Hossain M Shahadat, Salam Mohammad A, Rabbani Golam H, Kabir Iqbal, Biswas Rabi, Mahalanabis Dilip
Clinical Sciences Division, ICDDR,B: Centre for Health and Population Research, GPO Box 128, Dhaka 1000, Bangladesh.
J Health Popul Nutr. 2003 Dec;21(4):325-31.
This study examined the comparative efficacies of rice-based oral rehydration solution (R-ORS) and glucose-based oral rehydration solution (G-ORS) in the management of severe cholera due to Vibrio cholerae O139 Bengal that causes epidemic cholera in many developing countries. Stool culture-proved adult male patients with severe cholera due to V. cholerae O139 Bengal were randomly assigned in a 1:1 ratio to receive either R-ORS or G-ORS after their initial rehydration with intravenous (i.v.) fluid and subsequently four hours of observation. They also received the usual hospital diet and tetracycline capsules (500 mg 6 hourly for three days) immediately after their enrollment in the study. The primary outcomes for observation were stool output during the first 24 hours after intervention and treatment failure as measured by the incidence of re-institution of i.v. fluid after initiation of trial therapy and duration of diarrhoea. Of 113 patients finally included in the study, 57 received R-ORS and 56 G-ORS. The admission characteristics of the two treatment groups were comparable. No significant differences in the first 24 hours of median (inter-quartile range) stool output [179 (67-206) g/kg in R-ORS group vs 193 (80-237) g/kg in G-ORS group; p = 0.52], incidences of unscheduled i.v. fluid requirement [21% (12/57) in R-ORS group vs 25% (14/56) in G-ORS group; p = 0.78], and median (inter-quartile range) duration of diarrhoea [32 (24-48) hours in R-ORS group vs 32 (24-56) hours in G-ORS group; p = 0.64] were observed. It is concluded that rice-based ORS is effective but not superior to standard glucose-based ORS in the management of adult males with severe cholera due to V. cholerae O139 Bengal.
本研究探讨了以大米为基础的口服补液盐（R-ORS）和以葡萄糖为基础的口服补液盐（G-ORS）在治疗由霍乱弧菌O139孟加拉型引起的严重霍乱中的相对疗效，该型霍乱在许多发展中国家引发霍乱流行。经粪便培养证实因霍乱弧菌O139孟加拉型导致严重霍乱的成年男性患者，在通过静脉输液进行初始补液并随后观察4小时后，按1:1比例随机分配接受R-ORS或G-ORS治疗。他们在纳入研究后还立即接受常规医院饮食和四环素胶囊（500毫克，每6小时一次，共三天）。观察的主要结局指标为干预后首24小时的粪便排出量以及治疗失败情况，治疗失败通过试验治疗开始后重新静脉补液的发生率和腹泻持续时间来衡量。最终纳入研究的113例患者中，57例接受R-ORS治疗，56例接受G-ORS治疗。两个治疗组的入院特征具有可比性。在首24小时的中位数（四分位间距）粪便排出量方面[R-ORS组为179（67 - 206）克/千克，G-ORS组为193（80 - 237）克/千克；p = 0.52]、非计划静脉补液需求发生率[R-ORS组为21%（12/57），G-ORS组为25%（14/56）；p = 0.78]以及中位数（四分位间距）腹泻持续时间[R-ORS组为32（24 - 48）小时；G-ORS组为32（24 - 56）小时；p = 0.64]方面均未观察到显著差异。得出的结论是，在治疗因霍乱弧菌O139孟加拉型导致严重霍乱的成年男性患者时，以大米为基础 的口服补液盐有效，但并不优于标准的以葡萄糖为基础的口服补液盐。
