CN111602817A - Dietary composition for preventing and treating hepatic sarcopenia and preparation method thereof - Google Patents

Dietary composition for preventing and treating hepatic sarcopenia and preparation method thereof Download PDF

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Publication number
CN111602817A
CN111602817A CN202010423225.3A CN202010423225A CN111602817A CN 111602817 A CN111602817 A CN 111602817A CN 202010423225 A CN202010423225 A CN 202010423225A CN 111602817 A CN111602817 A CN 111602817A
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parts
vitamin
extract
powder
schisandra chinensis
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廖侠
贾庆安
卜阳
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First Affiliated Hospital of Medical College of Xian Jiaotong University
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First Affiliated Hospital of Medical College of Xian Jiaotong University
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    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
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    • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
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    • A23L33/105—Plant extracts, their artificial duplicates or their derivatives
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Abstract

The invention discloses a dietary composition for preventing and treating hepatic sarcopenia and a preparation method thereof, wherein the composition comprises the following components in parts by mass: 5-15 parts of lycium ruthenicum powder extract, 5-15 parts of schisandra chinensis powder extract, 2.5-5 parts of licorice extract powder, 10-30 parts of leucine, 5-7.5 parts of arginine, 1.5-2.25 parts of lysine, 5-10 parts of glutamine, 10-30 parts of maltodextrin, 5-10 parts of medium-chain triglyceride, 0.2-0.5 part of vitamin C, 0.01-0.02 part of vitamin E, 0.0024-0.0046 part of vitamin B, and 10-one of vitamin D66‑10*10‑6Portion, selenium 3 x 10‑5‑5*10‑50.008 to 0.015 portion of zinc and 0.1 to 0.3 portion of magnesium. The composition has liver protecting, antiinflammatory and antioxidant effects, and can be used for promoting muscle protein synthesis and improving sarcopenia.

Description

Dietary composition for preventing and treating hepatic sarcopenia and preparation method thereof
Technical Field
The invention belongs to the technical field of nutritional diet and drug research and development, and particularly relates to a dietary composition for preventing and treating hepatic sarcopenia and a preparation method thereof.
Background
Malnutrition is an important complication in patients with chronic liver disease. The literature reports an incidence of 65% to 90% (Caregaro L, Alberino F, Amodio P, et al. major in alcoholic and viral-related mutations [ J ]. The American Journal of Clinical Nutrition,1996,63(4):602-609. Kerwin A J. Nussbaum M. Adjuvant Nutrition Management of Patents with light facility, Including displacement [ J ]. protective Clinics of North America, 91(3): 2011 578). Protein-energy malnutrition was present in 81% of hospitalized cirrhosis patients. The incidence of malnutrition in Patients with Cirrhosis of the Child-Pugh grade A and B is 21% -40%, and the incidence of malnutrition in Patients with Cirrhosis of the C grade is 70% -90% (③ Meng Q H, Wang J H, Yu H W, et al, curing Energy expedition and substrate Metabolism in Chinese Patents with acid or Chronic Hepatitis B or liver circulation [ J ]. Internal Medicine,2010,49(19): 2085. quadrature 2091.). From 48% to 80.3% of patients with cirrhosis present with insufficient heat (Campilo B, Richardet J P, Scherman E, equivalent. evaluation of statistical positive in hospitalized pathological patients-Results of a proactive study [ J ] Nutrition,2003,19(6): 515) -521.). Patients with liver disease who are awaiting liver transplantation have a higher incidence of malnutrition (nutritional of Support Therapy in the additive Critical patent: Society of Clinical Care Medicine (SCCM) and American Society of scientific Industrial Nutrition (A.S.P.E.N.) [ J. JPEN J participant Industrial Nutr,2009,33(3): 277-316.). Malnutrition of liver cirrhosis is mainly manifested by a decrease in skeletal muscle mass and muscle weakness. Such patients are associated with higher fatality rates and decreased quality of life, particularly with muscle weakness prior to liver transplantation indicating poor clinical outcome after transplantation. Therefore, nutritional intervention is of great importance to chronic liver diseases, especially to correction of malnutrition caused by hepatic sarcopenia, and is of great significance to improve clinical outcome of patients with liver cirrhosis.
Sarcopenia is one of the major manifestations of malnutrition in patients with liver cirrhosis, but it has not yet been appreciated. The existing treatment strategies for improving the muscle quality of patients with liver cirrhosis comprise strengthening diet guidance, strengthening physical activities and exercises, treating primary diseases and the like. However, on one hand, patients often cannot obtain effective nutritional treatment due to insufficient attention paid to the nutritional status of patients with liver cirrhosis by clinical treatment; on the other hand, under the condition of the disease of the cirrhosis patients, especially the patients with the liver cirrhosis in the decompensation stage, the factors such as obviously reduced food intake, reduced motor function, poor treatment tolerance and the like cause the existing curative effect for preventing and treating the sarcopenia of the cirrhosis to be unsatisfactory. At present, no medicine combination which is homologous in medicine and food, is used as dietary supplement and has a therapeutic effect can improve liver functions, promote muscle protein synthesis, prevent muscle loss and prevent and treat hepatic sarcopenia.
