Touhami M, Boudraa G, Mary J Y, Soltana R, Desjeux J F
Service de Pédiatrie, Oran, Algérie.
Ann Pediatr (Paris). 1992 Feb;39(2):79-86.
Persistent diarrhea is an episode of diarrhea that begins acutely but lasts longer than expected for this usually self-limited disease. Treatment of this ill-defined syndrome is not well standardized but immediate intervention is required to minimize the risk of malnutrition with its various consequences. This randomized clinical trial was undertaken to evaluate the clinical efficacy of substituting yogurt for milk, as the only treatment. After a one to two-day observation period during which a standard milk diet was given, 78 children aged 3 to 36 months with confirmed persistent diarrhea of more than 15 days but less than one month duration and negative tests for fecal blood were fed either milk (infant formula) or yogurt (infant formula fermented with Lactobacillus bulgaricus and Streptococcus thermophilus). At inclusion both groups were comparable for age, nutritional status, diarrhea, and lactose hydrogen breath test results. Clinical treatment failure (weight loss greater than 5% in one day or persistent diarrhea after 5 days) was significantly less common in children fed yogurt (15 +/- 6%) than in children fed milk (45 +/- 8%). The beneficial effects of feeding yogurt were apparent within 48 hours in 67 +/- 8% of infants. In conclusion, these data confirm the clinical efficacy of substituting yogurt for milk in young children with persistent diarrhea. They also suggest that yogurt may be a good alternative for the initial treatment of persistent diarrhea.
持续性腹泻是一种急性起病但持续时间长于这种通常自限性疾病预期的腹泻发作。这种定义不明确的综合征的治疗尚未得到很好的标准化,但需要立即进行干预,以将营养不良及其各种后果的风险降至最低。本随机临床试验旨在评估用酸奶替代牛奶作为唯一治疗方法的临床疗效。在给予标准牛奶饮食的一到两天观察期后,78名3至36个月大、确诊为持续性腹泻超过15天但少于1个月且粪便潜血试验阴性的儿童,分别喂食牛奶(婴儿配方奶粉)或酸奶(用保加利亚乳杆菌和嗜热链球菌发酵的婴儿配方奶粉)。纳入时,两组在年龄、营养状况、腹泻情况和乳糖氢呼气试验结果方面具有可比性。喂食酸奶的儿童临床治疗失败(一天内体重减轻超过5%或5天后仍持续腹泻)的情况明显少于喂食牛奶的儿童(分别为15±6%和45±8%)。67±8%的婴儿在48小时内就显现出喂食酸奶的有益效果。总之,这些数据证实了用酸奶替代牛奶治疗持续性腹泻幼儿的临床疗效。它们还表明,酸奶可能是持续性腹泻初始治疗的良好替代选择。