CN105901703B

CN105901703B - Marine organism type enteral nutrition preparation for burn patients

Info

Publication number: CN105901703B
Application number: CN201610242367.3A
Authority: CN
Inventors: 李娓; 张静怡; 王婷; 刁小真; 李慧婷; 欧爱宁; 郭锐华; 包斌; 吴文惠
Original assignee: Shanghai Ocean University
Current assignee: Shanghai Water Technology Transfer Co ltd
Priority date: 2016-04-19
Filing date: 2016-04-19
Publication date: 2020-03-10
Anticipated expiration: 2036-04-19
Also published as: CN105901703A

Abstract

The invention discloses an enteral nutrition preparation for burn patients, which contains the following effective components of protein, fat, carbohydrate, compound vitamin, compound mineral, taurine, choline and the like, wherein the protein is provided in the form of nereis protein, lactalbumin, arginine and glutamine, the fat is provided in the form of nereis fat, α -linolenic acid and linoleic acid, and the carbohydrate is provided in the form of nereis polysaccharide, glucose, sucrose, maltodextrin, microcrystalline cellulose and corn starch.

Description

Marine organism type enteral nutrition preparation for burn patients

Technical Field

The invention belongs to the field of medicines, and particularly relates to a special medical application formula food added with silkworm excrement powder, which is particularly suitable for burn patients, and can be directly administered through a gastrointestinal internal pipeline or orally taken.

Background

Enteral Nutrition (EN) support, which helps to maintain the structural and functional integrity of the intestinal mucosa, is the main direction for the development of clinical support, and is the preferred route when patients require nutritional support and have full or partial gastrointestinal tract function.

Burn refers to thermally induced damage to the skin or other tissue. Patients with burns, especially large-area burns, are prone to develop malnutrition. On one hand, the whole body consumption is increased due to the reasons of high metabolic rate, vigorous decomposition, exudation of wound surface, skin cutting, skin grafting, infection, bleeding after operation and the like; on the other hand, the digestive dysfunction and the sharp appetite of the burn patient cause difficulty in both absorption and supplement of nutrients. Clinical observations indicate that the more severe the burn, the greater the likelihood of a nutritional disorder. Malnutrition can delay wound healing, reduce body resistance and easily cause infection, and seriously affect prognosis.

The burn patient often can cause the ultrahigh metabolism of the body due to the striking of the wound, thereby causing the serious complications of nutrient deficiency, such as the unhealed wound until the visceral multiple organ failure, and the like. Malnutrition can delay wound healing, reduce body resistance, easily cause infection and seriously affect prognosis, so that maintaining nutrition and reasonably treating diet are an important link in the whole body treatment of burn patients. Therefore, the monitoring of the nutrition condition of the burn patient is helpful for knowing the condition of the patient in time and improving the nutrition condition of the patient.

With the deep understanding of nutrition, the concept and content of nutrition support has been developed. The 20 th century and the 80 th century put forward the concepts of metabolic support and metabolic regulation, and the 90 th interdisciplines of nutrition and immunity, namely, nutrition pharmacology and immunonutrition, were in turn developed. The immunonutrition is based on the original standard nutritional formula (general nutrition required by adults) and is added with special nutrient substances to regulate the immune system, intervene and improve cellular immunity and humoral immunity. However, when immunosuppression is caused by stress, trauma, burns, and severe infections, the traditional nutritional support effect is very slight, and it is necessary to administer nutrient substances with the function of regulating and controlling immunity to improve the nutritional status of the organism and enhance the immune function of the organism. The nutrients with special immunological function and pharmacological action mainly include glutamine, arginine, omega-3 fatty acid, nucleotide, dietary fiber, vitamin A, C, E and growth factor. These nutrients can regulate the immune function of the body by regulating the immune defense mechanisms, inflammatory responses, intestinal barrier function, tissue oxygenation, nitrogen balance and ischemia reperfusion injury of the body.