Therefore, there is a need to provide a dietary composition for the prevention and treatment of hepatic sarcopenia.
Disclosure of Invention
In view of the above, the present invention provides a dietary composition for preventing and treating sarcopenia and a preparation method thereof, which are directed to the problems of poor pertinence, difficult execution, poor patient compliance and insignificant curative effect of the treatment measures for sarcopenia of patients with liver cirrhosis.
In order to solve the technical problems, the invention discloses a dietary composition for preventing and treating hepatic sarcopenia, which comprises the following components in parts by mass: 5-15 parts of lycium ruthenicum powder extract, 5-15 parts of schisandra chinensis powder extract, 2.5-5 parts of licorice extract powder, 10-30 parts of leucine, 5-7.5 parts of arginine, 1.5-2.25 parts of lysine, 5-10 parts of glutamine, 10-30 parts of maltodextrin, 5-10 parts of medium-chain triglyceride, 0.2-0.5 part of vitamin C, 0.01-0.02 part of vitamin E, 0.0024-0.0046 part of vitamin B, and 10-one of vitamin D66-10*10-6Portion, selenium 3 x 10-5-5*10-50.008 to 0.015 portion of zinc and 0.1 to 0.3 portion of magnesium.
Optionally, the vitamin E is alpha-tocopherol.
Optionally, the vitamin B comprises vitamin B1, vitamin B2, vitamin B6, and vitamin B12 in a mass ratio of 1:1:1: 0.017.
The invention also discloses a preparation method of the dietary composition for preventing and treating hepatic sarcopenia, which comprises the following steps:
step 1, preparing a lycium ruthenicum extract, a schisandra chinensis extract and a liquorice extract;
step (ii) of2. Weighing: weighing the following components in parts by mass: 5-15 parts of lycium ruthenicum powder extract, 5-15 parts of schisandra chinensis powder extract, 2.5-5 parts of licorice extract powder, 10-30 parts of leucine, 5-7.5 parts of arginine, 1.5-2.25 parts of lysine, 5-10 parts of glutamine, 10-30 parts of maltodextrin, 5-10 parts of medium-chain triglyceride, 0.2-0.5 part of vitamin C, 0.01-0.02 part of vitamin E, 0.0024-0.0046 part of vitamin B, and 10-one of vitamin D66-10*10-6Portion, selenium 3 x 10-5-5*10-50.008 to 0.015 part of zinc and 0.1 to 0.3 part of magnesium;
step 3, preparing a water phase: adding purified water into the weighed lycium ruthenicum extract, schisandra chinensis extract, liquorice extract, leucine, arginine, lysine, glutamine, maltodextrin, vitamin C, vitamin E, vitamin B, vitamin D, selenium, zinc and magnesium, and shearing at constant temperature to prepare a water-phase mixture;
step 4, oil phase preparation: uniformly stirring the weighed n-3 fatty acid under the constant temperature condition to prepare an oil phase mixture;
step 5, homogenizing and sterilizing: adding the prepared oil phase mixture into the water phase mixture, stirring uniformly under constant temperature and shearing conditions, adjusting the pH value to 6.5-7, and homogenizing for 1-4 times; sterilizing the homogenized mixture, cooling the suspension to below 30 deg.C, and transferring into a finished product tank;
step 6, filling and sterilizing: filling the suspension in the finished product tank into a glass bottle through a filling machine under the protection of inert gas and sealing the glass bottle; and (3) sterilizing the sealed glass bottle to prepare a suspension, namely the dietary composition for preventing and treating the hepatic sarcopenia.
Optionally, the preparing of the lycium ruthenicum extract, the schisandra chinensis extract and the licorice extract in the step 1 specifically comprises:
step 1.1, drying and crushing fresh lycium ruthenicum at 55 ℃ to prepare lycium ruthenicum powder, precisely weighing the lycium ruthenicum powder, adding 50% ethanol according to a ratio of 1:25(g/mL), carrying out reflux extraction at 70 ℃ for 3 times, carrying out reflux extraction for 2 hours/time, carrying out reduced pressure concentration, and carrying out freeze drying to obtain a lycium ruthenicum extract;
step 1.2, drying and crushing the schisandra chinensis at the temperature of 60 ℃ to prepare schisandra chinensis powder, precisely weighing the schisandra chinensis powder, adding 70% ethanol according to a ratio of 1:10(g/mL), carrying out reflux extraction at 80 ℃ for 3 times and 2 h/time, concentrating under reduced pressure, and carrying out freeze drying to obtain a schisandra chinensis extract;
step 1.3, crushing the dried liquorice to prepare liquorice powder, precisely weighing the liquorice powder, adding 60% ethanol according to a ratio of 1:20(g/mL), carrying out reflux extraction for 2 times and 1 h/time at 70 ℃, concentrating under reduced pressure, and carrying out freeze drying to obtain the schisandra extract.
Optionally, the temperature of the purified water in the step 3 is 25-50 ℃, the temperature of the constant temperature condition is 25-50 ℃, and the shearing rotation speed is 3000-.
