CN103330215A - Nutrition formula food applicable to tumor patient - Google Patents
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Abstract
The invention relates to nutrition formula food applicable to a tumor patient, and aims at providing nutrition formula food which is applicable to the tumor patient and is prepared according to pathological characteristics of metabolic disorder of the tumor patient. The nutrition formula food applicable to the tumor patient, per 100kcal thermal content, comprises 3.8-5.8g protein or hydrolysate of the protein, 5.6-8.4g carbohydrate, 4.8-7.2g fat, 0.9-1.4g dietary fiber, 3.31-108.62mg vitamin complex, 0-40mg taurine and 0.33-2.333g complex mineral. The food has the main characteristics that the food contains unbalance amino acid, high protein, slow-release carbohydrate, and high fat, and has high energy density; the treatment effect of the patient is better than that of a patient supported by ordinary nutrition after the food provides clinical nutrition support for the patient undergoing lung cancer chemotherapy; and the complication rate of the patient is also obviously lower than that of the patient supported by the ordinary nutrition.
Description
Technical field
The present invention relates to a kind of nutrient formulation food, be specifically related to a kind of nutrient formulation food that is applicable to tumor patient.
Background technology
Tumour is at the abnormality that medically is phalangeal cell, and this pathology makes the body part cell that uncontrolled hyperplasia be arranged, and can be combined into when many to be lump.Along with industrial development is on the rise to environment damage, the incidence of disease of tumour also obviously improves.China only 2012 1 year malignant tumour new cases just up to 3,500,000, annual oncotherapy correlative charges has reached 1.5 hundred billion yuan, account for 5.8% of national medical total cost 2.6 trillion, patient above 2,800,000 has accepted chemicotherapy, but interior patient's of oncotherapy phase mean survival time, nutrition product scarcity, technological means that its major reason is to be suitable for the tumor patient metabolic characteristic fell behind less than 1/3 of developed country.The patient of the nutrition treatment of China's acquisition at present accounts for total treatment numbers less than 10%, and malnutrition and complication thereof become the immediate cause of most tumors death.
The bad incidence of tumors of nutrients is about 31～87% according to the literature, and malnutrition often can cause the bad reaction of patient's chemicotherapy to increase the weight of, treat compliance descending, and the risk of being admitted to hospital again and being in hospital for a long time is also higher, also can cause the rising of the death rate when serious.Therefore, develop that to be suitable for the nutrition product that tumor patient replenishes most important.
At present, developed country mainly adopts the EA support as the main means of tumors of nutrients treatment, and is aided with the parenteral nutrition support, and the ratio of the two is 9:1.And the main means of China's tumors of nutrients treatment are based on intestines outward, and the ratio of parenteral nutrition and EA is 1:9, and this is because the clinical nutrition subject developing stage of China is more elementary, lacks suitable clinical nutrition products.
Tumor patient is different for metabolism and the common normal person of nutrition substrate, and its metabolism has following particularity:
1, the amino acid whose full spectrin matter of balance also causes tumor cell proliferation when satisfying the body needs;
2, carbohydrate mainly adopts maltodextrin to cross corn syrup, and they easily cause patient's hyperglycaemia under the situation of malignant tumour insulin resistance;
3, high fat content can adapt to the characteristics that tumour cell is not had a liking for fat, satisfies patient's energy requirement, but excessive absorption can increase the weight of burden of liver, makes metabolism more disorderly.
And the three big metabolisms that malignant tumour causes are unusual, have the distinguishing feature that is different from other diseases:
1, protein is synthetic reduces and the decomposition increase, and skeletal muscle atrophy, visceral protein consumption, the group of lean tissue mass descend, and body presents negative nitrogen balance;
2, tumour cell has the glucose dependence, is main energy substrate with glucose;
3, tumor tissues can not utilize fat as energy source, and the host can utilize, and triglycerides-aliphatic acid circulation strengthens, and the energy consumption of body, tissue consumption increase.
