Montalto M, Gallo A, Santoro L, D'Onofrio F, Curigliano V, Covino M, Cammarota G, Grieco A, Gasbarrini A, Gasbarrini G
Institute of Internal Medicine, Catholic University, Rome, Italy.
Aliment Pharmacol Ther. 2008 Oct 15;28(8):1003-12. doi: 10.1111/j.1365-2036.2008.03815.x. Epub 2008 Jul 24.
Despite the reported tolerance to a low dose of lactose, many lactose malabsorbers follow a rigorous lactose-free diet also avoiding lactose-containing drugs. Up to now, only a few case reports have described the onset of gastrointestinal symptoms in lactose malabsorbers following the ingestion of these drugs. It has been suggested that capsules/tablets contain no more than 400 mg of lactose.
To evaluate breath H(2) excretion and intolerance symptoms after ingestion of a capsule containing 400 mg of lactose or placebo through a randomized, cross-over, double-blind, controlled study.
Seventy-seven lactose maldigesters with intolerance underwent two H2 breath tests with both 400 mg of lactose and 400 mg of placebo. Gastrointestinal symptoms occurring in the 8 h following the ingestion of different substrates were evaluated by a visual-analogue scale.
Ingestion of 400 mg of lactose did not cause a significant difference in breath H2 excretion or in the severity of gastrointestinal symptoms compared to placebo.
In patients with lactase deficiency, drugs containing 400 mg of lactose or less can be used safely.
尽管有报道称对低剂量乳糖存在耐受性，但许多乳糖吸收不良者仍遵循严格的无乳糖饮食，也避免使用含乳糖的药物。到目前为止，只有少数病例报告描述了乳糖吸收不良者在摄入这些药物后出现胃肠道症状。有人建议胶囊/片剂中乳糖含量不超过400毫克。
通过一项随机、交叉、双盲、对照研究，评估摄入含400毫克乳糖的胶囊或安慰剂后呼气中氢气的排泄情况和不耐受症状。
77名有不耐受症状的乳糖消化不良者分别接受了含400毫克乳糖和400毫克安慰剂的两次氢气呼气试验。通过视觉模拟量表评估摄入不同底物后8小时内出现的胃肠道症状。
与安慰剂相比，摄入400毫克乳糖后呼气中氢气的排泄或胃肠道症状的严重程度没有显著差异。
对于乳糖酶缺乏的患者，可以安全使用含400毫克或更少乳糖的药物。