Optionally, the temperature of the constant temperature condition in the step 4 is 30-70 ℃, and the stirring speed is 3000-8000 rpm/min.
Optionally, the temperature of the constant temperature condition in the step 5 is 25-50 ℃, the stirring speed is 3000-8000rpm/min, the homogenizing pressure is 40-65 Mpa, the sterilization temperature is 138-141 ℃, and the sterilization time is 3-10 s.
Optionally, the sterilization time in the step 6 is 3-30min, the sterilization temperature is 115-125 ℃, and the FO value is 12-18 min.
Compared with the prior art, the invention can obtain the following technical effects:
1) the invention realizes excellent effects of protecting liver, promoting muscle protein synthesis and preventing and treating liver sarcopenia. The leucine rich in the product is beneficial to protecting liver function and promoting the recovery and regeneration of damaged liver cells. The dietary supplementation of patients with leucine in higher proportion, in conjunction with arginine, lysine, glutamine, can reverse the decline of muscle mass and function in patients with cirrhosis. The total amino acid supply amount is not more than 50g/d, and mainly leucine, so that hepatic encephalopathy is not easily induced while maintaining positive nitrogen balance of patients. A plurality of medicinal and edible homologous substances (lycium ruthenicum mill, schisandra chinensis and liquorice) are applied to clinical liver cirrhosis patients, and have good effects of improving liver functions, promoting muscle protein synthesis and improving sarcopenia.
2) The products of the invention have a high compliance, i.e. palatability, which is of great importance for foods for specific medical uses. The taste of the product not only influences the effect of nutrition therapy, but also influences the market promotion of the product. The raw materials of the invention have strong bitter taste of leucine and arginine, and the glutamine has slightly sweet taste. The method is caused by the relative balance of free amino acids, the harmony of the taste of the lycium ruthenicum mill, the schisandra chinensis and the liquorice extract and the mutual synergy of various flavor developing substances.
3) The product of the invention has high patient compliance. The invention belongs to a non-total nutrient formula, improves the dosage of effective components such as leucine, vitamins and minerals, and has the advantage of better compliance compared with the traditional special liver disease enteral nutrient preparation which needs large dosage for multiple use. At present, no dietary supplement with liver protection and muscle enhancement effects for patients with liver cirrhosis exists in the market, and the huge market gap and the obvious curative effect of the product are both the guarantee of higher compliance of the patients. In addition, the dietary supplement is a suspension, is not limited by the environment, can be directly taken orally, and further ensures the convenience of use.
Of course, it is not necessary for any one product in which the invention is practiced to achieve all of the above-described technical effects simultaneously.
Detailed Description
The following embodiments are described in detail with reference to the accompanying drawings, so that how to implement the technical features of the present invention to solve the technical problems and achieve the technical effects can be fully understood and implemented.
The invention discloses a dietary composition for preventing and treating hepatic sarcopenia, which comprises the following components in parts by mass: 5-15 parts of lycium ruthenicum powder extract, 5-15 parts of schisandra chinensis powder extract, 2.5-5 parts of licorice extract powder, 10-30 parts of leucine, 5-7.5 parts of arginine, 1.5-2.25 parts of lysine, 5-10 parts of glutamine, 10-30 parts of maltodextrin, 5-10 parts of medium-chain triglyceride, 0.2-0.5 part of vitamin C, 0.01-0.02 part of vitamin E, 0.0024-0.0046 part of vitamin B, and 10-one of vitamin D6-6-10*10-6Portion, selenium 3 x 10-5-5*10-50.008 to 0.015 portion of zinc and 0.1 to 0.3 portion of magnesium.
Wherein the vitamin E is alpha-tocopherol.
The vitamin B comprises vitamin B1, vitamin B2, vitamin B6 and vitamin B12 in a mass ratio of 1:1:1: 0.017.
The formula of the invention has the effects of protecting liver, resisting inflammation and resisting oxidation, and the components synergistically promote muscle protein synthesis and improve sarcopenia.
The invention also discloses a preparation method of the dietary composition for preventing and treating hepatic sarcopenia, which comprises the following steps:
step 1, preparing extracts of lycium ruthenicum, schisandra chinensis and liquorice:
step 1.1, drying and crushing fresh lycium ruthenicum at 55 ℃, precisely weighing lycium ruthenicum powder, adding 50% ethanol according to a ratio of 1:25(g/mL), carrying out reflux extraction at 70 ℃ for 3 times and 2 h/time, concentrating under reduced pressure, and carrying out freeze drying to obtain a lycium ruthenicum extract;
step 1.2, drying and crushing the schisandra chinensis at 60 ℃, precisely weighing the schisandra chinensis powder, adding 70% ethanol according to a ratio of 1:10(g/mL), carrying out reflux extraction at 80 ℃ for 3 times and 2 h/time, carrying out reduced pressure concentration, and carrying out freeze drying to obtain a schisandra chinensis extract;
step 1.3, crushing the dried liquorice, precisely weighing the liquorice powder, adding 60% ethanol according to a ratio of 1:20(g/mL), carrying out reflux extraction at 70 ℃ for 2 times and 1 h/time, carrying out reduced pressure concentration, and carrying out freeze drying to obtain the schisandra extract.
