Duke Trevor
Centre for International Child Health, University of Melbourne, Royal Children's Hospital, Parkville, Victoria 3052, Australia.
P N G Med J. 2011 Mar-Jun;54(1-2):17-22.
Over the last 10 years more than 40 randomized trials of zinc sulphate in diarrhoea have been done in developing countries throughout the world. Almost all have shown a benefit of zinc therapy for 5-10 days, if given with oral rehydration solution, in reducing the severity and duration of severe diarrhoea and preventing diarrhoea in the subsequent 3 months. Zinc has also been proven to reduce mortality in the management of children with severe malnutrition. Two studies have shown a benefit of zinc treatment on the clinical resolution of pneumonia and another study from Africa showed that zinc adjuvant treatment led to a significant reduction in mortality from pneumonia. Despite this overwhelming evidence, few countries in the Asia-Pacific region have scaled up the use of zinc in the treatment or prevention of diarrhoea or other infections. The reasons for this are several, including obstacles to incorporating new treatments into routine drug procurement and distribution mechanisms, and failure to appreciate the steps involved in the promotion of new routine treatments. A much higher priority must be given to ensuring that children with malnutrition, diarrhoea and other infections have access to zinc and oral rehydration solution--both of which are low-cost and life-saving treatments.
在过去十年里，全球发展中国家针对硫酸锌治疗腹泻开展了40多项随机试验。几乎所有试验都表明，如果在口服补液盐的同时给予锌治疗5至10天，可减轻严重腹泻的严重程度和持续时间，并预防接下来3个月内的腹泻。锌还被证明可降低重度营养不良儿童治疗过程中的死亡率。两项研究表明锌治疗对肺炎的临床治愈有益，非洲的另一项研究表明锌辅助治疗可显著降低肺炎死亡率。尽管有这些压倒性的证据，但亚太地区很少有国家扩大锌在治疗或预防腹泻或其他感染方面的使用。原因有几个，包括将新治疗方法纳入常规药品采购和分发机制存在障碍，以及未能认识到推广新常规治疗方法所涉及的步骤。必须更加优先确保营养不良、腹泻和其他感染的儿童能够获得锌和口服补液盐，这两种都是低成本且能救命的治疗方法。