Glutamine (Gln) is the most abundant free amino acid in the human body, accounting for 20% of the total amount of free amino acids in plasma. Gln can provide a nitrogen source for the synthesis of amino acid, protein and nucleic acid, can oxidize and release energy, and is an important energy substance of intestinal mucosa cells, macrophages and lymphocytes. Due to the limited ability of muscle cells to produce Gln, it is not amenable to body needs in a hypermetabolic state and plasma Gln concentrations decrease. If the glutamic acid is not supplemented in time after the burn, the insufficient supply and the reduced utilization capacity of Gln can cause the barrier function of the intestinal mucosa to be damaged, the immunity of the intestinal related lymphatic tissue to be reduced, and intestinal bacteria to be translocated. The literature indicates that Gln can effectively reduce damage of intestinal mucosa, promote the repair of the intestinal mucosa and enhance the barrier function of the intestinal tract.

Arginine is a conditionally essential amino acid that has previously only been used clinically as a nutritional ingredient. Previous studies reported that arginine promotes the release of synthetic hormones and improves nitrogen balance. With the progress of research, people recognize that arginine is not a common amino acid, can improve the immune function of the organism, promote protein synthesis, reduce catabolism and protect gastrointestinal mucosa, and is the key research object of the current nutripharmacology. Early animal experiments have described some effects of arginine on the immune system. In recent years, the research finds that the immune dysfunction of the body after burn is possibly related to the deficiency of arginine in the body. The arginine added into the nutrient substances after burn can effectively protect the organ tissues.

Omega-3 PUFA as competitive inhibitor of arachidonic acid metabolic pathway has inhibitory effect on abnormal activity of arachidonic acid metabolism after burn, and can increase intake of fish oil for burn animal, and omega-3 PUFA can improve function of lymphocyte.

Nereid protein belongs to a high-quality protein source, perinereis aibuhitensis is selected according to the formula, the content of various amino acids is detected, the types of the amino acids contained in the Nereis aibuhitensis are complete, and the rest 17 amino acid types except the tryptophan destroyed in the hydrolysis process are detected and contain all essential amino acids required by aquatic animals. Among all amino acids, glutamic acid is the highest, aspartic acid and alanine are the next lowest, and cysteine is the lowest. The aquatic animals require 10 essential amino acids of lysine, histidine, arginine, valine, methionine, threonine, phenylalanine, leucine, isoleucine and tryptophan. We have found in the research that the content of essential amino acids in human body of Nereid is up to 47.21% and the ratio of essential amino acids to non-essential amino acids is 89%, according to the mode of essential amino acids in human body in ideal protein proposed by FAO/WH0(1973), the amino acid composition of the protein with better quality is about 40% of essential amino acids/total amino acids and more than 60% of essential amino acids/non-essential amino acids, and the Nereis grubes amino acid composition selected by us meets the standard, so that Nereis aibuhitensis is a high-quality raw material with wide development prospect.

The whey protein is called protein king, is a protein extracted from milk, has the characteristics of high nutritional value, easy digestion and absorption, various active ingredients and the like, and is one of the accepted high-quality protein supplements for human bodies. The low-fat high-protein food is added into a special medical formula food for burn patients, and is matched with high-quality nereis protein to achieve the formula characteristics of low fat and high protein, so that the functions of improving the immunity after burn, enhancing the barrier function of intestinal tracts, increasing the synthesis of protein, promoting the healing of wound surfaces and the like are achieved.