Step 2, weighing: weighing the following components in parts by mass: 5-15 parts of lycium ruthenicum powder extract, 5-15 parts of schisandra chinensis powder extract, 2.5-5 parts of licorice extract powder, 20-30 parts of leucine, 5-7.5 parts of arginine, 1.5-2.25 parts of lysine, 5-10 parts of glutamine, 20-30 parts of maltodextrin, 1-2 parts of n-3 fatty acid, 0.2-0.5 part of vitamin C, 0.007-0.014 part of vitamin E, 0.0024-0.0046 part of vitamin B and 10 parts of vitamin D6-6-10*10-6Fraction, selenium 3 x 10-5-6*10-50.007-0.012 parts of zinc and 0.1-0.3 part of magnesium;
step 3, preparing a water phase: adding the weighed lycium ruthenicum mill, schisandra chinensis, licorice extract, leucine, arginine, lysine, glutamine, maltodextrin, vitamin C, vitamin E, vitamin B, vitamin D, selenium, zinc and magnesium into purified water at 25-50 ℃, and preparing a water phase mixture by using a shearing machine under the condition of constant temperature of the purified water at 25-50 ℃ and strong shearing speed of 3000 plus 8000 rpm/min;
step 4, oil phase preparation: uniformly stirring the weighed n-3 fatty acid at the constant temperature of 30-70 ℃ and the rotating speed of 300-800rpm/min to prepare an oil phase mixture;
step 5, homogenizing and sterilizing: adding the prepared oil phase mixture into the water phase mixture, uniformly stirring at the constant temperature of 25-50 ℃ and the strong shearing speed of 8000rpm/min by using a shearing machine 3000-; sterilizing the homogenized mixture at 138-141 ℃ for 3-10s, cooling the suspension to below 30 ℃ after sterilization, and then sending the suspension into a finished product tank;
step 6, filling and sterilizing: filling the suspension in the finished product tank into a glass bottle through a filling machine under the protection of inert gas and sealing the glass bottle; and (3) sterilizing the sealed glass bottle, and sterilizing the glass bottle at the temperature of 115-125 ℃ for 3-30min, wherein the FO value is 12-18min, thus obtaining the special medical dietary suspension for preventing and treating hepatic sarcopenia.
The dietary composition for preventing and treating hepatic sarcopenia prepared by the invention has reasonable nutrition component collocation and proper processing technology, can keep the product state, taste and uniform and stable nutrition components for a long time, and the produced product does not contain preservatives and synthetic sweeteners.
The lycium ruthenicum extract, the schisandra chinensis extract and the liquorice extract have the highest total phenol and flavone content under different concentrations in ethanol extracts, have the strongest scavenging capability on DPPH, ABTS + free radicals and iron ion reducing capability, and have higher antioxidant activity. And under the conditions of ethanol concentration and temperature extraction, the total phenol and flavone yield of the extract is highest.
The dietary nutrition suspension prepared by the invention is fully dispersed and dissolved uniformly by adding the mineral substances, then is uniformly stirred under the conditions of 3000 plus 8000rpm/min strong shearing speed by using the shearing machine, and the product is sterilized at the temperature of 115 plus 125 ℃ for 3-30min, so that protein precipitation can not occur in a longer quality guarantee period, and the stability is good. Example 1
A dietary composition for preventing and treating hepatic sarcopenia comprises the following components in parts by mass: 5g of lycium ruthenicum powder extract, 5g of schisandra chinensis powder extract, 2.5g of liquorice extract powder, 10g of leucine, 5g of arginine, 1.5g of lysine, 5g of glutamine, 10g of maltodextrin, 5g of medium-chain triglyceride, 200mg of vitamin C, 10mg of vitamin E (alpha-TE), 10mg of vitamin B (B10.8mg, B20.8mg, B60.8mg and B121.36ug), 6ug of vitamin D, 30ug of selenium, 8mg of zinc and 100mg of magnesium.
The preparation method of the dietary composition for preventing and treating hepatic sarcopenia comprises the following steps:
step 1, preparing extracts of lycium ruthenicum, schisandra chinensis and liquorice:
step 1.1, drying and crushing fresh lycium ruthenicum at 55 ℃, precisely weighing lycium ruthenicum powder, adding 50% ethanol according to a ratio of 1:25(g/mL), carrying out reflux extraction at 70 ℃ for 3 times and 2 h/time, concentrating under reduced pressure, and carrying out freeze drying to obtain a lycium ruthenicum extract;
step 1.2, drying and crushing the schisandra chinensis at 60 ℃, precisely weighing the schisandra chinensis powder, adding 70% ethanol according to a ratio of 1:10(g/mL), carrying out reflux extraction at 80 ℃ for 3 times and 2 h/time, carrying out reduced pressure concentration, and carrying out freeze drying to obtain a schisandra chinensis extract;
step 1.3, crushing the dried liquorice, precisely weighing the liquorice powder, adding 60% ethanol according to a ratio of 1:20(g/mL), carrying out reflux extraction at 70 ℃ for 2 times and 1 h/time, carrying out reduced pressure concentration, and carrying out freeze drying to obtain the schisandra extract.
