Chen Chien-Chang, Walker W Allan
Chang Gung University and Chang Gung Children's Hospital, Taoyuan, Taiwan.
Adv Pediatr. 2005;52:77-113. doi: 10.1016/j.yapd.2005.03.001.
Parents of pediatric patients are seeking alternatives to conventional therapy in the prevention and treatment of gastrointestinal disease states because of therapeutic failures caused by the increased incidence of antibiotic resistance. One such alternative is the use of probiotics and prebiotics to stimulate health-promoting indigenous flora to affect pathogen colonization and expression of disease. Probiotics are live flora given in oral quantities that allow for colonization of the colon. Probiotics are given as functional foods or dietary supplements, and function to activate the mucosal immune system and prevent pathogen colonization and translocation by strengthening the mucosal barrier, interfering with pathogen colonization, and in some instances, producing secretory antibacterial substances. Prebiotics are nondigestible carbohydrates, principally oligosoccharides, that are fermented by colonic commensals, stimulating their proliferation and producing short-chain fatty acids. Both protective nutrients have been shown to reduce the incidence and severity of infantile diarrhea, particularly rotaviral gastroenteritis, prevent antibiotic-induced diarrhea, and prevent and treat intestinal food allergy. With additional multicenter clinical trial confirmations, these substances may become routine in the care of infants and young children.
由于抗生素耐药性增加导致治疗失败，儿科患者的家长正在寻求传统疗法之外的方法来预防和治疗胃肠道疾病。其中一种替代方法是使用益生菌和益生元来刺激促进健康的本土菌群，以影响病原体的定植和疾病的表现。益生菌是口服的活菌群，可在结肠定植。益生菌作为功能性食品或膳食补充剂服用，其功能是激活黏膜免疫系统，并通过加强黏膜屏障、干扰病原体定植以及在某些情况下产生分泌性抗菌物质来防止病原体定植和易位。益生元是不可消化的碳水化合物，主要是低聚糖，可被结肠共生菌发酵，刺激它们的增殖并产生短链脂肪酸。这两种保护性营养素都已被证明可降低婴儿腹泻（尤其是轮状病毒性肠胃炎）的发病率和严重程度，预防抗生素引起的腹泻，以及预防和治疗肠道食物过敏。随着更多多中心临床试验的证实，这些物质可能会成为婴幼儿护理中的常规用药。