The previous researches show that myocardial ischemia and anoxia damage exists in the early stage of burn, myocardial damage occurs in the early stage after serious burn, the damage can not only cause cardiac insufficiency, but also induce or aggravate shock to cause or aggravate ischemia and anoxia damage and inflammatory reaction of other tissues and organs of the whole body, and taurine has important significance for maintaining cardiovascular function, and the taurine has wide biological effects of balancing cellular osmotic pressure, regulating cellular calcium homeostasis, maintaining membrane stability, resisting lipid peroxidation, protecting vascular endothelium, inhibiting proliferation of arterial intimal smooth muscle cells, resisting fibrosis and the like. The cytoprotective effect is the main action basis of taurine in the aspects of resisting atherosclerosis, arrhythmia, myocardial ischemia-reperfusion injury and the like. Therefore, the taurine-added nutrient source can be guided to be taken by the patient in the early stage of burn to play a positive role in preventing and treating the occurrence and development of diseases.

Inositol is one of vitamin B group, is lipotropic vitamin like choline, plays an important role in supplying nutrition to brain cells like choline, and has the function of metabolizing fat and cholesterol. And has effects in reducing cholesterol, promoting healthy hair growth on burn, preventing alopecia, preventing eczema, promoting fat redistribution, and tranquilizing mind. In the absence of one, insufficient production of lecithin occurs. If both are in adequate supply, especially choline, it will accelerate the conversion of cholesterol to bile salts. If both are deficient, the fat and cholesterol in the blood will pool on the arterial vessel wall, posing a health threat. If the choline is deficient, the utilization of cholesterol by body tissues is reduced, the burning of fat is reduced, and the excretion of cholesterol along with excrement is reduced.

However, clinical nutrition prepared by terrestrial organisms has been widely used, but the production scale of clinical nutrition at home and abroad still cannot meet the requirements of clinical patients. The development of a novel special biological EN preparation becomes a brand new development direction of EN preparations in China. At present, in the research of EN preparations at home and abroad, main nutrient substances comprise proteins, saccharides, fat, vitamins, minerals and the like. The raw materials mainly comprise terrestrial animals and plants and extracts thereof. In recent years, due to frequent infectious diseases of livestock such as avian influenza, foot-and-mouth disease and the like, the traditional livestock food raw materials have great potential safety hazards, and in addition, the defects of low amino acid value, limited functional components and the like are overcome, so that the requirements of EN preparations are difficult to meet; the terrestrial plants have low amino acid content and single and unbalanced nutrient content, and cannot well meet the nutritional requirements of clinical patients. Therefore, the clam worm powder is specifically added on the basis of the whey protein to serve as another part of protein source.

In addition, the existing research foundation is only limited to the detection of nereistoxin, and no relevant literature describes how to remove the nereistoxin, so that a nereistoxin removing technology with strong simplicity and operability and low residue rate is researched. Based on the fact that NTX belongs to sulfur nitrogen toxin, the method has the characteristics of thermal instability and easiness in depolymerization, and nereistoxin is removed in the production process.

At present, a series of enteral nutrition formula foods such as 'an essence', 'energy full power', 'rui essence', 'lithopone', 'Liyangkang', 'Liheng full power', 'Jiaweizi' and the like exist in the market, but the enteral nutrition formula foods are generally suitable for patients with gastrointestinal tract function malnutrition or malabsorption, and are particularly suitable for burn patients in a few types.

Disclosure of Invention

The invention aims to overcome the defects of the prior art and provide an enteral nutrition preparation for burn patients. The invention specifically adjusts the composition and the proportion of the components according to the nutritional and metabolic requirements of the burn patients, develops the personalized enteral nutrition preparation for the burn patients, provides balanced nutrition for the patients and improves the life quality of the patients.

The purpose of the invention is realized by the following technical scheme:

the invention relates to application of clam worm powder in preparing an enteral nutrition preparation for burn patients, wherein the clam worm powder is one of sources of protein, fat and carbohydrate in the enteral nutrition preparation.

Preferably, the protein comprises nereis protein, lactalbumin, arginine and glutamine, the fat comprises nereis fat, α -linolenic acid and linoleic acid, and the carbohydrate comprises nereis polysaccharide, glucose, sucrose, maltodextrin, microcrystalline cellulose and corn starch.