Step 2, preparing a water phase: weighing water phase components according to the above dosage, wherein the water phase components comprise lycium ruthenicum, schisandra chinensis, licorice extract, leucine, arginine, lysine, glutamine, maltodextrin, vitamin C, vitamin E, vitamin B, vitamin D, selenium, zinc and magnesium, adding purified water at 25-50 ℃, and preparing a water phase mixture under the condition of constant temperature of the purified water at 25-50 ℃ and strong shearing at 3000 plus 8000 rpm/min;
step 3, oil phase preparation: weighing oil phase components according to the using amount, wherein the oil phase components comprise n-3 fatty acid, and uniformly stirring the oil phase components at the constant temperature of 30-70 ℃ at the rotating speed of 300-800rpm/min to prepare an oil phase mixture;
step 4, homogenizing and sterilizing: adding the prepared oil phase mixture into the water phase mixture, uniformly stirring under the conditions of constant temperature of 35 ℃ and strong shearing at 5500rpm/min, adjusting the pH value to 6.8, and homogenizing for 3 times under the pressure of 40-65 MpPa; sterilizing the homogenized mixture at 138-141 ℃ for 3-10s, cooling the suspension to below 30 ℃ after sterilization, and then sending the suspension into a finished product tank;
step 5, filling and post-sterilization: filling the suspension in the finished product tank into a glass bottle through a filling machine under the protection of inert gas and sealing the glass bottle; and (3) sterilizing the sealed glass bottle, and sterilizing at the temperature of 115-125 ℃ for 3-30min to obtain a suspension with the FO value of 12-18min, wherein the suspension is the dietary composition for preventing and treating hepatic sarcopenia.
Example 2
A dietary composition for preventing and treating hepatic sarcopenia comprises the following components in parts by mass: 10g of lycium ruthenicum powder extract, 10g of schisandra chinensis powder extract, 3.5g of liquorice extract powder, 15g of leucine, 6g of arginine, 2g of lysine, 8g of glutamine, 15g of maltodextrin, 8g of medium-chain triglyceride, 300mg of vitamin C, 15mg of vitamin E (alpha-TE), 15mg of vitamin B (B10.1mg, B20.1mg, B60.1mg and B121.7ug), 8ug of vitamin D, 40ug of selenium, 10mg of zinc and 200mg of magnesium.
The preparation method of the dietary composition for preventing and treating hepatic sarcopenia is the same as that of example 1.
Example 3
A dietary composition for preventing and treating hepatic sarcopenia comprises the following components in parts by mass: 15g of lycium ruthenicum powder extract, 15g of schisandra chinensis powder extract, 5g of liquorice extract powder, 30g of leucine, 7.5g of arginine, 2.25g of lysine, 10g of glutamine, 30g of maltodextrin, 10g of medium-chain triglyceride, 500mg of vitamin C, 20mg of vitamin E (alpha-TE), 20mg of vitamin B (B10.15mg, B20.15mg, B60.15mg and B122.5ug), 10ug of vitamin D, 50ug of selenium, 15mg of zinc and 300mg of magnesium.
The preparation method of the dietary composition for preventing and treating hepatic sarcopenia is the same as that of example 1.
Comparative example 1
A dietary composition for preventing and treating hepatic sarcopenia comprises leucine 30mg, arginine 7.5mg, lysine 2.25mg, glutamine 10g, maltodextrin 30g, medium chain triglyceride 10g, vitamin C500 mg, vitamin E (alpha-TE) 20mg, vitamin B (B10.15mg, B20.15mg, B60.15mg, B122.5ug) 4mg, vitamin D10ug, selenium 50ug, zinc 15mg, and magnesium 300 mg.
Comparative example 2
A dietary composition for preventing and treating hepatic sarcopenia comprises 15g of Lycium ruthenicum Murr powder extract, 15g of Schisandra chinensis powder extract, 5g of licorice extract powder, 7.5mg of arginine, 2.25mg of lysine, 10g of glutamine, 30g of maltodextrin, 10g of medium chain triglyceride, 500mg of vitamin C, 20mg of vitamin E (alpha-TE), 4mg of vitamin B (B10.15mg, B20.15mg, B60.15mg, B122.5ug), 10mg of vitamin D10ug, 50ug of selenium, 15mg of zinc and 300mg of magnesium.
The technical effects of the invention are illustrated below with reference to specific experimental data:
1. data and method
1.1 study subjects: 300 patients with liver cirrhosis in the decompensated stage who were hospitalized in my hospital from 2018 month 1 to 2019 month 1 were selected and divided into treatment groups 1 to 5 (50 cases each) and a control group (50 cases). The diagnosis standard is executed according to the diagnosis standard in the 2000 th edition ((viral hepatitis prevention and treatment scheme) and the 2003 th edition alcoholic liver disease diagnosis standard). the main exclusion standard comprises that the upper gastrointestinal hemorrhage is existed within 2 weeks before admission, the diabetes mellitus and blood sugar can not be controlled, the malignant tumor is merged, the hepatic encephalopathy clinical manifestation is existed, and the infection is clearly merged.