In addition, the toxic and side effect of chemicotherapy, destroy intestinal absorption and immunization barrier function, cause the synthetic metabolism function that waits of liver albumen impaired, liver-intestines axle and stomach and intestine-maincenter s function disorder, concrete clinical manifestation is apocleisis, nausea,vomiting,diarrhea, mucositis, intestinal bacilli illness etc., cause taking in and reduce, aggravation metabolic disorder and malnutrition/cachexia development, influence tolerance and the validity of antineoplaston, formation is core with the dysbolism, the treatment difficult point that treatment side effect and malnutrition/the cachexia circulation worsens.Early stage reasonably clinical nutrition support can effectively improve patients ' life quality, remissive treatment toxicity, improves treatment tolerance and validity, prolong life span.
If therefore give the general principle of tumor patient nutritional support just according to the tumor patient metabolic characteristic, when satisfying the body nutritional need, reduce the nourishing to tumour cell as far as possible.So being directed to the metabolism particularity of tumor patient, to prepare the nutrient formulation food that is fit to tumor patient significant for treatment and the rehabilitation of tumor patient.
Summary of the invention
It is foundation that main purpose of the present invention provides a kind of pathological characteristic with the tumor patient metabolic disorder: the synthetic minimizing of protein and decomposition increase, tumour cell sugar rely on, tumor tissues is not had a liking for fat, the body energy consumption increases with tissue consumption, and design provides a kind of nutrient formulation food that is applicable to tumor patient that is particularly suitable for the tumor patient metabolic characteristic.
For achieving the above object, the technical solution used in the present invention is: a kind of nutrient formulation food that is applicable to tumor patient, and the product of every heat content 100kcal is made up of 3.8～5.8g protein or its hydrolysate, 5.6～8.4g carbohydrate, 4.8～7.2g fat, 0.9～1.4g dietary fiber, 3.31～108.45mg B B-complex, 0～40mg taurine, 0.33～2.333g composite mineral matter;
Described B B-complex is the mixture of vitamin A, vitamin D, vitamin E, vitamin K, vitamin B1, vitamin B2, vitamin B6, cobalamin, vitamin C, biotin, nicotinic acid, pantothenic acid, folic acid;
Described composite mineral matter is the mixture of sodium, potassium, copper, magnesium, iron, zinc, manganese, calcium, chlorine, phosphorus, iodine.
The heat that is to say the nutrient formulation food that is configured to by 3.8～5.8g protein or its hydrolysate, 5.6～8.4g carbohydrate, 4.8～7.2g fat, 0.9～1.4g dietary fiber, 3.31～108.45mg vitamin, 0～40mg taurine, 0.33～2.333g mineral matter is 100kcal.
Wherein, the tortuous material with certain space structure that is folded to form of polypeptide chain process that protein is made up of in the mode of " dehydrating condensation " amino acid, the hydrolysate of protein then is polypeptide or amino acid; Carbohydrate namely is saccharide compound, all belongs to carbohydrate as glucose, sucrose, starch and cellulose etc.; The fatty glyceride that fat is made up of glycerine and aliphatic acid is the main source of energy; Dietary fiber mainly is the polysaccharide that can not be utilized by human body, namely can not be by in the mankind's the intestines and stomach digestive ferment digested, and the polysaccharide that is not absorbed by the body and utilizes mainly comes from the cell membrane of plant, comprises cellulose, hemicellulose, resin, pectin and lignin etc.; Mineral matter then is inorganic salts, can not synthesize in the human body body, must absorb from food and drinking water, and described mineral formulations is best suited for the tumor patient nutritional supplementation, and these inorganic salts can be halide, oxide, sulfate or other inorganic salts.
Further preferred, described composite mineral matter is the mixture of 30～175mg sodium, 80～295mg potassium, 60～500mg copper, 7.5～42mg magnesium, 0.5～2.8mg iron, 0.5～3.5mg zinc, 50～680mg manganese, 35～210mg calcium, 30～175mg chlorine, 30～194mg phosphorus, 6.5～55.6mg iodine.Described composite mineral matter is that common mineral matter premix gets.
Further preferred, described B B-complex is vitamin E, 3.5～3.3 μ g vitamin Ks, 0.06～2.8mg vitamin B1,0.07～0.17mg vitamin B2,0.07～5.6mg vitamin B6,0.07～0.17 μ g cobalamin, 2.25～83mg vitamin C, 0.75～60 μ g biotin, 0.16～6.7mg nicotinic acid, 0.15～5.04mg pantothenic acid of vitamin A, 0.28～2.5 μ g vitamin D, 0.5～4.8mg μ g alpha-tocopherol equivalent of 35～245 μ g retinol equivalents, the mixture of 10～21.6 μ g folic acid.0.5 the vitamin E of～4.8mg μ g alpha-tocopherol equivalent calculates with the alpha-tocopherol equivalent, just the content of alpha-tocopherol is 0.5～4.5mg μ g in the vitamin E; Equally, the vitamin A of 35～245 μ g retinol equivalents refers to contain in the vitamin A retinol of 35～245 μ g.Described B B-complex is that the usual vitamin premix gets.