The invention also relates to an enteral nutritional preparation for burn patients, comprising per 100g of enteral nutritional preparation the following components: 20-25 g of protein, 5-15 g of fat, 60-70 g of carbohydrate, 91-93 mg of choline, 17.3-17.5 mg of inositol and 42-44 mg of taurine. The balance is compound vitamin and mineral element with the mass ratio of 1: 15-1: 20; the silkworm powder is one of the sources of the protein, the fat and the carbohydrate.

Preferably, the α -linolenic acid has omega-3 and linoleic acid with omega-6 in the ratio of 1: 1.

Preferably, the carbohydrate comprises 1.5-2.5% of nereis polysaccharide, 15-25% of glucose, 20-25% of sucrose, 20-25% of maltodextrin, 10-20% of microcrystalline cellulose and 10-20% of corn starch.

Besides the clam worm powder, the vitamin complex also comprises the following components according to the vitamin indexes marked by GB 29922-2013: 1.5-2.5% of vitamin E, 85-95% of vitamin A, 5-6% of vitamin C, 0.0005-0.002% of vitamin D, 0. 10.008-0.012% of vitamin K, 10.2-0.25% of vitamin B, 20.2-0.25% of vitamin B, 60.2-0.25% of vitamin B, 120.0002-0.0004% of vitamin B, 0.4-0.6% of nicotinamide, 0.04-0.08% of folic acid, 0.6-0.8% of pantothenic acid and 0.01-0.03% of biotin.

Preferably, the mineral elements, besides the clam worm powder contained in the clam worm powder, should be added according to the mineral element index labeled in GB29922-2013, including: : 0.06-0.07% of zinc, 0.007-0.008% of copper, 4.5-5.5% of phosphorus, 1.5-2.5% of magnesium, 0.006-0.007% of manganese, 0.004-0.005% of selenium, 0.17-0.18% of iron, 10-11% of sodium, 14.5-15.5% of potassium, 40-50% of iodine, 15-16% of chlorine and 5.5-6.5% of calcium.

Preferably, the feed comprises 20-25 g of protein, 5-15 g of fat, 60-70 g of carbohydrate, 85-95 mg of choline, 15-25 mg of inositol, 40-50 mg of taurine, 160-170 mg of vitamin complex and 3-4 g of mineral.

Compared with the prior art, the invention has the following beneficial effects:

1) the product contains five nutrients required by human body, is rich in choline, inositol and taurine, and has balanced nutrition.

2) Glutamine and arginine are added into the formula food with special medical application as special nutrient substances, and the nutrient substances with the function of regulating and controlling immunity are added to achieve the functions of improving the nutrient condition of the organism and strengthening the immune function of the organism.

3) Omega-3 fatty acid (essential fatty acid) is added as competitive inhibitor of arachidonic acid metabolic pathway, and has inhibitory effect on abnormal activity of arachidonic acid metabolism after burn.

4) Nereid was used pioneering as one of the sources of protein, fat, carbohydrate. As a high-quality protein source, the enteral nutrition preparation is added into a special medical application formula food for burn patients, so that the utilization rate of ocean resources is widened, and the gastrointestinal nutrition support of the enteral nutrition preparation for the burn patients is improved.

5) The composition and the proportion of the three nutrients are regulated strictly according to the nutritional and metabolic requirements of the burn patients, the three nutrients are optimized to the optimal proportion, the pertinence is strong, and the effect is better.

6) The enteral nutrition preparation suitable for the burn patients takes the marine organism type food material as one of the sources of the total nutrition formula, the components have synergistic effect, so that comprehensive nutrition and sufficient energy are reasonably supplemented, the protein synthesis, the immune function improvement and the wound healing after injury are facilitated, the physiological reaction brought by surgical treatment is relieved, the treatment effect is improved, the organism immunity is improved, the recovery period of the burn patients is finally accelerated, the enteral nutrition preparation has very important social value, the preparation method is simple, and the enteral nutrition preparation is suitable for application of large-scale industrial production.

