炎症性肠病患者饮食限制现况及其饮食限制种类影响因素的多中心研究

背景饮食是影响炎症性肠病（IBD）发生、发展和转归的重要因素，而饮食限制是IBD患者常见饮食管理问题之一，但目前国内关于IBD患者饮食限制行为的研究鲜见。目的了解IBD患者饮食限制现况并分析其饮食限制种类的影响因素。方法2020年1—10月，采用方便抽样法在南京市4家综合性医院〔江苏省中医院（南京中医药大学附属医院）、南京市中医院（南京中医药大学附属南京中医院）、南京鼓楼医院、东南大学附属中大医院〕消化科和肛肠科进行实地调研，选取自愿接受调研的IBD患者作为研究对象。采用自行编制的调查问卷收集IBD患者一般资料与疾病相关情况、饮食限制行为、接受饮食指导情况；IBD患者饮食限制的影响因素分析采用多元线性回归分析。结果共回收调查问卷622份，其中有效问卷608份，有效问卷回收率为97.7%（608/622）。最终纳入的608例IBD患者中562例（92.4%）存在1种或1种以上的饮食限制，平均饮食限制种类为6.9种。不同性别、体质指数、居住状态、经济负担、IBD类型、病程、手术情况、并发症发生情况以及是否接受过饮食指导、营养师饮食指导、胃肠病医生饮食指导的IBD患者饮食限制种类比较，差异有统计学意义（P<0.05）。多元线性回归分析结果显示，性别（β=0.697）、体质指数（β=0.777）、居住状态（β=1.141）、并发症发生情况（β=0.884）是IBD患者饮食限制种类的影响因素（P<0.05）。结论IBD患者饮食限制情况较普遍且严重，而性别、体质指数、居住状态、并发症发生情况是IBD患者饮食限制种类的影响因素。

Prevalence and Associated Factors of Kinds of Dietary Restrictions in Patients with Inflammatory Bowel Disease:a Multicenter Study

Background Diet has been proven to be an important factor affecting the occurrence,development and outcome of inflammatory bowel disease(IBD),but there are few studies in China on dietary restriction,a common diet management problem in patients with IBD.Objective To investigate the prevalence and associated factors of kinds of dietary restrictions in patients with IBD.Methods From January to October in 2020,a field survey was conducted with a convenience sample of IBD patient volunteers who were selected from gastroenterology and anorectal departments in four general hospitals in Nanjing,including Jiangsu Province Hospital of Chinese Medicine/Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing Hospital of Chinese Medicine/Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Nanjing Drum Tower Hospital and Zhongda Hospital,Southeast University.A self-made questionnaire was used to collect general demographic information,disease-related conditions,dietary restriction behaviors and prevalence of receiving dietary guidance in these patients.Multiple linear regression analysis was used to analyze the associated factors of kinds of dietary restrictions.Results Altogether,622 cases attended the survey,and 608 of them gave an effective response,with a response rate of 97.7%(608/622).Of the responders,92.4%(562/608)had at least one kind of dietary restrictions,with 6.9 kinds of dietary restrictions on average.The kinds of dietary restrictions differed significantly by gender,body mass index,living status(living alone or with others),economic burden,type of IBD,course of IBD,prevalence of surgical treatment,incidence of complications,prevalence of receiving dietary guidance,and receiving dietary guidance from dietitian or gastroenterologist in IBD patients(P<0.05).Multiple linear regression analysis results showed that,gender(β=0.697),body mass index(β=0.777),living status(β=1.141),and incidence of complications(β=0.884)were associated with the kinds of dietary restrictions in IBD patients(P<0.05).Conclusion Dietary restrictions are common and serious in IBD patients,whose kinds may be related to patients'gender,body mass index,living status and incidence of complications.