Vivatvakin B, Jongpipatvanich S, Harikul S, Eksaengri P, Lortholary O
Department of Pediatrics, Chulalongkorn University Hospital, Bangkok, Thailand.
Southeast Asian J Trop Med Public Health. 1992 Sep;23(3):414-9.
Dioctahedral smectite, a non systemic antidiarrheal agent, is mucoprotective and absorbs enterotoxins and rotavirus as demonstrated in animal models. Smectite has been successfully used in various countries in children and adults with acute diarrhea. This study was to assess the efficiency of smectite associated with rehydration in infants with acute secretory diarrhea. Sixty-two hospitalized Thai infants, aged 1-24 months, with acute secretory diarrhea were randomly divided into 2 groups receiving (1) oral rehydration solution (ORS) (30 cases), (2) ORS and Smectite (3.6 g/day) (32 cases). Both groups were comparable for age, weight, nutritional status and duration of symptoms before treatment. All 62 infants received lactose free formula and chicken rice soup as the standard diet. Stool frequency, weight change and duration of diarrhea were recorded. The mean duration of diarrhea was 84.7 +/- 48.5 hours in group 1, and 43.3 +/- 25.1 hours in group 2 (p = 0.005). The number of infants with diarrhea was significantly lower in group 2 on Day 1 (p < 0.01) and Day 3 (p = 0.001); furthermore 27% of infants in group 1 and 3% in group 2 had still diarrhea on Day 5. The stool frequency and weight changes were not statistically different in the two groups. No major side effects were observed except two cases of vomiting and hardened stools. It is concluded that (1) Smectite shortens the course of acute secretory diarrhea in Thai infants; (2) smectite may reduce the occurrence of prolonged diarrhea; furthermore (3) in our study dioctahedral smectite was found to be safe in children aged 1 to 24 months.
二八面体蒙脱石是一种非全身性止泻剂，具有黏膜保护作用，并能吸收肠毒素和轮状病毒，这已在动物模型中得到证实。蒙脱石已在各国成功用于治疗儿童和成人的急性腹泻。本研究旨在评估蒙脱石联合补液对急性分泌性腹泻婴儿的疗效。62名年龄在1至24个月的泰国住院急性分泌性腹泻婴儿被随机分为两组，分别接受：（1）口服补液盐（ORS）（30例），（2）ORS和蒙脱石（3.6克/天）（32例）。两组在年龄、体重、营养状况和治疗前症状持续时间方面具有可比性。所有62名婴儿均接受无乳糖配方奶粉和鸡肉米汤作为标准饮食。记录大便次数、体重变化和腹泻持续时间。第1组腹泻的平均持续时间为84.7±48.5小时，第2组为43.3±25.1小时（p = 0.005）。第2组在第1天（p < 0.01）和第3天（腹泻婴儿数量显著低于第1组（p = 0.001）；此外，第1组27%的婴儿和第2组3%的婴儿在第5天仍有腹泻。两组的大便次数和体重变化无统计学差异。除两例呕吐和大便干结外，未观察到重大副作用。结论为：（1）蒙脱石可缩短泰国婴儿急性分泌性腹泻的病程；（2）蒙脱石可能减少迁延性腹泻的发生；此外（3）在我们的研究中，发现二八面体蒙脱石对1至24个月的儿童是安全的。