Detailed Description

For a better understanding of the invention, specific examples thereof are set forth below, but the invention is by no means limited to these examples.

Example 1

The embodiment relates to an enteral nutrition preparation for burn patients, and the specific formula is shown in the following table 2, wherein the protein contains 7.93g of clamworm protein, 10.37g of lactalbumin, 1.04g of arginine and 1.04g of glutamine, the fat contains 0.8g of clamworm fat, α -linolenic acid 3g and linoleic acid 3g, and the carbohydrate contains 1.41g of clamworm polysaccharide, 14.25g of glucose, 15.02g of sucrose, 15.97g of maltodextrin, 10.04g of microcrystalline cellulose and 10.04g of corn starch.

The preparation method comprises weighing the solid raw materials of Bombycis Mori powder, arginine, glutamine, lactalbumin, α -linolenic acid, linoleic acid, glucose, sucrose, maltodextrin, microcrystalline cellulose, corn starch, compound mineral substance, and compound vitamin at a certain proportion, mixing in a dry mixer for 1 hr, sieving to obtain particle size of about 200 μm, and packaging under aseptic condition.

TABLE 1

Example 2

The embodiment relates to an enteral nutrition preparation for burn patients, and the specific formula is shown in the following table 2, wherein the protein contains 9.73g of clamworm protein, 12.75g of lactalbumin, 1.25g of arginine and 1.25g of glutamine, the fat contains 1.42g of clamworm fat, 5.29g of α -linolenic acid and 5.29g of linoleic acid, and the carbohydrate contains 1.2g of clamworm polysaccharide, 12.84g of glucose, 13.5g of sucrose, 14.4g of maltodextrin, 9g of microcrystalline cellulose and 9g of corn starch.

TABLE 2

Example 3

The embodiment relates to an enteral nutrition preparation for burn patients, and the specific formula is shown in the following table 3, wherein the protein contains 8.56g of clam worm protein, 11.22g of lactalbumin, 1.1g of arginine and 1.1g of glutamine, the fat contains 0.826g of clam worm fat, 3.09g of α -linolenic acid and 3.09g of linoleic acid, and the carbohydrate contains 1.2g of clam worm polysaccharide, 12.84g of glucose, 13.5g of sucrose, 14.4g of maltodextrin, 9g of microcrystalline cellulose and 9g of corn starch.

TABLE 3

The components are combined in a specific ratio, are mutually synergistic, reasonably supplement comprehensive nutrition and sufficient energy, relieve physiological reaction brought by surgical treatment, improve treatment effect, improve organism immunity and finally accelerate the recovery period of a burn patient, and are specifically embodied in the following test experiments:

animal experiments:

1 materials and methods

1.1 scald model preparation and material drawing treatment: clean SD mice 72, weighing about 25g, male, were normally kept for one week. Before unhairing, each mouse is injected with 10% chloral hydrate into abdominal cavity for anesthesia (0.1mL/20g), the hair is cut by an elbow scissors (the skin is not hurt as much as possible), the mouse is moistened by water, barium sulfide depilatory (the preparation ratio is that barium sulfide 2 parts, talcum powder 2 parts and soap powder 1 part) and 4% sodium chloride are coated, the depilatory is scraped off slightly after a plurality of minutes, and the mouse is wiped clean by clean water. Because barium sulfide has a certain stimulation effect on skin, scald is performed on ld after depilation. Fasting was 12h each before and after injury.

