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鞣酸明胶治疗急性胃肠炎:一项系统评价

Gelatin tannate for treating acute gastroenteritis: a systematic review.

作者信息

Ruszczyński Marek, Urbańska Magdalena, Szajewska Hania

机构信息

Department of Pediatrics, The Medical University of Warsaw, Poland.

出版信息

Ann Gastroenterol. 2014;27(2):121-124.

Abstract

Gelatin tannate (GT) is a complex of tannic acid, which possesses astringent, antibacterial, and anti-inflammatory properties, and a protective gelatin. It is increasingly being marketed as an antidiarrheal drug. Our aim was to review data on the effectiveness of GT in treating acute gastroenteritis (AGE) in children and adults. The MEDLINE, EMBASE, and the Cochrane Library databases were searched in July 2013, with no language restrictions, for controlled clinical trials. Additional references were obtained from reviewed articles. Two trials met the inclusion criteria. In adults, one randomized controlled trial involving 40 subjects (mean age: 43±13 years) found that, compared with placebo, GT may be more effective at reducing some symptoms of AGE in the first 48 h after initiation of treatment. In children, one poor quality study (no randomization and no blinding) involving 211 children (mean age: 2.5±2.4 years) reported some beneficial effect of GT at 12 h after initiation of treatment. None of the studies evaluated the effect of GT on the primary outcome measures for this review such as stool output, duration of diarrhea, admission to hospital, duration of hospital stay, and (in children) weight gain after rehydration. Currently, there is no evidence to support the use of GT for treating AGE in children and only sparse evidence to support the use of GT in adults. Further well-designed trials, with sufficient power, adequate follow-up periods, and clinically relevant outcome measures, are needed. These include stool volume, duration of diarrhea, admission to hospital, duration of hospital stay, weight gain after rehydration, and adverse effects.

摘要

鞣酸明胶(GT)是鞣酸与具有收敛、抗菌和抗炎特性的保护性明胶形成的复合物。它作为一种止泻药越来越多地投放市场。我们的目的是综述GT治疗儿童和成人急性胃肠炎(AGE)有效性的数据。2013年7月检索了MEDLINE、EMBASE和Cochrane图书馆数据库,纳入无语言限制的对照临床试验。从综述文章中获取了其他参考文献。两项试验符合纳入标准。在成人中,一项涉及40名受试者(平均年龄:43±13岁)的随机对照试验发现,与安慰剂相比,GT在治疗开始后的前48小时可能更有效地减轻AGE的某些症状。在儿童中,一项质量较差的研究(无随机分组和无盲法)涉及211名儿童(平均年龄:2.5±2.4岁),报告了GT在治疗开始后12小时有一些有益效果。没有一项研究评估GT对本次综述的主要结局指标的影响,如粪便排出量、腹泻持续时间、入院情况、住院时间以及(儿童)补液后体重增加情况。目前,没有证据支持使用GT治疗儿童AGE,仅有少量证据支持在成人中使用GT。需要进一步设计良好的试验,具备足够的检验效能、足够的随访期以及临床相关的结局指标。这些指标包括粪便量、腹泻持续时间、入院情况、住院时间、补液后体重增加以及不良反应。

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