Effect Of Intensive Dietary Education On Nutrition,Immunity And Quality Of Life In Patients With Tuberculosis Complicated By Glucose Metabolism Disorders

Objectives: 1)To understand the occurrence status of nutrition,nutritional risk,immunity level and patients' living quality with pulmonary tuberculosis complicated with glucose metabolism disorder.2)To explore the impact of intensive dietary education on nutrition,nutritional risk and patients' living quality with pulmonary tuberculosis complicated with glucose metabolism disorder.3)To analyze the impact of intensive dietary education on nutrition,serum nutrition indicators and immune detection indicators(Th1/Th2 cytokines)of pulmonary tuberculosis patients with glucose metabolism disorders.Methods: From August 2018 to October 2019,152 patients with pulmonary tuberculosis and glucose metabolism disorder hospitalized in the Second People's Hospital of Xinjiang Aksu Region(TB Prevention and Treatment Hospital)were selected.The study objects were randomly divided into control group and experimental group.There were 76 cases in each group.The treatment programs of the two groups were the same but the dietary education intervention programs were different.That is,the control group was given a routine nursing education,and the experimental group was given an intensive dietary education on the basis of routine nursing education.The study intervention time was 3 months.Before and after intervention,the two groups of patients were evaluated the changes in nutritional risk,serum nutritional indicators,Th1/Th2 cytokines,and quality of life.And analyzed the effects of two interventional methods on nutrition,immunity,and quality of life in patients with tuberculosis complicated by abnormal glucose metabolism.Forty healthy people who met the inclusion and exclusion criteria of the hospital staff were selected.The blood samples were taken for comparativestudy of cytokines.Results: 1)The Baseline data shows : there are no significant differences in demographic data,disease status,nutrition and nutritional risk,and quality of life between the two groups of patients(P>0.05);2)The incidence of nutritional risk has discrepancy in different ages,treatment conditions and residential address.These discrepancies are statistically significant(P<0.05).There is a difference in serum nutritional indicators of patients with different gender(P<0.05).Except for lymphocytes,we compared different nutritional risk screening scores with the other indicators of serum nutrition and find some differences.These differences are statistically significant(P<0.05).The results of single factor and multiple stepwise regression analysis showes that gender,age,educational level,occupation,course of disease,and monthly household income can affect the patient's living quality.There are significant differences in living quality scores(P<0.05);3)Before the intervention,nutritional risk screening scores,albumin,and hemoglobin of the two groups were all reduced.And their detection rates were 55.92%,55.92%,and55.26%.The national norm level is low(P<0.05),and the expression level of IL-4 in Th1/Th2 cytokines is not statistically significant(P>0.05);The levels of IFN-?,TNF-?,IL-10,IL-6 and IL-2 are significantly different from those healthy people(P<0.01).4)After the intervention,the difference between nutritional risk screening scores,albumin,hemoglobin,and lymphocyte counts was statistically significant(P<0.05).Before and after intervention,the TNF-? intervention difference between the control group was statistically significant(P<0.05).Before and after intervention,TNF-?,IL-4,IL-2 and IL-6 in the experimental group was statistically significant(P<0.05).These datas all showed a downward trend.And the nutritional status of the patients of experimental group,Th1/Th2 cytokines and the improvement of quality of life are all better than the control group(P<0.05).Conclusion: Patients with pulmonary tuberculosis complicated with glucose metabolism disorders have a higher incidence of malnutrition and nutritional risk,and a lower quality of life.Intensive diet education can effectively improve the incidence of malnutrition and nutritional risk of patients.And it can also promote the patients to restore their balance of Th1/Th2 cytokines to a certain extent.