Further preferred, described protein comprises the whole albumen of lactalbumin, casein, soybean protein, these four kinds of albumen of albumen or one or more mixing in its hydrolysate.That is to say that described protein is the polypeptide that obtains of these four kinds of albumen or this four kinds of proteolysis or one or more mixtures in the amino acid.Lactalbumin and casein are the protein that extracts from milk; Soybean protein is the contained protein of big bean products; Albumen then is the contained protein of egg white in the egg.This some protein all is the protein of high-quality, and its source is also comparatively extensive.
Further preferred, described protein also comprises one or more mixing in glutamic acid, glutamine, arginine, leucine, beta-hydroxy-Beta-methyl calcium butyrate, methionine, the valine; Described protein is non-equilibrium aminogram albumen.Be non-equilibrium aminogram albumen with one or more and usual protein mixed preparing in these several materials, the albumen that is suitable for tumor patient more replenishes demand: because tumor tissues can more effectively be captured amino acid than body, therefore the non-equilibrium aminogram albumen that provides of this product, by adding arginine, leucine, glutamine, glutamic acid or reducing methionine, valine content, change the Argine Monohydrochloride spectrum, improve the nutrition condition of body when can effectively suppress tumor growth again, strengthen immunity of organisms.
Further, in the described carbohydrate mass fraction more than 50% for being the source with the resistant starch of slowly-releasing or the resistant dextrin of slowly-releasing.Resistant starch claims enzyme resistant starch and indigestibility starch again, can not be by enzymolysis in small intestine, but in people's intestines and stomach colon, can play fermentation reaction with volatile fatty acid.Resistant dextrin is processed by starch, is that the indigestibility composition that will bake dextrin is handled a kind of Low Caloric Polydextrose that also refining forms with the industrial technology extraction.
The resistant starch of slowly-releasing namely be with porous carriers such as sodium alginate or shitosans with the resistant starch embedding, make the digestion time of resistant starch in intestines postpone, the glucose that digestion forms enters also phase delay of blood.The resistant dextrin of slowly-releasing namely is the material that the resistant dextrin embedding is got up with porous carriers such as sodium alginate or shitosans.Because tumour cell lacks the key enzyme of oxidation free fatty and degraded ketoboidies, therefore can not directly utilize aliphatic acid and metabolite thereof as the energy, the main glucose oxidase that relies on supplies, this product provides the slowly-releasing carbohydrate, limit tumour cell sugar dependence as far as possible, alleviate the hyperglycaemia that causes because of the insulin resistance effect, steady postprandial blood sugar when replenishing human body energy suppresses tumor growth.
Further, described carbohydrate also comprises one or more mixtures in fructose, maltitol, the maltodextrin.
Further, described fat is medium chain fatty acid glyceride, and described chain fatty acid glyceride source is two or more mixing in corn oil, sunflower oil, safflower oil, soybean oil, coconut oil, linseed oil, palm oil, palm-kernel oil, perilla herb oil, the fish oil.Medium chain fatty acid glyceride namely is that 6～12 carbon atoms are formed the aliphatic acid of carbochain and the fatty glyceride that glycerine is formed.Tumor patient is because of the toxic and side effect of chemicotherapy, destroy intestinal absorption and barrier function, be prone to Disorder of Digestion and A orption, and the absorbability of small intestine centering chain triglycerides is greater than LCT, this product fat is supplied with and is being satisfied under the conditions of demand of patient to essential fatty acid, increase the content of medium chain triglyceride, account for total fatty gross mass 50～60%, and adopt special emulsification homogeneous technology, make fatty particle diameter and human body chyle particle diameter roughly the same, adopt this method to be beneficial to tumor patient and digest and assimilate fat, alleviate its burden of liver.