Before scalding, 10% chloral hydrate was intraperitoneally injected into the abdominal cavity of the mouse for anesthesia (0.1mL/20g), the mouse was placed in a prone position, the four limbs were stretched, and the four limbs were fixed on an operation panel with an adhesive tape to make the back skin flat. At room temperature (20-24 ℃), a flat-bottom test tube with scales and a sealed end and an outer diameter of 3cm is erected on the back of a mouse, one end of the flat-bottom test tube is in close contact with the skin of the dorsal skin of the mouse (the contact pressure ensures that boiling water is at a 2mL position), the other end of the flat-bottom test tube is quickly injected into a plastic tube by a preheated injector (97-100 ℃) until the boiling water reaches the 2mL scale mark, and the bottom of the flat-bottom test tube is in continuous contact with the skin for 20 s. After scald, wipe out water stain with gauze, inject 1ml lactic acid ringer's solution in the abdominal cavity immediately to resist shock.

The scald area is circular, the diameter is 3cm, 8% of deep II-degree scald wound surfaces (Yang army, Liu Xiao a, preparation of a rat scald wound surface model and wound surface observation. Shanxi journal of medicine 2009,38(7): 795-. After shearing the skin on the back of the control group mice before injury, the operation steps are the same as those of the experimental group, and the boiling water is replaced by the distilled water at room temperature.

1.2 groups of experimental animals and enteral nutritional support: after 30min of scald, the scald liquid is randomly divided into 6 groups, 9 pieces in each group are placed in an environment with room temperature of 25 ℃ and humidity of 50%. The mice are divided into experimental groups 1 according to different feeding raw material proportions: high-dose nereis EN tablet group, experimental group 2: medium dose nereis EN tablet group, experimental group 3: low dose nereis EN tablet group, control group 1: whey protein source EN tablet group, control group 2: glutamine + arginine protein source EN tablet group, control group 3: control group (same operation is only carried out, but no scald is caused, and the control group is fed by common feed).

All samples of the nereis enteral nutrition preparation are pressed into tablets with the mass of about 0.8g and the thickness of 3-5mm by using a tablet press, and the same operation is carried out on other groups. The three groups of clam worm nutrition formulas are equal volume isothermal cards.

The nutrition intake of the experimental animal is calculated according to 732KJ/kg/d, the standard intake amount of the nereis EN tablet in the scheme is 1.4 g/day, and the calculated amount of 1/3 is given at the 1 st 24h after the animal is scalded; the 2 nd 24h gives a calculated amount of 2/3; the full dose is given daily from day 3 to day 21 of the termination day of the experiment (Zhang Jian et al. Experimental study of the three major nutrient ratios in post-burn enteral nutrition. China burn journal. 2009,38(7): 795-. Therefore, 1/3 on the first day, 2/3 on the second day, and 3/3 on the third day after scalding were administered to the EN tablets in experimental groups 1, 2, and control groups 1, 2. Control group 3 was fed the same volume of diet with the same calories. All mice were moved to a water-flushed cage for feeding, and sufficient deionized water was provided daily to keep their environment dry and clean.

The tablets were placed in wire mesh bags, and each group of mice was fed with the corresponding nutritional formulation and feed for 14 days, and experimental groups 1, 2, and 3 and control groups 1 and 2 were dosed with the corresponding EN tablets once every night at 9:00-11:00, with the mice freely eating and drinking water the rest of the time.

1.3 calculation of Scald area

The body surface area of the mouse is calculated according to the Rubner formula (Shinover 29495, medical animal experimental methodology [ M ]. Beijing: people and military medical publishers, 1980:146,247.) S (M2) is approximately equal to 0.1 multiplied by the body mass (kg)2/3, according to the experimental conditions, 8 percent of the body surface area is simulated to be scalded, and the mass of the mouse is calculated according to 25g, then the scalding area: s (cm2) × (25/1000)2/3 × 8% ≈ 0.0007m2 ≈ 7(cm 2).

2 measurement index

2,1 body weight, observation of scalded area

2.2 serum Total protein and Albumin detection

Taking blood, centrifuging to obtain supernatant, and sending to six hospitals.

The obtained blood can not be anticoagulated, and is placed in centrifuge tube or vessel capable of centrifuging, standing or placed in 37 deg.C environment to promote coagulation, after blood coagulation, balancing and centrifuging (generally 3000rpm, centrifuging for 10min) to obtain supernatant as serum, carefully sucking out supernatant (taking care not to suck out cell components), and subpackaging for use.

