An AHEI Dietary Intervention to Reduce Pain in Women with Endometriosis

项目摘要/摘要 子宫内膜异位症，一种以子宫内膜样组织在子宫外的存在为特征的疾病 在美国，大约10%的育龄妇女会受到子宫的影响。尽管流行，但其病因学 子宫内膜异位症尚未完全阐明。它产生了巨大的医疗费用，并极大地影响了 生命(QOL)。超过80%的患有子宫内膜异位症的女性报告慢性盆腔疼痛(CPP)，症状通常是 没有通过荷尔蒙抑制或手术而充分减弱的。因此，对其他证据的识别- 改善疼痛和生活质量的基于可修改的因素对于改善患有癌症的女性的生活至关重要 子宫内膜异位症。 这项研究的目标是评估为期12周的饮食干预对患有糖尿病的女性的影响。 经腹腔镜确诊的子宫内膜异位症患者，视觉模拟评分至少为7分(满分10分) 基准前一个月的规模(VAS)。干预措施将包括基于替代方案的饮食 2010年健康饮食指数(AHEI-2010)指南，因为观察性研究表明，遵守 AHEI-2010可降低遭受疼痛的女性在腹腔镜下诊断为子宫内膜异位症的风险 症状。拟议研究的具体目的是测试基于AHEI-2010指南的效果 饮食干预：1)VAS疼痛评分、疼痛灾害性评分和平均止痛片数量 每周服用；2)用子宫内膜异位症健康档案测量身体和精神生活质量的组成部分 (EHP-30)问卷和简式问卷(SF-12)；3)循环炎症标志物(IL-6、IL-6)水平。 1β、hs-CRP、sTNFR-1、sTNFR-2)。 经腹腔镜术确诊的子宫内膜异位症患者(n=100)将随机接受为期12周的饮食治疗。 干预组或对照组。干预组将把配料直接运往他们的 在干预的前4周回家。在剩下的8周里，用餐计划和食谱将是 如果是这样的话。疼痛、生活质量和炎症标记物将在基线、4周、8周和12周时使用 遵循世界子宫内膜异位症研究基金会(WERF)指南的有效问卷 子宫内膜异位症表型组和生物库协调项目(EPHect)。此外，更长期的影响 将通过检查6个月和1年的疼痛和生活质量结果来评估干预措施。 许多患有子宫内膜异位症的妇女由于慢性盆腔疼痛和其他身体原因，生活质量不佳 以及子宫内膜异位症的精神后遗症。因为激素往往不能充分减轻症状。 抑制或手术，识别其他以证据为基础的、可改变的因素，改善疼痛和 生活质量对改善子宫内膜异位症患者的生活至关重要。

PROJECT SUMMARY/ABSTRACT Endometriosis, a disorder characterized by the presence of endometrial-like tissue outside of the uterus, affects approximately 10% of reproductive age women in the US. Despite its prevalence, the etiology of endometriosis has not been fully delineated. It incurs significant health care costs and greatly impacts quality of life (QOL). Over 80% of women with endometriosis report chronic pelvic pain (CPP) and symptoms are often not sufficiently abated with hormonal suppression or surgery. Hence, the identification of other evidenced- based, modifiable factors, that improve pain and QOL are critical to improving the lives of women with endometriosis. The goal of this study is to evaluate the effects of a 12-week dietary intervention among women with laparoscopically-confirmed endometriosis who had a pain score of at least 7 out of 10 on the Visual Analog Scale (VAS) in the month prior to baseline. The intervention will consist of a diet based on the Alternative Health Eating Index-2010 (AHEI-2010) guidelines, as observational research suggests that adherence to the AHEI-2010 may decrease risk of laparoscopically-diagnosed endometriosis among women experiencing pain symptoms. The specific aims of the proposed study are to test the effect of the AHEI-2010 guideline-based dietary intervention on: 1) the VAS pain score, the pain catastrophizing scale, and mean number of pain pills taken per week; 2) physical and mental QOL components measured with the Endometriosis Health Profile (EHP-30) Questionnaire and Short Form Survey (SF-12); 3) circulating levels of inflammatory markers (IL-6, IL- 1β, hs-CRP, sTNFR-1, sTNFR-2). Women with laparoscopically-confirmed endometriosis (n=100) will be randomized to a 12-week dietary intervention or a control group. The intervention group will have meal ingredients shipped to directly to their home during the first 4 weeks of the intervention. For the remaining 8 weeks, meal plans and recipes will be provided. Pain, quality of life, and inflammatory markers will be assessed at baseline, 4, 8, and 12-weeks using validated questionnaires following the guidelines of the World Endometriosis Research Foundation (WERF) Endometriosis Phenome and Biobanking Harmonization Project (EPHect). In addition, longer-term effects of the intervention will be assessed by examining pain and QOL outcomes at 6 months and 1 year. Many women with endometriosis experience poor QOL due to chronic pelvic pain and other physical and mental sequelae of endometriosis. As symptoms are often not sufficiently abated with hormonal suppression or surgery, the identification of other evidenced-based, modifiable factors, that improve pain and QOL are critical to improving the lives of women with endometriosis.