Further, described dietary fiber is made up of by mass ratio 1～36:6 soluble dietary fiber and insoluble diedairy fiber.But soluble dietary fiber refers to be dissolvable in water water imbibition again, and can be mainly contained pectin, natural plant gum, viscose etc. by a fiber of microorganism glycolysis in the large intestine; And namely can not being dissolved in water, insoluble diedairy fiber can not be mainly contained cellulose, hemicellulose, lignin etc. by a fiber of microorganism glycolysis in the large intestine.
Further, described nutrient formulation food is powdery, or adds water and be modulated into liquid.It is for the ease of storing and transportation that nutrient formulation food is made Powdered.And usually the tumor patient alimentary canal absorbs and is bad, and especially the gastroenteric tumor patient needs by nasal tube, stomach tube or intestinal tube feed, thus add water be modulated into liquid can so that patient's feed also be convenient to the patient and absorb nutrition.So the nutrient formulation food that is applicable to tumor patient of the present invention's preparation can directly be prepared into Powdered packing and dispatch from the factory, for the patient that needs are taken liquid food, add water in use and be modulated into liquid and take, also can when producing, directly add the water auxiliary tone and make the liquid bottling and dispatch from the factory.
The consumption of each component is the optimum feed stock ratio that participates in reaction in the technique scheme, but the variation that those skilled in the art can instruction according to the present invention be equal to.For example: because the parameter that the error of industrial production itself causes changes and technical scheme of the present invention is equal to, composite other assisted and be equal to agent and technical scheme of the present invention on prescription of the present invention basis.
Main feature of the present invention: contain non-equilibrium amino acid high protein, slowly-releasing carbohydrate, high fat, high-energy-density, energy bins becomes carbohydrate about 28%, protein about 19%, fat about 53%.Using product of the present invention and common nutritional support that the lung cancer chemotherapy patient is carried out clinical nutrition supports check experiment to show: two week the back use these products to descend at leucocyte as the nutritional support test group all significantly to be lower than general nutritional support group aspect incidence, the adverse reaction rate, and the interdependent rate of chemotherapy is significantly higher than general nutritional support group.
The specific embodiment
For making the clear more and clear and definite technical scheme of the present invention of those skilled in the art, the spy provides following preferred embodiment, but technological thought of the present invention is not limited to following examples.
Embodiment one
Each nutrition composition proportioning is as shown in table 1:
Table 1 is applicable to the nutritional food formula embodiment one of tumor patient
| Batching | Addition (every 100kcal) |
| Maltodextrin | 2.2g |
| Resistant starch | 3.8g |
| Fructose | 0.76g |
| Maltitol | 0.74g |
| Soyprotein peptide | 0.4g |
| Casein-sodium | 0.9g |
| Lactalbumin | 0.64g |
| Leucine | 0.4g |
| Glutamine | 1.0g |
| Arginine | 1.0g |
| Beta-hydroxy-Beta-methyl calcium butyrate | 0.24g |
| Coconut oil | 2.9g |
| Corn oil | 1.6g |
| Medium chain fatty acid glyceride | 1.3g |
| FOS | 0.4g |
| Fibre and soya | 0.6g |
| B B-complex | 0.016g |
| Composite mineral matter | 0.03g |
Described B B-complex is vitamin E, 3.5 μ g vitamin Ks, 2.75mg vitamin B1,0.1mg vitamin B2,3.5mg vitamin B6,0.15 μ g cobalamin, 3.1mg vitamin C, 50 μ g biotins, 5.5mg nicotinic acid, the 0.2mg pantothenic acid of vitamin A, 20 μ g vitamin Ds, the 0.6mg μ g alpha-tocopherol equivalent of 200 μ g retinol equivalents, the mixture of 10 μ g folic acid.
Described composite mineral matter is the mixture of 0.5mg sodium, 0.5mg potassium, 3mg copper, 7.5mg magnesium, 0.5mg iron, 0.5mg zinc, 6mg manganese, 0.5mg calcium, 6mg chlorine, 5mg phosphorus, 6.5mg iodine.
Because contained the mineral matter of a large amount of vitamin in the coconut oil that itself adds, the corn wet goods raw material, so the addition of locating is to guarantee that the product that makes can reach the nutritional need of tumor patient.
Each component in the above-mentioned prescription mixed add water by every 100kcal food and be deployed into 100mL liquid food.