1.2 methods of treatment: (1) the four groups are treated by conventional liver protection and antiviral treatment; (2) nutritional support treatment: the treatment groups were given nutritional interventions according to table 1 on the basis of conventional therapy for 4 weeks without plasma and albumin. The control group was given a regular diet, and patients with plasma albumin (Alb) below 30g/L were given human Alb (10/Alb) L-2 weekly, and a 400ml infusion of fresh frozen plasma. Both groups were followed for 4 weeks.
TABLE 1 treatment group nutritional treatment regimen
Figure BDA0002497736330000091
1.3 observation indexes: recording human body measurement parameters such as Triceps Skin Fold (TSF), Body Mass Index (BMI), upper arm circumference (mid-arm circumference, MAC) and grip strength at the time of group baseline and at the time of 4 weeks of nutritional intervention (1); measurement of body weight, limb muscle mass (ASM), etc. was performed using InBody 720; (2) albumin (Albumin, ALB), Prealbumin (PA), nitrogen balance (g/d) ═ uptake of nitrogen (g/d) - (24h urea nitrogen +4g)), Cholinesterase (CHE), transaminase, and bilirubin levels; (3) the subjective symptoms of anorexia, asthenia, abdominal distention, nausea were recorded.
1.4 statistical methods: statistical analysis was performed using SPSS 24.0 software, and the mean. + -. standard deviation was used for data measurement
Figure BDA0002497736330000101
Showing that the mean comparison of a plurality of samples adopts variance analysis of repeated measures, and the comparison of the rate adopts chi2Inspection, P<A difference of 0.05 is statistically significant.
2. Results
As can be seen from table 2, after the conventional clinical treatment combined with 4 weeks of nutritional treatment, BMI, TSF, MAC, grip strength, ASM were all increased compared to before treatment in treatment groups 1-5, with statistical differences (P < 0.05); the above-mentioned anthropometric parameters were significantly increased in the treatment groups 2-4 after treatment compared to the control group, and the difference was statistically significant compared to the control group, and the effect of increasing the above-mentioned parameters was more prominent in the treatment group 3.
TABLE 2 measurement of parameters of the human body before and after treatment of each group
Figure BDA0002497736330000102
Figure BDA0002497736330000103
Figure BDA0002497736330000111
P <0.05 compared to before treatment; compared with the control group, # P <0.05
As can be seen from table 3, after the conventional clinical treatment combined with the 4-week nutritional treatment, ALB, PA, nitrogen balance ALT, TBil, CHE were all improved in the treatment groups 1-5 and the control group compared to those before treatment, and the difference was statistically significant (P < 0.05); the ALB and PA contents in the treatment groups 2-4 are obviously increased compared with the control group after treatment, the difference has statistical significance (P is less than 0.05), and the effect of the treatment group 3 on improving the biochemical indexes is more prominent.
TABLE 3 comparison of biochemical indices of hepatic function and nitrogen balance before and after treatment of each group
Figure BDA0002497736330000112
Figure BDA0002497736330000113
P <0.05 compared to before treatment; compared with the control group, # P <0.05
As can be seen from Table 4, the differences between the treatment groups 1-5 after conventional clinical treatment combined with 4 weeks of nutritional treatment, such as anorexia, abdominal distension, asthenia and nausea, are statistically significant (P < 0.01); the effect of the treatment group 3 on the amelioration of the above symptoms was more prominent.
TABLE 4 post-treatment clinical symptoms and signs improvement (n/(%))
Figure BDA0002497736330000114
Figure BDA0002497736330000121
P <0.01 (multiple comparisons of multiple sample rates, corrected test level α ═ 0.01) compared to control group
Leucine, isoleucine and valine are all Branched Chain Amino Acids (BCAAs), and a low ratio of BCAAs to Aromatic Amino Acids (AAA) in plasma is considered as a physiological marker of liver cirrhosis. Clinical observations during the design of the present invention have shown that leucine exhibits a concentration-dependent effect on muscle maintenance and enhancement. Administration of 10-15g of leucine per day to treatment groups 1 and 2 prevented a decline in muscle leucine, while administration of 30g of leucine per day to treatment group 3 significantly increased the leucine levels, as well as the patient's Body Mass Index (BMI), triceps skinfold Thickness (TSF), upper arm circumference (MAC), grip strength, and limb musculature (ASM) all increased compared to prior treatment. Comparative example 2 the above human body test and correction of nitrogen balance was not significantly effective after leucine removal. Lysine belongs to one of essential amino acids of human body. Patients with cirrhosis often have an inadequate intake of lysine due to a cereal diet or due to food intake restrictions. Since muscle protein is rich in lysine, any stimulation beyond the maintenance of muscle growth requires the addition of a certain amount of lysine to the diet. Glutamine is an important transport carrier of nitrogen and carbon in the body, provides a nitrogen source for the synthesis of other amino acids and proteins, can increase the volume of muscle cells, and inhibits the decomposition of proteins. Meanwhile, the oxidation resistance of the organism is improved. The glutamine can be supplemented, so that the oxidation resistance of the organism can be improved, the cell membrane and protein structure can be stabilized, and the functions of liver and immune cells can be protected by keeping and increasing the glutathione reserve in tissue cells. The treatment group 3 of the invention applies leucine with higher dose, which is supplemented with arginine, lysine and glutamine, to patients with liver cirrhosis in decompensation period, and serum Albumin (ALB) and Prealbumin (PA) of the treatment group are obviously improved compared with those before treatment, and the treatment group 1 and the treatment group 2 have obvious curative effect, effectively improve negative nitrogen balance, correct amino acid imbalance, synergistically promote protein synthesis and improve the negative nitrogen balance of the patients.
