摘要营养治疗在儿童炎症性肠病(inflammatory bowel disease,IBD)中的治疗和随访管理中占重要地位.特定碳水化合物饮食(specific carbohydrate diet,SCD)在1951年提出,是一种比较严格的针对碳水化合物种类的饮食限制:只允许摄入单糖类碳水化合物,去除双糖和大多数的多糖、淀粉等复杂碳水化合物,但不限制蛋白质和脂肪的摄入,并适当减少经过加工的肉类或其他加工食品.目前SCD治疗IBD机制尚未完全阐明.理论假设在于:(1)IBD患者肠道发生炎症后会引起双糖酶功能的降低,因此只能吸收葡萄糖、半乳糖和果糖.(2)IBD发生发展与肠道菌群紊乱有关,改变饮食结构能调整肠道菌群,可能有助于改善IBD症状.已有来自回顾性的病例研究和个案报道初步提示SCD改善儿童IBD症状和维持缓解的临床有效性,但目前尚缺乏高质量的循证医学证据支持.SCD中对于碳水化合物摄入的限制,为指导IBD患儿的饮食提供了参考.但是具体执行需要根据当地饮食习惯和常见食品进行食谱的设计,同时兼顾儿童生长发育的需求.

abstractsNutrition treatment plays an important role in the treatment and follow - up management of pediatric inflammatory bowel disease (IBD). The theory of specific carbohydrate diet(SCD),first presented in 1951,is a strict diet limitation focused on the sorts of carbohydrate:monosaccharide is the only kind of carbohydrate that is permitted, disaccharide and most complex carbohydrate like polysaccharide and starch are eliminated,intake of protein and fat is not limited,and processed meat and other processed food are cut down appropriately. Currently,mechanism of SCD diet′s treatment efficacy on IBD is not elucidated clearly. The hypothesis of this theory is:(1)Bowel inflammation of IBD patients leads to the decline of disaccharidase′s function,thus glucose,galactose and fructose are the only kinds of car-bohydrate that can be absorbed. (2)Occurrence of IBD is related to the disorder of bowel bacteria. The change of diet may regulate the bowel bacteria,which may be helpful to the symptoms of IBD. Retrospective case studies and case re-ports preliminarily indicated the efficacy of SCD in improving pediatric IBD symptoms and maintenance of clinical re-mission. However,high level evidence is still required to support the hypothesis. The limitation of carbohydrate by SCD would be the clue for the diet of pediatric IBD patients. However,the menu should be formulated according to the eating habits and the available food,as well as the requirement of the growth and development in children.