低血糖指数饮食在儿童难治性癫痫的应用进展  

Application of low glycemic index treatment in children with refractory epilepsy

作　　者：刘曼[1] 李斌[2] 卢艳敏[1] Liu Man;Li Bin;Lu Yanmin(Department of Clinical Nutrition,Binzhou Medical University Hospital,Binzhou 256600,China;Department of Neurology,Binzhou Medical University Hospital,Binzhou 256600,China)

机构地区：[1]滨州医学院附属医院临床营养科,滨州256600 [2]滨州医学院附属医院神经内科,滨州256600

出　　处：《中华实用儿科临床杂志》2023年第6期477-480,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：山东省省级临床重点专科学科建设经费(SLCZDZK-0706);山东省自然科学基金(ZR2015HL084)。

摘　　要：生酮饮食(KD)治疗癫痫已有百年历史,但因其制作对于初学者来说较复杂,随着抗癫痫药物的出现,此治疗方式在一段时间内被忽视;由于药物治疗癫痫的机制存在局限性,而癫痫的发病机制比较复杂,多年来,药物难治性癫痫的发病率未随着药物的发展有所改善。KD可通过多种机制发挥抗癫痫和神经保护作用,对于难治性癫痫也有明显效果,所以KD再次被重视。经典KD脂肪含量高,操作较繁琐,当培训不够精细时,很多患者不能理解和合格操作。为了改善传统KD的弊端,又出现更接近正常饮食结构、耐受性好的改良KD,即低血糖指数饮食(LGIT),这种饮食对碳水化合物的摄入有所放宽,制餐简约,口感较前改善,提高了患者的耐受性。现就LGIT在儿童难治性癫痫的机制、临床应用效果及适应证进行综述。Ketogenic diet(KD)has been applied to the treatment of epilepsy for the last century,although it has been underestimated due to the complicated preparation for beginners and the emergence of antiepileptic drugs.Due to the limitations of the mechanism of drug treatment of epilepsy,and the pathogenesis of epilepsy is complex,the incidence of drug-resistant epilepsy has not improved with the development of drugs over the years.KD plays an anti-epileptic and neuroprotective role through a variety of mechanisms,which is also effective to refractory epilepsy.As a result,KD has been emphasized again.Classical KD has high fat content and complicated operation.When the training is not fine enough,many patients cannot understand and qualify the operation.To overcome the disadvantages of the conventional KD,a modified KD has been developed that is closer to a normal diet structure and has a good tolerance,namely the low glycemic index treatment(LGIT).LGIT is featured by a slightly higher intake of carbohydrates,simplified meal preparation,improved taste and tolerance.This review aims to describe the mechanism,clinical outcomes and indications of LGIT in children with refractory epilepsy.

关 键 词：生酮饮食 低血糖指数饮食 难治性癫痫 儿童 

分 类 号：R742.1[医药卫生—神经病学与精神病学]