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腹泻期去乳糖奶粉辅助治疗婴儿急性腹泻的疗效观察
Efficiency of lactose-free formula feeding as an adjunctive therapy in infants with acute diarrhea
目的：探讨腹泻期去乳糖配方奶粉对婴儿急性腹泻病的辅助治疗作用。方法：采用严格的双盲、随机、对照等效性试验。120例婴儿急性腹泻病例被随机分为二组：去乳糖奶粉喂养组（去乳糖组）和常规奶粉喂养组（常规组），每组60例。两组均给予常规药物和口服补液治疗。观察1周后两组的治疗效果。结果：去乳糖组腹泻的治愈率及总有效率分别为58.3%和96.7%；常规组治愈率及总有效率分别为8.3%和85.0%，两组疗效的差异有显著性意义（P<0.05）。去乳糖组腹泻缓解天数为（3.17±1.04）d，明显低于常规组的（5.25±1.58）d （P<0.05）。治疗后去乳糖组大便菌群紊乱发生率亦低于常规组（P<0.05）。两组均无明显的不良事件发生。结论：去乳糖奶粉联合腹泻常规治疗方案治疗婴儿腹泻病能明显缩短病程，提高治疗效果。［中国当代儿科杂志，2009，11（7）：532-536］
OBJECTIVE: To study the efficiency of lactose-free formula feeding as an adjunctive therapy in infants with acute diarrhea. METHODS: A rigorous double-blind, randomized, controlled equivalence trial was performed. One hundred and twenty infants with acute diarrhea were randomly divided into two groups: lactose-ree formula and conventional formula feeding. The two groups were given conventional medical treatment and oral rehydration therapy. The therapeutic effects were observed 1 week after treatment. RESULTS: The cure rate and the total effective rate were 58.3% and 96.7% respectively in the lactose-free formula group, and they were 8.3% and 85.0% respectively in the conventional formula group. There were significant differences in the therapeutic effect between the two groups (P<0.05). The duration of diarrhea remission (3.17±1.04 days) in the lactose-free formula group was significantly shorter than that in the conventional formula group (5.25±1.58 days) (P<0.05). After treatment the incidence of fecal flora disturbance was lower in the lactose-free formula group than that in the conventional formula group (P<0.05). No aderverse events were observed in the two groups. CONCLUSIONS: Lactose-free formula feeding together with conventional therapy can significantly shorten the disease course and improve the treatment outcome in infants with acute diarrhea.［Chin J Contemp Pediatr, 2009, 11 (7):532-536］
［1］Hutyra T, Iwańczak B. Determination of lactose intolerance frequency in children with food allergy［J］. Pol Merkur Lekarski, 2008, 25(148)：340-344.
［2］Kukuruzovic RH, Brewster DR. Milk formulas in acute gastroenteritis and malnutrition: a randomized trial［J］. J Paediatr Child Health, 2002, 38(6):571-577.
［3］方鹤松.小儿感染性腹泻病治疗中的关键问题［J］.现代实用医学, 2008, 2（20）：81-83.
［4］沈晓明，王卫平.儿科学［M］. 第7版.北京：人民卫生出版社，2008, 246.
［5］吴红梅，于莹.去乳糖奶粉配合常规疗法治疗婴幼儿病毒性腹泻45例疗效观察［J］.现代医药卫生, 2006, 22（8）：1131-1132.
［6］张秀荣，周殿元，徐智民，王文风，潘令嘉.肠道菌群粪便涂片检查图谱［M］．北京:人民军医出版社, 2000, 63-65.
［7］方鹤松,魏承毓,段恕诚,董宗祈,董永绥,胡皓夫. 腹泻病疗效判断标准的补充建议［J］. 中国实用儿科杂志, 1998, 13(6):384.
［8］Sungkapalee T, Puntukosit P, Eunsuwan O, Theamboonlers A, Chongsrisawat V, Poovorawan Y. Incidence and clinical manifestations of rotavirus infection among children with acute diarrhea admitted at Buri Ram Hospital, Thailand［J］. Southeast Asian J Trop Med Public Health, 2006, 37(6):1125-1131.
［9］赵聪敏，张雨平，温恩懿，廖伟，尹晓娟.儿童乳糖酶缺乏的临床评价［J］.第三军医大学学报, 2000, 6(22):594-596.
［10］Turck D. Prevention and treatment of acute diarrhea in infants［J］. Arch Pediatr, 2007, 14(11):1375-1378.
［11］Davidson GP, Goodwin D, Robb TA. Incidence and duration of lactose malabsorption in children hospitalized with acute enteritis: study in a wellnourished urban population［J］. J Pediatr, 1984, 105(4):587-590.
［12］Mao M, Yu T, Xiong Y, Wang Z, Liu H, Gotteland M, et al. Effect of a lactose-free milk formula supplemented with bifidobacteria and streptococci on the recovery from acute diarrhoea［J］. Asia, Pac J Clin Nutr, 2008, 17(1):30-34.
［13］金汉珍.婴儿乳糖不耐受症［J］.中国实用儿科杂志, 2000, 15(5):312.
［14］Maiuri L, Rossi M, Raia V, Garipoli V, Hughes LA, Swallow D, et al. Mosaic regulation of lactase in human adult-type hypolactasia［J］. Gastroenterology, 1994, 107(1):54-60.
［15］Simakachorn N, Tongpenyai Y, Tongtan O, Varavithya W. Randomized, double-blind clinical trial of a lactose-free and a lactose-containing formula in dietary management of acute childhood diarrhea［J］. J Med Assoc Thai, 2004, 87(6):641-649.
［16］赵显峰，潘丽莉，孟晶，王茵，荫士安.乳糖不耐受小学生饮奶方法的探讨［J］.中华预防医学杂志, 2007, 41(3):176-178.
［17］Sarma-Rupavtarm RB, Ge Z, Schauer DB, Fox JG, Polz MF. Spatial distribution and stability of the eight microbial species of the altered schaedler flora in the mouse gastrointestinal tract［J］. Appl Environ Microbiol, 2004, 70(5):2791-2800.
［18］董泮亮，范萍.肠道菌群失调与小儿腹泻的关系探讨［J］．潍坊医学院学报, 2008, 30（4）：361.
［19］李希诗，欧阳钦.微生态制剂在消化系统疾病中的作用［J］.四川医学，2003, 24(6)：639．