2.3 preparation of homogenate of scald wound surface tissue of mouse and determination of Vascular Endothelial Growth Factor (VEGF) content

10% chloral hydrate (350mg.kg-1) is used for abdominal injection anesthesia, about 100mg of wound surface whole layer skin tissue is taken, the crust is removed firstly for the person with crust, the blood stain is sucked by filter paper, the person is weighed and put into normal saline as soon as possible, and the homogenate is prepared by grinding lmL normal saline and 100mg-1 tissue. Centrifuging the specimen at 10000rpm below 4 ℃ for 15 minutes, and taking the supernatant to store below-20 ℃. The scald wound of the mouse is respectively at four time points of 24h, 48h, 7d and 14d after the scald, 3 mice are respectively taken from each group, and the detection specimen is determined by an ELISA method.

2.4 serum endotoxins

Blood is taken from the heart, centrifuged at 3500rpm for 15 minutes, and the supernatant is stored in a refrigerator at-20 ℃.3 mice were taken from each group 24h, 48h, 7d, 14d after scald, and the samples were assayed by limulus kit.

2.5 preparation of serum of scald mouse and detection of serum tumor necrosis factor-a (TNF-a) and interleukin-1 (IL-1) level

10% chloral hydrate (350mg.kg-1) was intraperitoneally injected to anesthetize mice, blood was collected from the heart, centrifuged at 3500rpm for 15 minutes, and the supernatant was stored in a low-temperature refrigerator at-80 ℃.3 mice are respectively taken from each group 24h, 48h, 7d and 14d after scald, an ELISA method is adopted to determine a sample, an OD value is measured at 492nm, and the TNF-a concentration is in direct proportion to the OD value.

2.6TNF-a assay

Measured by an ELISA kit.

2.7IL-1 assay

Measured by an ELISA kit.

3. Discussion of Experimental data and results

3.1 body weight

TABLE 4 weight change (g) before and after scald in mice

Note: the same letter in the same row indicates that no significant difference exists between different groups, P is more than or equal to 0.05, different letters indicate significant difference, and P is less than 0.05.

In the study, the body weight of the mice continuously decreases in PBD2 and 4 days, PBD 8, the high-dose group, the whey protein source group and the control group have no significant difference, and PBD 12 only has no significant difference between the high-dose group and the control group, which suggests that the enteral nutrition preparation added with the clamworm in the study has similar promotion effect on the body weight recovery of the mice after injury and the whey protein source group.

3.2.1 Total protein

TABLE 5 Total protein Change (g/L) after Scald mice

The total protein value of each group except the glutamine + arginine group after injury is higher than that of the control group, and the PBD2,7 and 14 of the high-dose group are obviously higher than that of the control group. (P <0.05)

2.2 Albumin

TABLE 6 Change of Albumin after scald mice (g/L)

The high dose group, the whey protein source group, was significantly higher in PBD7,14 than the control group. (P <0.05)

3IL-1

TABLE 7 Change in serum IL-1 (ng/L) in Scald mice

Mouse serum IL-1 from glutamine + arginine protein source group was significantly higher in PBD2,7,14 than control group after injury, and the high dose group was lower than control group at each time phase point, but there was no significant difference (P > 0.05).

4.TNF-α

TABLE 8 changes in serum TNF- α (ng/L) in scalded mice

Note: the same letter in the same row represents no significant difference between different groups, P is more than or equal to 0.05, different letters represent significant difference, and P is less than 0.05

The mouse serum TNF- α has obvious increase (p <0.05) in PBD1 compared with a control group before injury, values of each group are also continuously reduced after injury, and phase points of a high-dose group are obviously lower than those of a glutamine + arginine group (p <0.05) at each time phase point

5.ET

TABLE 9 Change in serum endotoxin (Eu/L) of scalded mice

In this study, ET in mice was significantly increased after injury compared to the control group, and the high dose group was not significantly different from the control group at the beginning of PBD 14.