The dietary supplementation of patients with leucine in higher proportion, in conjunction with arginine, lysine, glutamine, can reverse the decline of muscle mass and function in patients with cirrhosis. However, since excessive protein supplementation is likely to induce hepatic encephalopathy, particularly in patients with liver cirrhosis with poor nutritional status, the total amino acid supply amount of the present invention is not more than 50g/d, and leucine is mainly used, so that the present invention does not easily induce hepatic encephalopathy while maintaining the normal nitrogen balance of the patients.
Carbohydrates have a sheltering effect on proteins and promote the utilization of amino acids, and the supplementation of carbohydrates can increase liver glycogen stores, is very important for maintaining the activity of liver microsomal enzymes and enhancing the resistance of liver cells to poisons. When the patient has anorexia, the maltodextrin is taken in a proper amount, so that the energy can be supplied, the protein can be stored, and the muscle reduction of the patient with liver cirrhosis can be favorably reversed. Therefore, the invention is applied to clinical liver cirrhosis patients, not only improves the nutritional status, obviously improves the ALB and PA levels compared with the levels before treatment, but also obviously improves the subjective symptoms of anorexia, hypodynamia, abdominal distension, nausea and the like. The Medium Chain Triglyceride (MCT) has the characteristics of small molecular weight and high solubility, does not pass through a lymphatic system, directly enters the liver through a portal vein, and has a rapid oxidation function. However, MCT is easily and rapidly digested, and high osmotic pressure is formed in the lumen of small intestine, so that large amount of MCT can cause gastrointestinal discomfort symptoms such as diarrhea, vomiting, abdominal distension and the like. The treatment groups 1-3 of the invention administer MCT5-10 g/day to patients with liver cirrhosis, improve the nutritional status of patients, promote protein synthesis, and do not increase gastrointestinal discomfort.
Muscle loss in patients with cirrhosis is due to reduced stimulation of muscle protein synthesis by nutrients, resulting in a diminished anabolic effect on dietary intake, known as muscle anabolic resistance. In addition, oxidative stress and/or low grade inflammation is associated with weakness caused by liver cirrhosis sarcopenia, resulting in anabolic resistance. In order to prepare a safe, efficient and pure natural antioxidant by utilizing lycium ruthenicum, liquorice and schisandra chinensis, the invention tries to obtain extracts under different conditions, and finds that the total phenol content and the flavone content of the extracts are highest under the conditions of solvent concentration, temperature and the like, the scavenging capacity of DPPH, ABTS + free radicals and the iron ion reducing capacity are strongest, and the extracts have higher antioxidant activity. The total phenol and flavone yield of the extract is highest, and the extract and amino acid in the formula cooperate to promote muscle protein synthesis and improve muscle reduction. In comparative example 1, after the extracts of lycium ruthenicum mill, liquorice and schisandra chinensis are removed, the human body measurement parameters, various biochemical indexes of liver function and the improvement condition of nitrogen balance are weakened compared with those of treatment groups 1-3.
Vitamin deficiency is very common in patients with liver cirrhosis. Vitamin B has the functions of protecting liver cells and preventing fatty liver, and meanwhile, the B vitamins are beneficial to quickly clearing lactic acid (the B vitamins are necessary in the metabolic process of the lactic acid), so that the sour feeling of muscles is reduced. Daily supplementation with sufficient vitamin C and vitamin E helps to reduce damage to hepatocytes. In addition, as antioxidant vitamins, vitamin C and vitamin E can also inhibit anabolic resistance of muscle proteins. The serum selenium level of chronic liver disease patients is reduced by about 30 percent. The supplement of zinc and selenium can improve the metabolism of amino acids of patients with liver cirrhosis, thereby improving hepatic encephalopathy.
While the foregoing description shows and describes several preferred embodiments of the invention, it is to be understood, as noted above, that the invention is not limited to the forms disclosed herein, but is not to be construed as excluding other embodiments and is capable of use in various other combinations, modifications, and environments and is capable of changes within the scope of the inventive concept as expressed herein, commensurate with the above teachings, or the skill or knowledge of the relevant art. And that modifications and variations may be effected by those skilled in the art without departing from the spirit and scope of the invention as defined by the appended claims.

