut 2002;51:659-664
30 Malin M, Suomalainen H, Saxelin M, Isolauri E. Promotion of IgAimmune response in patients with Crohn'sdiseasse
byoral bacteriotherapy with Lactobacillus GG. Ann Nutr Metab 1996;40:137-145
31 Gupta P, Andrew H, Kirschner BS, Guandalini S. Is lactobacillus GGhelpful in children with Crohn'sdisease? Results
ofa preliminary, open-label study. J Pediatr Gastroenterol Nutr 2000;31:453-457
, http://www.100md.com
32 Guslandi M, Giollo P, Testoni PA. A pilot trial of Saccharomycesboulardii in ulcerative colitis.
EurJ Gastroenterol Hepatol 2003;15:697-698
33 Prantera C, Scribano ML, Falasco G, Andreoli A, Luzi C.Ineffectiveness of probiotics in preventing recurrence after
curativeresection for Crohn'sdisease: a randomised controlled trial with Lactobacillus GG. Gut 2002;51:405-409
, 百拇医药
34 Fukuda M, Kanauchi O, Araki Y, Andoh A, Mitsuyama K, Takagi K,Toyonaga A, Sata M, Fujiyama Y, Fukuoka M,MatsumotoY, Bamba T. Prebiotic treatment of experimental colitis with germinatedbarley foodstuff:a comparison
withprobiotic or antibiotic treatment. Int J Mol Med 2002;9:65-70
35 Bamba T, Kanauchi O, Andoh A, Fujiyama Y. A new prebiotic fromgerminated barley for nutraceutical treatment
, http://www.100md.com ofulcerative colitis. J Gastroenterol Hepatol 2002;17:818-824
36 Kanauchi O, Suga T, Tochihara M, Hibi T, Naganuma M, Homma T,Asakura H, Nakano H, Takahama K, Fujiyama Y,AndohA, Shimoyama T, Hida N, Haruma K, Koga H, Mitsuyama K, Sata M, Fukuda M,Kojima A, Bamba T. Treatment
ofulcerative colitis by feeding with germinated barley foodstuff: firstreport of a multicenter open control trial.
JGastroenterol 2002;37(Suppl14):67-72
编辑 王谨晖 审读 张海宁, 百拇医药( 陈 焰, 姒健敏)
姒健敏,浙江大学医学院附属邵逸夫医院胃肠疾病研究所 浙江省杭州市 310016
通讯作者:姒健敏,310016, 浙江省杭州市,浙江大学医学院附属邵逸夫医院胃肠疾病研究所. sijm@163.com
电话: 0571-86090073-2005
收稿日期:2005-04-04 接受日期:2005-04-09
摘要炎症性肠病(inflammatorybowel disease，IBD)与营养关系密切，一些特殊的营养素如短链脂肪酸、鱼油、谷氨酰胺、益生菌、益生素可以维持肠道适当的免疫应答，减轻炎症反应，对炎症性肠病的治疗有一定作用.
, 百拇医药
陈焰, 姒健敏.炎症性肠病特殊营养素的补充.世界华人消化杂志 2005;13(13):1577-1580
Breuer RI, Soergel KH, Lashner BA, Christ ML, Hanauer SB, VanagunasA, Harig JM, Keshavarzian A, Robinson M,Sellin JH, Weinberg D, Vidican DE, FlemalKL, Rademaker AW. Short-chain fatty acid rectal irrigation for leftsided
ulcerative colitis: A randomized,placebo-controlled trail. Gut 1997;40:485-491
2 Vernia P, Cittadini M, Caprilli R, Torsoli A. Topical treatment ofrefractory distal ulcerative colitis with 5-ASA and
, 百拇医药
sodium butyrate. Dig Dis Sci 1995;40:305-307
3 Vernia P, Annese V, Bresci G, d'AlbasioG, D'Inca R, Giaccari S, Ingrosso M, Mansi C, Riegler G, Valpiani D, Caprilli
R;Gruppo Italiano per lo Studio del Colon and del Retto. Topicalbutyrate improves efficacy of 5 ASA in refractory
distal ulcrtative colitis: result of a multicentre trial. Eur J ClinInvest 2003;33:244-248
, 百拇医药
4 Venkatraman A, Ramakrishna BS, Shaji RV, Kumar NS, Pulimood A,Patra S. Amelioration of dextran sulfate
colitis by butyrate: role of heat shock protein 70 and NF-kappaB. AmJ Physiol Gastrointest Liver Physiol
