本文選題：兒童 + 食物不良反應(yīng)�。� 參考：《山西醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的: (1)分析慢性消化系統(tǒng)疾病患兒食物特異性IgG檢測結(jié)果為陽性的常見食物種類。 (2)對慢性消化系統(tǒng)疾病患兒食物特異性IgG檢測結(jié)果進(jìn)行分析，并探討食物異性IgG介導(dǎo)的食物不良反應(yīng)與生后早期喂養(yǎng)方式的關(guān)系。 (3)探討食物特異性IgG抗體檢測在兒童慢性消化系統(tǒng)疾病中的臨床價(jià)值。 (4)比較食物回避、食物回避加口服雙歧桿菌制劑兩種治療方案在食物特異性IgG抗體檢測陽性的慢性消化系統(tǒng)疾病患兒中的臨床療效的差異，探討最佳的治療方法。 方法: (1)采用ELISA法檢測156例慢性消化系統(tǒng)疾病患兒（病例組）和70例正常兒童（對照組）血清中14種食物特異性IgG抗體水平。 (2)分析病例組檢測結(jié)果中最常見的陽性食物種類。 (3)將病例組與對照組檢測結(jié)果進(jìn)行比較，分析檢測結(jié)果的差異是否具有統(tǒng)計(jì)學(xué)意義。 (4)據(jù)患兒生后4個(gè)月內(nèi)的喂養(yǎng)方式不同將病例組食物特異性IgG抗體檢測陽性的患兒分為三組（母乳喂養(yǎng)組、人工喂養(yǎng)組、混合喂養(yǎng)組），探討早期喂養(yǎng)方式是否對食物異性IgG介導(dǎo)的食物不良反應(yīng)有影響。 (5)將病例組134例陽性患兒分為兩組，第一組71人，囑回避相關(guān)食物，第二組63人，，囑回避相關(guān)食物同時(shí)予以雙歧活菌制劑輔助治療，隨訪3月，觀察4周、8周、12周時(shí)癥狀改善情況，研究兩組間的差異是否具有統(tǒng)計(jì)學(xué)差異。 結(jié)果: (1)156例患兒中，食物特異性IgG檢測陽性所占比例為85.90%,其中僅一種食物檢測陽性所占比例是35.90%；兩種食物檢測陽性占37.82%；兩種及兩種以上食物檢測陽性在所研究患兒中占50%。 (2)病例組與對照組結(jié)果比較有統(tǒng)計(jì)學(xué)差異（P0.05）的食物為牛奶、大豆、雞蛋。且均為病例組高于對照組。 (3)134例食物特異性IgG檢測陽性患兒生后4月內(nèi)的喂養(yǎng)方式：母乳喂養(yǎng)62例，占39.74%；人工喂養(yǎng)13例，占8.33%；混合喂養(yǎng)81例，51.93%。 (4)將134例食物特異性IgG檢測陽性患兒分為食物回避組及食物回避同時(shí)予以雙歧活菌制劑輔助治療組，兩組癥狀改善情況（第一組有3人失訪；第二組7人失訪）：4周時(shí)隨訪兩組的癥狀改善有統(tǒng)計(jì)學(xué)差異（p0.05），為第二組癥狀改善優(yōu)于第一組；8周、12周癥狀改善無明顯統(tǒng)計(jì)學(xué)意義。 結(jié)論:食物特異性IgG檢測陽性的食物是經(jīng)常接觸的食物中的一種或兩種甚至多種，以雞蛋、牛奶為主,其發(fā)生可能與生后早期的喂養(yǎng)方式有關(guān)，對食物特異性IgG檢測陽性患兒的治療主要為回避相關(guān)食物，治療的前4周在禁食的基礎(chǔ)上予以雙歧活菌制劑輔助治療可能更有利于改善患兒癥狀。
[Abstract]:Objective: to analyze the food specific IgG of children with chronic digestive system disease. To explore the relationship between food adverse reactions mediated by food heterosexual IgG and early postnatal feeding. 3) to explore the clinical value of food specific IgG antibody detection in children with chronic digestive system diseases. 4) to compare food avoidance. The difference of clinical efficacy between food avoidance and oral bifidobacterium preparation in children with chronic digestive system diseases with food specific IgG antibody. Methods: Elisa was used to detect the serum levels of 14 food specific IgG antibodies in 156 children with chronic digestive system diseases (case group) and 70 normal children (control group). The positive food type seen here. 3) compare the test results between the case group and the control group. According to the feeding pattern within 4 months after birth, the children who were positive for IgG antibody were divided into three groups (breast-feeding group, artificial feeding group). In the mixed feeding group, the influence of early feeding mode on food adverse reactions mediated by food heterosexual IgG was investigated. (5) 134 cases of positive children in the case group were divided into two groups: the first group (71 cases), the second group (63 cases), the first group (71 cases), the second group (63 cases). The patients were followed up for 3 months to observe the improvement of symptoms at 4 weeks, 8 weeks and 12 weeks, and whether there was statistical difference between the two groups. Results: the proportion of food specific IgG positive was 85.90, of which only one was 35.90, and the positive rate of two kinds of food was 37.82. Two or more kinds of food test positive accounted for 50% of the children studied. 2) the results of the case group and the control group were statistically different (P0.05) the foods were milk, soybean, eggs. The feeding methods of 3134 children with positive food specific IgG were: breast feeding 62 cases (39.74%), artificial feeding 13 cases (8.33%), and the feeding methods of 3134 cases (39.74%) were higher than that of the control group. 134 children with positive food specific IgG were divided into food avoidance group and food avoidance group with bifidobacterium preparation as adjuvant treatment group. The symptoms of the two groups were improved (3 patients in the first group were not visited). There was a significant difference in symptom improvement between the two groups after 4 weeks follow-up in the second group (P < 0.05). The symptom improvement in the second group was better than that in the first group at 8 weeks and 12 weeks. There was no significant difference in the improvement of symptoms between the two groups at 8 weeks and 12 weeks. Conclusion: food specific IgG positive food is one or two or even more of the foods that are in frequent contact, mainly eggs and milk, and its occurrence may be related to the way of feeding in the early postnatal period. The treatment of food specific IgG positive children was mainly to avoid the related food, the first 4 weeks of treatment on the basis of fasting Bifidobacterium may be more conducive to improve the symptoms of children.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R725.7

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本文編號：2036137