Roggero P, Volpe C, Ceccatelli M P, Lambri A, Giuliani M G, Donattini T, Garavaglia M C, De Vincentiis A
Clinica Pediatrica I, Università degli Studi di Milano.
Minerva Pediatr. 1990 Apr;42(4):147-50.
Aspecific chronic diarrhea is one of the most common causes of protracted diarrhea in infancy. The pathology is characterised by an increased frequency of daily bowel movement with half-formed feces; it is not associated to malabsorption syndrome or enteric infections and appears to be correlated to an unbalanced diet and changes in microflora involved in the fermentation processes. A controlled randomised single-blind clinical trial was performed, using commercially available crystalline lactulose and lactic enzymes, in order to normalise the modified intestinal ecosystem. Twenty-four children (mean age 21.76 months) affected by aspecific chronic diarrhea were studied; weight and height parameters were not influenced. Patients were first divided by age and then randomly divided into two groups of 12. Group 1 received treatment with crystalline lactulose (Laevolac crystals, BBR) and Group 2 received lyophilised Lactipan. In both cases treatment continued for 15 days. At the end of the trial all subjects showed a complete remission of intestinal disorders. Children in Group 1 showed more fully formed feces following treatment. Fecal pH values were considerably reduced only in those subjects treated with crystalline lactulose. In the latter subjects H2 excretion diminished during the trial, a fact which may probably be attributed to reduced colic pH values. On the basis of these results, it is possible to conclude that both treatments proved efficacious. The re-establishment of a balanced intestinal ecosystem remains the choice treatment for subjects affected by aspecific chronic diarrhea.
特异性慢性腹泻是婴儿期迁延性腹泻最常见的病因之一。其病理特征为每日排便次数增加且粪便呈半成形；与吸收不良综合征或肠道感染无关，似乎与饮食不均衡以及参与发酵过程的微生物群变化有关。为使改变的肠道生态系统恢复正常，开展了一项对照随机单盲临床试验，使用市售的结晶乳果糖和乳酸酶。对24名受特异性慢性腹泻影响的儿童（平均年龄21.76个月）进行了研究；体重和身高参数未受影响。患者首先按年龄分组，然后随机分为两组，每组12人。第1组接受结晶乳果糖（乐腹康晶体，BBR）治疗，第2组接受冻干的拉克替醇治疗。两种情况的治疗均持续15天。试验结束时，所有受试者的肠道疾病均完全缓解。第1组儿童治疗后粪便成形更完全。仅在用结晶乳果糖治疗的受试者中粪便pH值显著降低。在后者中，试验期间H2排泄减少，这一事实可能归因于结肠pH值降低。基于这些结果，可以得出结论，两种治疗均证明有效。重建平衡的肠道生态系统仍然是受特异性慢性腹泻影响的受试者的首选治疗方法。