Embodiment two
Each nutrition composition proportioning is as shown in table 2:
Table 2 is applicable to the nutritional food formula embodiment two of tumor patient
| Batching | Addition (every 100kcal) |
| Maltodextrin | 3.0g |
| Resistant starch | 1.4g |
| Fructose | 1.5g |
| Maltitol | 1.5g |
| Soybean protein | 0.45g |
| Casein-sodium | 0.6g |
| Lactalbumin | 0.9g |
| Leucine | 0.4g |
| Glutamine | 1.0g |
| Arginine | 1.0g |
| Coconut oil | 2.6g |
| Corn oil | 2.6g |
| Linseed oil | 0.6g |
| Inulin | 0.6g |
| Fibre and soya | 0.4g |
| B B-complex | 0.016g |
| Taurine | 0.01g |
| Composite mineral matter | 0.03g |
Described B B-complex is vitamin E, 3.5 μ g vitamin Ks, 2.8mg vitamin B1,0.15mg vitamin B2,3mg vitamin B6,0.15 μ g cobalamin, 3.1mg vitamin C, 50 μ g biotins, 5.9mg nicotinic acid, the 0.18mg pantothenic acid of vitamin A, 2.5 μ g vitamin Ds, the 0.6mg μ g alpha-tocopherol equivalent of 200 μ g retinol equivalents, the mixture of 20 μ g folic acid.
Described composite mineral matter is the mixture of 0.5mg sodium, 0.5mg potassium, 2mg copper, 6.5mg magnesium, 1.5mg iron, 0.3mg zinc, 6mg manganese, 1.7mg calcium, 6mg chlorine, 5mg phosphorus, 6.5mg iodine.
Each component in the above-mentioned prescription mixed add water by every 100kcal food and be deployed into 100mL liquid food.
Application examples one
60 routine lung cancer chemotherapy patients are divided into EN treatment group and control group, every group of each 30 example.Two groups of patients relieving asthma, reduce phlegm, correct the treatments such as acid-base imbalance and electrolyte disturbance except giving normal diet, anti-infective, oxygen uptake, spasmolysis, the control group patient is by the feed of eating habit at ordinary times, general nutritional support treatment such as every day peripheral vein infusion 20% fatty newborn 250ml, 8.5% amino acid 250ml, 10% glucose injection 500ml and vitamin etc.; The product that EN treatment group makes embodiment 1 is given patient's oral nutrient supportive treatment: divide that to take total amount for four times be the product that the embodiment 1 of 800mL makes every day, patient that can not oral feeding gives nasogastric tube and takes.Two groups of patient's supportive treatments carry out the observation of nutrition assessment, biochemical indicator monitoring and bad reaction after 2 weeks before and after respectively two groups of patients being treated.
Table 3 embodiment one product treatment results of comparison
| Group | Leucocyte decline incidence | Adverse reaction rate | Chemotherapy is comply with rate |
| EN treatment group | 43.3% | 33.3% | 96.7% |
| Control group | 73.3% | 70.0% | 80.0% |
Results of comparison is as shown in table 3: EN treatment group and control group compare, and leucocyte decline incidence and adverse reaction rate obviously reduce, and the chemotherapy rate of complying with increases to some extent.Conclusion: the EN supportive treatment can obviously improve the nutrition condition of lung cancer patient, and raising patient's immunologic function reaches the tolerance to chemotherapy.
Application examples two
47 routine gastroenteric tumor patients are divided into EN treatment group and control group at random, 25 examples are organized in the EN treatment, adopt the product of embodiment two preparations to carry out the EA support, by nose/stomach/intestinal tube product that the embodiment 2 of 25mL/kg makes that instils every day, the volume (mL) that namely injects nutrient formulation food every day is 25 times of weight in patients (kg); Control group 22 examples adopt common parenteral nutrition support: instil 3L by glucose, amino acid, fatty breast and multivitamin and the micro-nutrients of preparing every day by nose/stomach/intestinal tube.Results of comparison is as shown in table 4:
Table 4 embodiment two products treatment results of comparison
| Group | The example number | Complication | Fever time (my god) | Hospital stays (my god) |
| EN treatment group | 25 | 1(4.0%) * | 4.6±1.4 * | 25.7±6.9 * |
| Control group | 22 | 7(31.8%) | 7.0±2.3 | 35.6±7.3 |
Annotate: compare * P＜0.05 with control group
From results of comparison as can be seen: the patient of the generation complication of EN treatment group is 1, incidence is 4.0%, and the patient of control group generation complication is 7, incidence is 31.8%, the complication rate of EN treatment group is starkly lower than control group, fever time and hospital stays obviously shorten in control group, and group difference has tangible statistical significance (P＜0.05).
