Brown K H, Perez F, Gastañaduy A S
Instituto de Investigacion Nutricional, Lima, Peru.
J Pediatr Gastroenterol Nutr. 1991 Apr;12(3):340-50. doi: 10.1097/00005176-199104000-00010.
A randomized, double-masked clinical trial was completed to compare the effects of four dietary regimens for the nutritional management of 116 Peruvian children between 3 and 24 months of age with acute diarrhea. Diets consisted of a modified whole milk formula (group M), a lactose-hydrolyzed milk formula (HM), wheat noodles and whole milk (N-M), or wheat noodles and lactose-hydrolyzed whole milk (N-HM), all offered in amounts up to 55 kcal/kg body weight/day for the first 2 days of treatment and up to 110 kcal/kg/day for 4 days thereafter. The clinical characteristics of the patients in each group were similar initially. Treatment failure rates in the two milk groups combined (M = 14.3%, HM = 20.0%) were greater than in the two noodle-milk groups combined (N-M = 3.4%, N-HM = 3.4%), p = 0.03. The average stool outputs by children in both M groups (range 40-66 g/kg body weight per day on all study days) were consistently greater than those by children in both N-M groups (range 29-50 g/kg/day). The differences by dietary group were statistically significant on days 3 and 4 (p less than 0.04, analysis of variance). The estimated median durations of illness [and 95% confidence limits (CL)] in each milk group (M = 138 h, CL: 88-214; HM = 113 h, CL: 75-170) were significantly greater than in each noodle-milk group (N-M = 52 h, CL: 35-76; N-HM = 67 h, CL: 45-100), p less than 0.001-0.071. In this group of patients, noodle-milk mixtures produced fewer treatment failures, lower fecal outputs, and shorter durations of diarrhea than did milk alone, regardless of the lactose contents of the respective milks or mixed diets. Small differences in intestinal absorption and changes in body weight by dietary group that were identified were of minor clinical importance during the short duration of study. Thus, the noodle-milk diets employed during this study were safer than the milk diets for the dietary management of children with acute diarrhea.
一项随机双盲临床试验完成，旨在比较四种饮食方案对116名3至24个月大患有急性腹泻的秘鲁儿童营养管理的效果。饮食包括改良全脂奶粉（M组）、水解乳糖奶粉（HM组）、面条和全脂牛奶（N-M组）或面条和水解乳糖全脂牛奶（N-HM组），在治疗的前两天，所有饮食的摄入量均高达55千卡/千克体重/天，此后4天则高达110千卡/千克/天。每组患者的临床特征最初相似。两个牛奶组（M组为14.3%，HM组为20.0%）的治疗失败率高于两个面条 - 牛奶组（N-M组为3.4%，N-HM组为3.4%），p = 0.03。两个M组儿童的平均粪便排出量（在所有研究日中范围为40 - 66克/千克体重/天）始终高于两个N-M组儿童（范围为29 - 50克/千克/天）。饮食组之间的差异在第3天和第4天具有统计学意义（p小于0.04，方差分析）。每个牛奶组疾病的估计中位持续时间[及95%置信区间（CL）]（M组为138小时，CL：88 - 214；HM组为113小时，CL：75 - 170）显著长于每个面条 - 牛奶组（N-M组为52小时，CL：35 - 76；N-HM组为67小时，CL：45 - 100），p小于0.001 - 0.071。在这组患者中，无论各自牛奶或混合饮食中的乳糖含量如何，面条 - 牛奶混合物产生的治疗失败更少、粪便排出量更低且腹泻持续时间更短。在研究的短时间内，饮食组在肠道吸收和体重变化方面的小差异在临床上并不重要。因此，在本研究中采用的面条 - 牛奶饮食对于急性腹泻儿童的饮食管理比牛奶饮食更安全。