2003;285:G177-G184
5 Hallert C, Bjorck I, Nyman M, Pousette A, Granno C, SvenssonH. Increasing fecal butyrate in ulcerative colitis
patients by diet: controlled pilot study. Inflamm Bowel Dis 2003;9:116-121
, http://www.100md.com
6 Aslan A, Triadafilopoulos G. Fish oil fatty acid supplementation inactive ulcerative colitis: a double-blind, placebo
controlled, crossover study. Am J Gastroenterol 1992;87:432-437
7 McCall TB, O'LearyD, Bloomfield J, O'MorainCA. Therapeutic potential of fish oil in the treatment of ulcerative
colitis.Aliment Pharmacol Ther 1989;3:415-424
8 Hawthorne AB, Daneshmend TK, Hawkey CJ, Belluzzi A, Everitt SJ,Holmes GK, Malkinson C, Shaheen MZ, Willars JE.
, 百拇医药
Treatmentof ulcerative colitis with fish oil supplementation:a prospective 12 monthrandomized controlled trial.
Gut 1992;33:922-928
9 Stenson WF, Cort D, Rodgers J, Burakoff R, DeSchryver-Kecskemeti K,Gramlich TL, Beeken W. Dietary
supplementationwith fish oil in ulcerative colitis. Ann Intern Med 1992;116:609-614
10 Loeschke K, Ueberschaer B, Pietsch A, Gruber E, Ewe K, Wiebecke B,Heldwein W, Lorenz R. n-3 fatty acid onlydelay
, 百拇医药
earlyrelapse in ulcerative colitis in remission. Dig Dis Sci 1996;41:2087-2094
11 Almallah YZ, Ewen SW, El-Tahir A, Mowat NA, Brunt PW, Sinclair TS,Heys SD, Eremin O. Distal proctocolitis and
n-3polyunsaturated fatty acids (n-3 PUFAs): the mucosal effect in situ. JClin Immunol 2000;20:68-76
12 Almallah YZ, El-Tahir A, Heys SD, Richardson S, Eremin O. Distal procto-colitis and n-3 polyunsaturated fatty acids:
, 百拇医药
themechanism (s) of natural cytotoxicity inhibition. Eur J Clin Invest 2000;30:58-65
13 Belluzzi A. N-3 fatty acids for the treatment of inflammatory boweldiseases. Proc Nutr Soc 2002;61:391-395
14 Lorenz-Meyer H, Bauer P, Nicolay C, Schulz B, Purrmann J, Fleig WE,Scheurlen C, Koop I, Pudel V, Carr L. Omega-3
fattyacids and law carbohydrate dietfor maintenance of remission in Crohn's disease. Scand JGastroemterology
, 百拇医药
1996;31:778-785
15 Ameho CK, Adjei AA, Harrison EK, Takeshita K, Morioka T, Arakaki Y,Ito E, Suzuki I, Kulkarni AD, Kawajiri A,YamamotoS. Prophylactic effect of dietary glutamine supplementation on interleukin8 and tumor necrosis factor
alphaproduction in trinitrobenene sulphonic acid induced colitis. Gut 1997;41:487-493
16 Gismondo MR, Drago L, Fassina MC, Vaghi I, Abbiati R, Grossi E.Immunostimulating effect of oral glutamine.
, http://www.100md.com
DigDis Sci 1998;43:1752-1754
17 Kaya E, Gur ES, Ozguc H, Bayer A, Tokyay R. L-glutamine enemasattenuate mucosal injury in experimental colitis.
DisColon Rectum 1999;42:1209-1215
18 Kanauchi O, Iwanaga T, Mitsuyama K. Germinated barley foodstufffeeding. A novel nrutraceutical therapeutic strategy
forulcerative colotis. Digestion 2001;63(Suppl 1):60-67
, http://www.100md.com
19 Wischmeyer P, Pemberton JH, Phillips SF. Chronic pouchitis afterileal pouch-anal anastomosis: responses to butyrate
andglutamine suppositories in a pilot study. Mayo Clin Proc 1993;68:978-981
20 Akobeng AK, Miller V, Stanton J, Elbadri AM, Thomas AG.Double-blind randomized controlled trial of glutamine
-enrichedpolymeric diet in the treatment of active Crohn's disease. J PediatrGastroenterol Nutr 2000;30:78-84
, 百拇医药
21 Den Hond E, Hiele M, Peeters M, Ghoos Y, Rutgeerts P. Effect oflong-term oral glutamine supplement on small
intestinalpermeability in patients with Crohn'sdisease. J Parenter Enteral Nutr 1999;23:7-11
