Study On The Development And Clinical Application Of Food For Special Medical Purpose For Cardio-cerebral Vascular Disease Patients With Disability And Semi-disability

There are currently 290 million patients with cardio-cerebral vascular disease in China,and the incidence rate has been increasing year by year.The resulting disability and semi-disability patients have also increased year by year.After the patient's disability,due to various reasons such as impaired nerve function,eating disorders,disturbance of consciousness,and lack of exercise,the food intake decreases,resulting in dehydration,electrolyte imbalance,lack of oxygen,and lack of vitamins and minerals.As a result,it causes protein and energy metabolism disorders and malnutrition.Malnutrition will not only lead to a decrease in the quality of life of patients,but also a decrease in the effectiveness of clinical treatment and an increase in the incidence of complications.This has brought great suffering to the patient and increased the economic burden on society and the family.Based on early research and literature data,this study analyzed the pathophysiology,nutritional and metabolic characteristics of the elderly with disability and semi-disability cardio-cerebral vascular diseases,developed a specialized support program,selected appropriate raw materials,and developed a full-nutrition formula for cardio-cerebral vascular disease patients with disability and semi-disability.Randomized clinical trials were conducted to evaluate the food's clinical nutritional support effect and safety,to provide support for effectively shortening the treatment cycle,reducing the cost of treatment and accelerating the speed of rehabilitation.Part 1 Formulation of food for special medical purpose for cardio-cerebral vascular disease patients with disability and semi-disabilityObjective: Based on the results of medical and nutritional research,and through selecting the appropriate raw material to optimize the prescription,comprehensively considering the patient's pathology,physiological status and various measurement indexes on the foundation of the whole nutrition formula,to develop the food for special medical purpose for cardio-cerebral vascular disease patients with disability and semi-disability.Methods: Based on the research results of nutritional metabolism in elderly patients and the characteristics of nutritional metabolism and complications,referring to the?Dietary guidelines for Chinese Residents(2016)?and the?Dietary reference intakes of Chinese Residents(DRIs)?published by the Chinese Nutrition Society and the high quality researches at home and abroad,collect,collate and analyze research materials,to carry on the research and development of full nutritional dietary nursing.Through the analysis of nutritional characteristics of cardio-cerebral vascular disease patients with disability and semi-disability,and on the foundation of full nutrition formula,to obtain the nutrient substrates that need to be fortified.Select the appropriate critical materials,developing nutritional products in compliance with such patients.Organize a group of 5 people with experience to carry out sensory evaluation of the taste and texture of the products.Result: Researched and developed the nutritional support scheme for cardio-cerebral vascular disease patients with disability and semi-disability.The source of carbohydrates was derived from maltodextrin and enzymatic hydrolysis of rice flour.Protein was derived from high quality whey protein and soy protein isolate.Fat was derived from plant fat powder.Dietary fiber was derived from oligosaccharide and glucose.When the addition of xanthan gum was 0.4%,the consistency was the most appropriate.Xylitol has the greatest influence on sensory,milk flavor was the second,and vanillin was the least.Conclusion: The risk of malnutrition in cardio-cerebral vascular disease patients with disability and semi-disability was higher.This study was based on the characteristics of nutrition metabolism,researched and developed the food for special medical purpose for such patients.Part 2 Study on the clinical application of food for special medicalpurpose for cardio-cerebral vascular disease patients withdisability and semi-disabilityObjective: To study the nutritional support and clinical safety of this food for special medical purpose for cardio-cerebral vascular disease patients with disability and semi-disabilityMethods: We selected patients with cardio-cerebral vascular disease patients with disability and semi-disability admitted to the First Hospital of Hebei Medical University from September 2017 to December 2017 as research subjects.Randomly divide 56 patients into 2 groups.During the treatment of the primary disease of the patients,a 14-day nutritional intervention was performed on the two groups of patients.Parenteral nutrition formulations were not applied during this period.In the intervention cycle,the control group used homemade homogenate meals,and the intervention group used the food for special medical purpose in this study.Before and after 14 days of the intervention,the circumference of the upper arm and main blood and biochemical indicators were measured,including hemoglobin(Hb),total protein(TP),serum albumin(ALB),fasting blood glucose(GLU),creatinine(Cr),urea nitrogen(BUN),total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL)and low density lipoprotein(LDL).Analyzed and compared the difference of indicators between the two groups and within the group before and after intervention.Observed patient complications: nausea,vomiting,abdominal pain,abdominal distension,diarrhea,gastrointestinal bleeding,constipation.The software SPSS 13.0 was used for the data statistics processing.Results:1.Upper arm circumferenceThere was no statistically significant difference in upper arm circumference between the two groups at the time of enrollment.After 14 days of intervention,compared with the values before intervention,there was no statistically significant difference within each group(P>0.05),and the upper arm circumference of the intervention group was slightly higher than that of the control group,which was 5.94% higher,however,this difference was not statistically significant(P>0.05).2.Hematology indexIntra-group comparison: After 14 days of nutrition intervention,in the control group,the Hb,TP,and ALB levels decreased by 6.16%,9.87%,and 8.63%,respectively.And this difference was statistically significant with P values of 0.00,0.00,and 0.00,respectively.And there was no significant change in GLU,Cr,BUN,TC,TG,HDL,and LDL(P>0.05).In the intervention group,TP and ALB increased,with an increase of 4.70% and 5.86%,respectively.The difference was statistically significant,with P values of 0.04,0.00,respectively,and Hb increased slightly,increased 2.68%,but the difference was not statistically significant(P=0.17),and GLU,Cr,BUN,TC,TG,HDL and LDL did not change significantly(P>0.05).Inter-group comparison: Before the intervention,there was no statistical difference in Hb,TP,ALB,GLU,Cr,BUN,TC,TG,HDL,and LDL between the two groups.After 14 days of intervention,compared with the control group,the Hb,TP,and ALB values of the intervention group were all higher,being 8.80%,11.08%,and 10.89% higher than the control group.The difference was statistically significant,with P values of 0.04,0.00,and 0.01 respectively.After 14 days of intervention,there was no significant difference in GLU,Cr,BUN,TC,TG,HDL and LDL between the two groups(P>0.05).3.Comparison of the incidence of gastrointestinal adverse reactionsOne patient(3.6%)had diarrhea in the control group and 2 patients(7.2%)had diarrhea in the intervention group.3 cases(10.7%)of constipation occurred in the control group and 1 case(3.6%)of constipation occurred in the intervention group.Vomiting occurred in 1 patient(3.6%)in both groups.No abdominal distention,abdominal pain,gastrointestinal bleeding was observed in both groups.Conclusion: Cardio-cerebral vascular disease patients with disability and semi-disability who were treated with foods for special medical purpose in this study,had significantly improved their nutritional status,and the incidence of adverse reactions was low,suggesting that the nutritional support and clinical safety of this food for special medical purpose was good,and worthy of further research,promotion and application.