结核病与糖尿病共病营养治疗专家共识

doi:10.19982/j.issn.1000-6621.20260187

中国防痨杂志 ›› 2026, Vol. 48 ›› Issue (7): 913-924.doi: 10.19982/j.issn.1000-6621.20260187

结核病与糖尿病共病营养治疗专家共识

中国防痨协会, 中国防痨协会营养专业分会, 湖南省防痨协会, 湖南省结核病防治所(湖南省胸科医院), 上海市肺科医院, 中南大学湘雅公共卫生学院

收稿日期:2026-04-02 出版日期:2026-07-10 发布日期:2026-07-02
通信作者: 张胜康,Email:1554705610@qq.com;陈薇,Email:niuangel@sina.com;任国峰,Email:renguofeng@csu.edu.cn;白丽琼,Email:liqiong99@126.com;成诗明,Email:smcheng@163.com
基金资助:
湖南省自然科学基金(2026JJ81959);国家卫生健康委能力建设和继续教育中心2025年度慢病管理研究课题(GWJJMB202510025043);中国防痨协会专项课题(CATA-TB20250704);湖南省卫健委2025年医学学科建设项目(结核病防控学科建设项目D-62);陈孝平科技发展基金会(CXPJJH123010-21)

Expert consensus on nutritional therapy for tuberculosis and diabetes mellitus comorbidity

Received:2026-04-02 Online:2026-07-10 Published:2026-07-02
Contact: Zhang Shengkang, Email: 1554705610@qq.com;Chen Wei, Email: niuangel@sina.com;Ren Guofeng, Email: renguofeng@csu.edu.cn;Bai Liqiong, Email: liqiong99@126.comCheng Shiming, Email: smcheng@163.com
Supported by:
Hunan Provincial Natural Science Foundation of China(2026JJ81959);2025 Chronic Disease Management Research Project of National Health Commission Capacity Building and Continuing Education Center(GWJJMB202510025043);Special Research Project of the Chinese Antituberculosis Association(CATA-TB20250704);Hunan Provincial Health Commission 2025 Medical Discipline Development Project(Control Discipline Development Project D-62);Chen Xiaoping Science and Technology Development Foundation(CXPJJH123010-21)

摘要/Abstract

摘要：

结核病与糖尿病是危害人类健康的两大公共卫生问题,其共病导致的营养问题也严重影响治疗效果。为规范我国结核病与糖尿病共病(tuberculosis-diabetes mellitus, TB-DM)患者的营养治疗实践,中国防痨协会联合多家单位组织多学科专家,基于国内外现有研究证据及临床实践经验,依据证据质量分级和推荐强度系统对证据质量与推荐强度进行综合评估,共同制定本共识。本文系统阐述了营养治疗的原则与目标、营养风险筛查与评估、膳食营养治疗、肠内及肠外营养治疗、营养治疗监测、药物对营养治疗的影响、合并症的营养治疗、特殊人群的营养治疗及健康教育等10个方面,共识形成了20条核心推荐意见,旨在为临床营养诊疗提供科学、规范、可操作的指导依据,通过优化营养治疗,有效改善患者血糖异常,提升抗结核治疗效果。

关键词: 结核, 糖尿病, 共病现象, 营养支持, 指南

Abstract:

Tuberculosis (TB) and diabetes mellitus (DM) are two major global diseases, and the comorbid nutritional problems seriously compromise treatment outcomes. To standardize the clinical practice of nutritional therapy for patients with TB-DM comorbidity in China, the Chinese Antituberculosis Association jointly collaborated with multiple institutions and assembled a multidisciplinary expert panel. Based on available domestic and international research evidence and clinical practice experience, the panel comprehensively evaluated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) System to formulate this consensus. This consensus systematically addresses 10 key components of nutritional therapy: principles and objectives, nutritional risk screening and assessment, dietary nutritional intervention, enteral and parenteral nutrition support, nutrition therapy monitoring, impacts of medications on nutritional management, nutritional intervention for comorbidities, nutritional care for special populations and health education. A total of 20 core recommendations have been established in this consensus. It aims to provide scientific, standardized and operational guidance for clinical nutritional diagnosis and management. By optimizing nutritional therapy, it can effectively improve glycemic abnormalities in patients and facilitate better anti-tuberculosis treatment outcomes.

Key words: Tuberculosis, Diabetes mellitus, Comorbidity, Nutritional support, Guidebooks

中图分类号:

R52
R587.1

中国防痨协会, 中国防痨协会营养专业分会, 湖南省防痨协会, 湖南省结核病防治所(湖南省胸科医院), 上海市肺科医院, 中南大学湘雅公共卫生学院. 结核病与糖尿病共病营养治疗专家共识[J]. 中国防痨杂志, 2026, 48(7): 913-924. doi: 10.19982/j.issn.1000-6621.20260187

Chinese Antituberculosis Association, Nutrition Branch of the Chinese Antituberculosis Association, Hunan Antituberculosis Association, Hunan Institute for Tuberculosis Control (Hunan Chest Hospital), Shanghai Pulmonary Hospital, Xiangya School of Public Health, Central South University. Expert consensus on nutritional therapy for tuberculosis and diabetes mellitus comorbidity[J]. Chinese Journal of Antituberculosis, 2026, 48(7): 913-924. doi: 10.19982/j.issn.1000-6621.20260187

图/表 2

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推荐强度	具体描述
强推荐(1级)	明确显示干预措施利大于弊
弱推荐(2级)	利弊不确定或无论质量高低的证据均显示利弊相当

证据级别	定义
高质量(A)	非常确信估计的效应值接近真实的效应值;进一步研究也不可能改变该估计效应值的可信度
中等质量(B)	对估计的效应值确信程度中等:估计值有可能接近真实值,但仍存在二者不相同的可能性;进一步研究有可能改变该估计效应值的可信度
低质量(C)	对估计的效应值的确信度有限:估计值与真实值可能大不相同;进一步研究极有可能改变该估计效应值的可信度
极低质量(D)	对估计的效应值几乎没有信心:估计值与真实值很可能完全不同;对效应值任何估计都很不确定

结核病与糖尿病共病营养治疗专家共识

Expert consensus on nutritional therapy for tuberculosis and diabetes mellitus comorbidity

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