Xinias Ioannis, Spiroglou Kleomenis, Demertzidou Vasiliki, Karatza Eliza, Panteliadis Christos
Third Department of Pediatrics, Gastroenterology Section, Aristotle University of Thessaloniki Medical School, Hippocration Hospital, Thessaloniki, Greece.
Curr Ther Res Clin Exp. 2003 Apr;64(4):270-8. doi: 10.1016/S0011-393X(03)00039-0.
Thickened milk formulas are used to treat infants with gastroesophageal reflux (GER), but these substances often increase the duration of reflux episodes and worsen symptoms, and they have been associated with diarrhea, constipation, and cough.
The aims of this study were to determine the efficacy of an antiregurgitation milk formula in the clinical and laboratory setting in infants with proved GER, to investigate any possible adverse events (cough and change in the number of bowel movements or the consistency of stools), and to identify its effects on height and body weight.
Infants with recurrent vomiting and GER who were not responsive to standard treatment were eligible for the study. Infants in the treatment group (group A) were managed for 4 weeks with a specific antiregurgitation milk formula (with cornstarch and an increased amount of casein), and those in the control group (group B) were given a standard milk formula. The number of episodes of vomiting, regurgitation, and cough, as well as the frequency and consistency of stool, height, and body weight were noted at least 10 days before and during the study. A second pH monitoring was performed after 4 weeks in both groups.
Fifty-six infants (30 boys, 26 girls; mean [SD] age, 3.1 [1.2] months) were included in the study; 30.4% had mild GER; 44.6%, moderate GER; and 25.0%, severe GER. Significantly more infants in group A than in group B (50.0% vs 14.3%, respectively) with mild or moderate GER had normal findings on the second pH monitoring (P<0.05). Changes in the reflux index and in the mean number of vomiting and regurgitation episodes were significantly different between the 2 groups (P<0.05). No significant differences in changes in the mean number of bowel movements and cough events or in the consumption time of the 2 formulas were found between the 2 groups.
Infants with mild or moderate GER can be managed effectively with this antiregurgitation milk formula. Improved clinical and laboratory findings were seen in the majority of infants, and the formula was well tolerated, without adverse events.
增稠奶粉用于治疗胃食管反流(GER)婴儿,但这些物质常增加反流发作持续时间并使症状加重,且与腹泻、便秘及咳嗽有关。
本研究旨在确定一种抗反流奶粉在经证实患有GER的婴儿临床及实验室环境中的疗效,调查任何可能的不良事件(咳嗽及排便次数或粪便性状改变),并确定其对身高和体重的影响。
对标准治疗无反应的反复呕吐及GER婴儿符合研究条件。治疗组(A组)婴儿使用特定抗反流奶粉(含玉米淀粉及酪蛋白量增加)治疗4周,对照组(B组)婴儿给予标准奶粉。在研究前至少10天及研究期间记录呕吐、反流及咳嗽发作次数,以及粪便频率、性状、身高和体重。两组在4周后均进行第二次pH监测。
56名婴儿(30名男孩,26名女孩;平均[标准差]年龄,3.1[1.2]个月)纳入研究;30.4%患有轻度GER;44.6%,中度GER;25.0%,重度GER。轻度或中度GER的A组婴儿在第二次pH监测中正常结果的比例显著高于B组(分别为50.0%对14.3%)(P<0.05)。两组间反流指数以及呕吐和反流发作平均次数的变化有显著差异(P<0.05)。两组间排便平均次数和咳嗽事件的变化或两种奶粉的食用时间无显著差异。
轻度或中度GER婴儿使用这种抗反流奶粉可有效治疗。大多数婴儿临床和实验室结果改善,且该奶粉耐受性良好,无不良事件。