6.VEGF

TABLE 10 Change in vascular endothelial growth factor (ng/L) in Scald mice

The experimental results show that: compared with glutamine and arginine, the high-dose whey protein source group in PBD7,14 can effectively increase the synthetic release of the VEGF (P is less than 0.05) of the scald wound surface, and the EN can induce the chemotaxis of vascular endothelial cells and stimulate the division and proliferation of the vascular endothelial cells by promoting the synthetic release of the VEGF of the scald wound surface and promote the healing of the wound surface.

In summary of all the above experimental results, we can see that the high dose group has similar nutritional support effect to the whey protein source group in some indexes and even better than the whey protein source group in individual indexes, so we have reason to prove that the enteral nutrition preparation for burn patients added to clamworm is effective for postoperative nutritional status recovery of burn patients.

The experimental nereis protein, nereis polysaccharide and nereis fat are added in the form of nereis powder and are not independently extracted and purchased.

Claims

1. An enteral nutrition preparation for burn patients is characterized in that every 100g of the enteral nutrition preparation comprises 20-25 g of protein, 5-15 g of fat, 60-70 g of carbohydrate, 91-93 mg of choline, 17.3-17.5 mg of inositol, 42-44 mg of taurine and the balance of composite vitamin and mineral elements in a mass ratio of 1: 15-1: 20, wherein the protein comprises nereis protein, lactalbumin, arginine and glutamine, the fat comprises nereis fat, α -linolenic acid and linoleic acid, and the carbohydrate comprises nereis polysaccharide, glucose, sucrose, maltodextrin, microcrystalline cellulose and corn starch;

the clam worm powder is one of sources of the protein, the fat and the carbohydrate, the protein is added with whey protein, arginine and glutamine besides the clam worm powder, the fat is added with α -linolenic acid and linoleic acid besides the clam worm powder, and the carbohydrate is added with glucose, sucrose, maltodextrin, microcrystalline cellulose and corn starch besides the clam worm powder.

2. Enteral nutritional preparation for burn patients according to claim 1, characterized in that the α -linolenic acid and linoleic acid are used in a ratio of 1: 1.

3. The enteral nutrition preparation for burn patients according to claim 1, wherein the carbohydrate comprises 1.5-2.5% of nereis polysaccharide, 15-25% of glucose, 20-25% of sucrose, 20-25% of maltodextrin, 10-20% of microcrystalline cellulose and 10-20% of corn starch.

4. An enteral nutritional preparation for burn patients according to claim 1, wherein the vitamin complex should be added according to the vitamin index as labeled in GB29922-2013, in addition to the nereis powder itself, including: 1.5-2.5% of vitamin E, 85-95% of vitamin A, 5-6% of vitamin C, 0.0005-0.002% of vitamin D and vitamin K₁0.008-0.012%, vitamin B₁0.2-0.25%, vitamin B₂0.2-0.25%, vitamin B₆0.2-0.25%, vitamin B₁₂0.0002-0.0004%, nicotinamide 0.4-0.6%, folic acid 0.04-0.08%, pantothenic acid 0.6-0.8%, and biotin 0.01-0.03%.

5. An enteral nutritional formulation for burn patients according to claim 1, wherein the mineral elements should be added in addition to the clam worm powder itself according to the mineral element index as labeled in GB29922-2013 including: 0.06-0.07% of zinc, 0.007-0.008% of copper, 4.5-5.5% of phosphorus, 1.5-2.5% of magnesium, 0.006-0.007% of manganese, 0.004-0.005% of selenium, 0.17-0.18% of iron, 10-11% of sodium, 14.5-15.5% of potassium, 40-50% of iodine, 15-16% of chlorine and 5.5-6.5% of calcium.