Claims (10)
1. nutrient formulation food that is applicable to tumor patient is characterized in that: the product of every heat content 100kcal is made up of 3.8～5.8g protein or its hydrolysate, 5.6～8.4g carbohydrate, 4.8～7.2g fat, 0.9～1.4g dietary fiber, 3.31～108.45mg B B-complex, 0～40mg taurine, 0.33～2.333g composite mineral matter;
Described vitamin is the mixture of B B-complex A, vitamin D, vitamin E, vitamin K, vitamin B1, vitamin B2, vitamin B6, cobalamin, vitamin C, biotin, nicotinic acid, pantothenic acid, folic acid;
Described composite mineral matter is the mixture of sodium, potassium, copper, magnesium, iron, zinc, manganese, calcium, chlorine, phosphorus, iodine.
2. a kind of nutrient formulation food that is applicable to tumor patient according to claim 1, it is characterized in that: described composite mineral matter is the mixture of 30～175mg sodium, 80～295mg potassium, 60～500mg copper, 7.5～42mg magnesium, 0.5～2.8mg iron, 0.5～3.5mg zinc, 50～680mg manganese, 35～210mg calcium, 30～175mg chlorine, 30～194mg phosphorus, 6.5～55.6mg iodine.
3. a kind of nutrient formulation food that is applicable to tumor patient according to claim 1, it is characterized in that: described B B-complex is the vitamin A of 35～245 μ g retinol equivalents, 0.28～2.5 μ g vitamin Ds, 0.5 the vitamin E of～4.8mg μ g alpha-tocopherol equivalent, 3.5～3.3 μ g vitamin Ks, 0.06～2.8mg vitamin B1,0.07～0.17mg vitamin B2,0.07～5.6mg vitamin B6,0.07～0.17 μ g cobalamin, 2.25～83mg vitamin C, 0.75～60 μ g biotins, 0.16～6.7mg nicotinic acid, 0.15～5.04mg pantothenic acid, the mixture of 10～21.6 μ g folic acid.
4. according to any described a kind of nutrient formulation food that is applicable to tumor patient in the claim 1～3, it is characterized in that: described protein comprises the whole albumen of lactalbumin, casein, soybean protein, these four kinds of albumen of albumen or one or more mixtures in its hydrolysate.
5. a kind of nutrient formulation food that is applicable to tumor patient according to claim 4, it is characterized in that: described protein also comprises one or more mixtures in glutamic acid, glutamine, arginine, leucine, beta-hydroxy-Beta-methyl calcium butyrate, methionine, the valine; Described protein is non-equilibrium aminogram albumen.
6. a kind of nutrient formulation food that is applicable to tumor patient according to claim 4 is characterized in that: in the described carbohydrate mass fraction more than 50% for being the source with the resistant starch of slowly-releasing or the resistant dextrin of slowly-releasing.
7. a kind of nutrient formulation food that is applicable to tumor patient according to claim 6, it is characterized in that: described carbohydrate also comprises one or more mixtures in fructose, maltitol, the maltodextrin.
8. according to any described a kind of nutrient formulation food that is applicable to tumor patient in the claim 1～3, it is characterized in that: 50～70% mass fractions are medium chain fatty acid glyceride in the described fat, and described chain fatty acid glyceride source is two or more mixing in corn oil, sunflower oil, safflower oil, soybean oil, coconut oil, linseed oil, palm oil, palm-kernel oil, perilla herb oil, the fish oil.
9. according to any described a kind of nutrient formulation food that is applicable to tumor patient in the claim 1～3, it is characterized in that: described dietary fiber is made up of by mass ratio 1～36:6 soluble dietary fiber and insoluble diedairy fiber.
10. according to any described a kind of nutrient formulation food that is applicable to tumor patient in the claim 1～3, it is characterized in that: described nutrient formulation food is powdery, or adds water and be modulated into liquid.
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