22 Gionchetti P, Rizzello F, Helwig U, Venturi A, Lammers KM, BrigidiP, Vitali B, Poggioli G, Miglioli M, Campieri M.
Prophylaxisof pouchitis onset with probiotic therapy: a double-blind,placebo-controlled trial. Gastroenterology
, http://www.100md.com
2003;124:1202-1209
23 Kruis W, Schutz E, Fric P, Fixa B, Judmaier G, Stolte M.Double-blind comparison of an oral Escherichia coli
preparationand mesalazine in maintaining remission of ulcerative colitis. AlimentPharmacol Ther 1997;11:853-858
24 Rembacken BJ, Snelling AM, Hawkey PM, Chalmers DM, Axon AT.Non-pathogenic Escherichia coli versus mesalazine
forthe treatment of ulcerative colitis: a randomised trial. Lancet 1999;354:635-639
, http://www.100md.com
25 Famularo G, Mosca L, Minisola G, Trinchieri V, De Simone C.Probiotic lactobacilli: a new perspective for the
treatmentof inflammatory bowel disease. Curr Pharm Des 2003;9:1973-1980
26 Steidler L, Hans W, Schotte L, Neirynck S, Obermeier F, Falk W,Fiers W, Remaut E. Treatment of murine colitis
byLactococcus lactis secreting interleukin-10. Science 2000;289:1352-1355
, http://www.100md.com
27 Vandenbroucke K, Hans W, Van Huysse J, Neirynck S, Demetter P,Remaut E, Rottiers P, Steidler L. Active delivery
oftrefoil factors by genetically modified Lactococcus lactis prevents andheals acute colitis in mice.
Gastroenterology 2004;127:502-513
28 Boudeau J, Glasser AL, Julien S, Colombel JF, Darfeuille-Michaud A.Inhibitory effect of probiotic Escherichia coli
, http://www.100md.com
strainNissle 1917 on adhesion to and invasion of intestinal epithelial cells byadherent-invasive E. coli strains isolated
frompatients with Crohn'sdisease. Aliment Pharmacol Ther 2003;18:45-56
29 Borruel N, Carol M, Casellas F, Antolin M, de Lara F, Espin E,Naval J, Guarner F, Malagelada JR. Increased mucosal
tumournecrosis factor alpha production in Crohn'sdisease can be downregulated ex vivo by probiotic bacteria.
, 百拇医药
Gut 2002;51:659-664
30 Malin M, Suomalainen H, Saxelin M, Isolauri E. Promotion of IgAimmune response in patients with Crohn'sdiseasse
byoral bacteriotherapy with Lactobacillus GG. Ann Nutr Metab 1996;40:137-145
31 Gupta P, Andrew H, Kirschner BS, Guandalini S. Is lactobacillus GGhelpful in children with Crohn'sdisease? Results
ofa preliminary, open-label study. J Pediatr Gastroenterol Nutr 2000;31:453-457
, http://www.100md.com
32 Guslandi M, Giollo P, Testoni PA. A pilot trial of Saccharomycesboulardii in ulcerative colitis.
EurJ Gastroenterol Hepatol 2003;15:697-698
33 Prantera C, Scribano ML, Falasco G, Andreoli A, Luzi C.Ineffectiveness of probiotics in preventing recurrence after
curativeresection for Crohn'sdisease: a randomised controlled trial with Lactobacillus GG. Gut 2002;51:405-409
, 百拇医药
34 Fukuda M, Kanauchi O, Araki Y, Andoh A, Mitsuyama K, Takagi K,Toyonaga A, Sata M, Fujiyama Y, Fukuoka M,MatsumotoY, Bamba T. Prebiotic treatment of experimental colitis with germinatedbarley foodstuff:a comparison
withprobiotic or antibiotic treatment. Int J Mol Med 2002;9:65-70
35 Bamba T, Kanauchi O, Andoh A, Fujiyama Y. A new prebiotic fromgerminated barley for nutraceutical treatment
, http://www.100md.com ofulcerative colitis. J Gastroenterol Hepatol 2002;17:818-824
36 Kanauchi O, Suga T, Tochihara M, Hibi T, Naganuma M, Homma T,Asakura H, Nakano H, Takahama K, Fujiyama Y,AndohA, Shimoyama T, Hida N, Haruma K, Koga H, Mitsuyama K, Sata M, Fukuda M,Kojima A, Bamba T. Treatment
ofulcerative colitis by feeding with germinated barley foodstuff: firstreport of a multicenter open control trial.
JGastroenterol 2002;37(Suppl14):67-72
编辑 王谨晖 审读 张海宁, 百拇医药( 陈 焰, 姒健敏)
