Mehta Sudhir, Khandelwal P D, Jain Vikramraj K, Sihag Manoj
Department of Medicine, SMS Medical College and Hospital, Jaipur, Rajasthan.
J Assoc Physicians India. 2012 Nov;60:12-5.
To assess the efficacy of single dose of octreotide and compare it with another antisecretory agent racecadotril in the management of acute infective diarrhea.
A randomized control study was done in the Department of Medicine and Infectious Disease Hospital (Department of Preventive and Social Medicine) of SMS Medical College and Hospital. 150 patients with moderate to severe acute diarrheal illness needing hospitalization were randomly allotted into 3 categories of 50 patients each. The control group received only fluids and antibiotics, the racecadotril group received fluid, antibiotics and oral racecadotril at dose of 1.5 mg/kg three times a day and the octreotide group received octreotide (100 microgram stat) along with fluid and antibiotics. The following end points of the study were compared, namely- frequency, quantity and consistency of stools and fluid requirement per day.
The mean (+/- SE) frequency of stools was significantly less (p < 0.001) from day 2 onwards in the octreotide group compared to the control and racecadotril group. Diarrhea stopped in half of the patients in the octreotide group by day 3. The consistency of stools changed significantly in the octreotide group (p < 0.001). No significant difference was seen between the racecadotril and control group (p > 0.05) in terms of the frequency and consistency of stools. The mean (+/- SE) quantity of stools was significantly decreased in the octreotide group (p < 0.001) on day 2 compared to the other two groups. The mean (+/- SE) quantity of fluid required was almost the same in all 3 groups on day 1 (p > 0.05) but it was significantly less in the octreotide group on day 2 (p < 0.001). No significant difference was seen with respect to the fluid requirement between the control and racecadotril group (p > 0.05).
Patients who received single dose of octreotide fared better than those patients in control and racecadotril group in terms of frequency, quantity and consistency of stools passed. The fluid requirement was also less in octreotide group. However more trials need to be done to substantiate this finding before octreotide becomes a standard of therapy in acute infective diarrhea.
评估单剂量奥曲肽的疗效，并将其与另一种抗分泌药物消旋卡多曲在急性感染性腹泻治疗中的效果进行比较。
在SMS医学院附属医院的内科和传染病医院（预防与社会医学科）进行了一项随机对照研究。150例需要住院治疗的中度至重度急性腹泻病患者被随机分为3组，每组50例。对照组仅接受补液和抗生素治疗，消旋卡多曲组接受补液、抗生素治疗以及每日3次、剂量为1.5mg/kg的口服消旋卡多曲，奥曲肽组接受奥曲肽（单次100微克）以及补液和抗生素治疗。比较了以下研究终点，即每日大便的频率、量和性状以及补液需求。
与对照组和消旋卡多曲组相比，奥曲肽组从第2天起大便平均（±标准误）频率显著降低（p<0.001）。到第3天，奥曲肽组有一半患者腹泻停止。奥曲肽组大便性状有显著变化（p<0.001）。消旋卡多曲组和对照组在大便频率和性状方面无显著差异（p>0.05）。与其他两组相比，奥曲肽组在第2天大便平均（±标准误）量显著减少（p<0.001）。第1天，所有3组的平均（±标准误）补液需求量几乎相同（p>0.05），但第2天奥曲肽组补液需求量显著减少（p<0.001）。对照组和消旋卡多曲组在补液需求方面无显著差异（p>0.05）。
在大便的频率、量和性状方面，接受单剂量奥曲肽治疗的患者比对照组和消旋卡多曲组的患者情况更好。奥曲肽组的补液需求也更少。然而，在奥曲肽成为急性感染性腹泻的标准治疗方法之前，还需要进行更多试验来证实这一发现。