Claims (9)

1. A dietary composition for preventing and treating hepatic sarcopenia is characterized by comprising the following components in parts by mass: 5-15 parts of lycium ruthenicum powder extract, 5-15 parts of schisandra chinensis powder extract, 2.5-5 parts of licorice extract powder, 10-30 parts of leucine, 5-7.5 parts of arginine, 1.5-2.25 parts of lysine, 5-10 parts of glutamine, 10-30 parts of maltodextrin, 5-10 parts of medium-chain triglyceride, 0.2-0.5 part of vitamin C, 0.01-0.02 part of vitamin E, 0.0024-0.0046 part of vitamin B, and 10-one of vitamin D66-10*10-6Portion, selenium 3 x 10-5-5*10-50.008 to 0.015 portion of zinc and 0.1 to 0.3 portion of magnesium.
2. The dietary composition for preventing sarcopenia according to claim 1, wherein the vitamin E is alpha-tocopherol.
3. The dietary composition for preventing sarcopenia as claimed in claim 1, wherein the vitamin B comprises vitamin B1, vitamin B2, vitamin B6 and vitamin B12 in a mass ratio of 1:1:1: 0.017.
4. A method for preparing a dietary composition for the prevention and treatment of hepatic sarcopenia, comprising the steps of:
step 1, preparing a lycium ruthenicum extract, a schisandra chinensis extract and a liquorice extract;
step 2, weighing: weighing the following components in parts by mass: 5-15 parts of lycium ruthenicum powder extract, 5-15 parts of schisandra chinensis powder extract, 2.5-5 parts of licorice extract powder, 10-30 parts of leucine, 5-7.5 parts of arginine, 1.5-2.25 parts of lysine, 5-10 parts of glutamine, 10-30 parts of maltodextrin, 5-10 parts of medium-chain triglyceride, 0.2-0.5 part of vitamin C, 0.01-0.02 part of vitamin E, 0.0024-0.0046 part of vitamin B, and 10-one of vitamin D66-10*10-6Portion, selenium 3 x 10-5-5*10-50.008 to 0.015 part of zinc and 0.1 to 0.3 part of magnesium;
step 3, preparing a water phase: adding purified water into the weighed lycium ruthenicum extract, schisandra chinensis extract, liquorice extract, leucine, arginine, lysine, glutamine, maltodextrin, vitamin C, vitamin E, vitamin B, vitamin D, selenium, zinc and magnesium, and shearing at constant temperature to prepare a water-phase mixture;
step 4, oil phase preparation: uniformly stirring the weighed n-3 fatty acid under the constant temperature condition to prepare an oil phase mixture;
step 5, homogenizing and sterilizing: adding the prepared oil phase mixture into the water phase mixture, stirring uniformly under constant temperature and shearing conditions, adjusting the pH value to 6.5-7, and homogenizing for 1-4 times; sterilizing the homogenized mixture, cooling the suspension to below 30 deg.C, and transferring into a finished product tank;
step 6, filling and sterilizing: filling the suspension in the finished product tank into a glass bottle through a filling machine under the protection of inert gas and sealing the glass bottle; and (3) sterilizing the sealed glass bottle to prepare a suspension, namely the dietary composition for preventing and treating the hepatic sarcopenia.
5. The preparation method according to claim 4, wherein the Lycium ruthenicum extract, the Schisandra chinensis extract and the licorice extract prepared in the step 1 are specifically:
step 1.1, drying and crushing fresh lycium ruthenicum at 55 ℃ to prepare lycium ruthenicum powder, precisely weighing the lycium ruthenicum powder, adding 50% ethanol according to a ratio of 1:25(g/mL), carrying out reflux extraction at 70 ℃ for 3 times, carrying out reflux extraction for 2 hours/time, carrying out reduced pressure concentration, and carrying out freeze drying to obtain a lycium ruthenicum extract;
step 1.2, drying and crushing the schisandra chinensis at the temperature of 60 ℃ to prepare schisandra chinensis powder, precisely weighing the schisandra chinensis powder, adding 70% ethanol according to a ratio of 1:10(g/mL), carrying out reflux extraction at 80 ℃ for 3 times and 2 h/time, concentrating under reduced pressure, and carrying out freeze drying to obtain a schisandra chinensis extract;
step 1.3, crushing the dried liquorice to prepare liquorice powder, precisely weighing the liquorice powder, adding 60% ethanol according to a ratio of 1:20(g/mL), carrying out reflux extraction for 2 times and 1 h/time at 70 ℃, concentrating under reduced pressure, and carrying out freeze drying to obtain the schisandra extract.
6. The method according to claim 4, wherein the temperature of the purified water in step 3 is 25-50 ℃, the temperature of the constant temperature condition is 25-50 ℃, and the shear rotation speed is 3000-8000 rpm/min.
7. The method as claimed in claim 4, wherein the temperature of the constant temperature condition in step 4 is 30-70 ℃, and the stirring speed is 3000-8000 rpm/min.
8. The method as claimed in claim 4, wherein the temperature of the constant temperature condition in step 5 is 25-50 ℃, the stirring speed is 3000-8000rpm/min, the homogeneous pressure is 40-65 MPa, the sterilization temperature is 138-141 ℃, and the sterilization time is 3-10 s.
9. The method as claimed in claim 4, wherein the sterilization time in step 6 is 3-30min, the sterilization temperature is 115-125 ℃, and the FO value is 12-18 min.
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