Stapleton M C
Essential Drugs Programme, WHO, Thimphu, Bhutan.
Soc Sci Med. 1989;28(6):593-604. doi: 10.1016/0277-9536(89)90254-2.
A study undertaken in Nepal collected information on believed causes of diarrhoea and traditional treatments. Natural causes for diarrhoea were more frequently reported than supernatural causes, the most important being teething (75% of respondents reporting it to be a cause) followed by food considered to be 'cold' in the Hindu ayurvedic classification (57.5%), stale food (52.5%), hot food (41%) and dirty water (38%). The terminology reported for dehydration however, indicates strong links with supernatural causes. For prevention of diarrhoea the recognition of the importance of stale food and dirty water is encouraging for health education programmes. Its association with teething may be an obstacle. In the promotion of correct diarrhoea management, the high proportion (83%) of mothers reportedly continuing to breast-feed is a good sign, but 75% of respondents reported that fluids are always or sometimes withheld, and 58% that foods are withheld. The literature does suggest that administration of certain foods and fluids is the commonest form of treatment of diarrhoea, but the choice of these is based upon the hot-cold principle. Both diarrhoea and dysentery were reported to be caused by both 'hot' and 'cold' influences in this study. In addition, 'hot' and 'cold' foods and fluids were reported to be both useful and harmful in their treatment. Thus, while treatment by giving foods or fluids is suitable, neither 'hot' nor 'cold' types will be universally acceptable. The promotion of oral rehydration solution consequently needs to be flexibly manipulated in terms of the hot-cold principle. The current recommendation of its preparation using cold water may be unacceptable in a proportion of cases. A wide variety of nutritious foods and fluids were reported to be considered beneficial and it is concluded that these traditionally accepted feeding practices should be reinforced, especially at the onset of diarrhoea in infants and children.
在尼泊尔开展的一项研究收集了关于腹泻的公认病因及传统治疗方法的信息。腹泻的自然病因比超自然病因更常被提及，其中最重要的是出牙（75%的受访者称其为病因），其次是印度教阿育吠陀分类中被认为“寒性”的食物（57.5%）、变质食物（52.5%）、热性食物（41%）和脏水（38%）。然而，所报告的脱水术语表明与超自然病因有紧密联系。对于腹泻的预防而言，认识到变质食物和脏水的重要性对健康教育项目来说是件好事。出牙与之的关联可能是个障碍。在推广正确的腹泻管理方面，据报道83%的母亲继续母乳喂养是个好迹象，但75%的受访者称总是或有时不给孩子喂液体，58%的受访者称不给孩子喂食物。文献确实表明给予某些食物和液体是治疗腹泻最常见的形式，但这些的选择基于寒热原则。在这项研究中，腹泻和痢疾都被报告是由“热性”和“寒性”影响所致。此外，“热性”和“寒性”食物及液体在治疗中被报告既有益处也有危害。因此，虽然给予食物或液体进行治疗是合适的，但“热性”或“寒性”类型都不会被普遍接受。因此，口服补液盐溶液的推广需要根据寒热原则灵活操作。目前建议用冷水配制它，在某些情况下可能不被接受。据报告，各种各样的营养食物和液体被认为有益，得出的结论是，这些传统上被接受的喂养做法应得到加强，尤其是在婴幼儿腹泻发作时。
