Haffejee I E
Department of Paediatrics and Child Health, R. K. Khan Hospital, Durban, South Africa.
J Pediatr Gastroenterol Nutr. 1990 Feb;10(2):193-8. doi: 10.1097/00005176-199002000-00009.
Acute infantile diarrhea is often managed by introducing lactose-free diets empirically from the time of diagnosis, in addition to conventional rehydration therapy. In order to assess the efficacy of this, a therapeutic trial was undertaken in which hospitalized gastroenteritis patients previously on milk-formula feeds were randomly fed, from the time of admission, either their original feed or a lactose-free soya preparation; patients previously on human milk with or without a supplement continued to receive this during their diarrheal illness. The results show that in nonrotaviral gastroenteritis, there is no difference in the duration of the illness irrespective of the type of feed given. In rotaviral gastroenteritis, continued breast-feeding significantly reduces the duration of acute diarrhea, while lactose-free soya feeds do not lead to a significant reduction in the duration of the illness when compared to cow's milk-formula feeds. Hence, it is concluded that (a) breast-feeding should be continued during an episode of infantile diarrhea, and that (b) empirical use of soya preparations from the time of hospital admission is not justified; however, the latter should be considered in infants whose purging rate goes up or diarrheal disease severity worsens 3 to 4 days after the onset of diarrhea or hospital stay and who are passing significant amounts of reducing sugars in their stool.
急性婴儿腹泻通常在诊断时除了进行常规补液治疗外，还会凭经验采用无乳糖饮食。为了评估其疗效，进行了一项治疗试验，将此前以配方奶喂养的住院肠胃炎患者从入院时起随机分为两组，一组继续喂食原来的奶，另一组喂食无乳糖大豆制品；此前以母乳（无论是否添加辅食）喂养的患者在腹泻期间继续接受母乳。结果显示，在非轮状病毒性肠胃炎中，无论给予何种类型的喂养，疾病持续时间并无差异。在轮状病毒性肠胃炎中，继续母乳喂养可显著缩短急性腹泻的持续时间，而与牛奶配方奶相比，无乳糖大豆制品并不能显著缩短疾病持续时间。因此得出结论：（a）婴儿腹泻期间应继续母乳喂养；（b）入院时凭经验使用大豆制品并无依据；然而，对于腹泻发作或住院3至4天后腹泻频率增加或腹泻疾病严重程度加重且粪便中含有大量还原糖的婴儿，应考虑使用后者。
