Baijal Rajiv, Tandon Rakesh K
Institute of Gastroenterology Pushpawati Singhania Hospital and Research Institute New Delhi India.
JGH Open. 2020 Dec 1;5(1):143-148. doi: 10.1002/jgh3.12463. eCollection 2021 Jan.
The absence of lactase in the intestinal villi due to mucosal injury or genetic factors causes undigested lactose to reach the colon where it is fermented. Lactose intolerance is diagnosed based on clinical symptoms like bloating, abdominal pain and flatulence, lactose hydrogen breath test (HBT), and lactose tolerance test. No Indian studies are available on the use of lactase supplements. The aim was to study the effect of lactase chewable tablets on clinical symptoms and hydrogen breath excretion in patients with lactose intolerance.
This was a randomized, double-blind, crossover placebo-controlled trial to study the effect of lactase tablets on symptoms and hydrogen breath levels in adults with lactose intolerance, confirmed by Lactose HBT. Clinical symptom severity was recorded using a visual analog scale, and HBT was performed every 30 min for 180 min. As it was a crossover design, the same patients were tested with both lactase and placebo, acting as their own controls with a washout period of 1 week between visits.
Forty-seven patients (mean age 33.6 years; 30 males) with lactose intolerance formed the study group. Clinical symptoms, mean clinical score ( < 0.05), and mean hydrogen breath levels ( < 0.05) were improved when the patients were given lactase. Reduction in cumulative hydrogen breath level over 180 min was 55% when patients received lactase compared to placebo.
Orally supplemented lactase enzyme significantly reduced the clinical symptoms and hydrogen breath excretion in patients with lactose intolerance.
由于黏膜损伤或遗传因素导致肠绒毛中乳糖酶缺乏，会使未消化的乳糖进入结肠并在那里发酵。乳糖不耐受是根据腹胀、腹痛、肠胃胀气等临床症状、乳糖氢呼气试验（HBT）和乳糖耐量试验来诊断的。目前尚无关于印度使用乳糖酶补充剂的研究。本研究旨在探讨乳糖酶咀嚼片对乳糖不耐受患者临床症状及呼氢排泄的影响。
这是一项随机、双盲、交叉安慰剂对照试验，旨在研究乳糖酶片对经乳糖HBT确诊的乳糖不耐受成年人症状及呼氢水平的影响。使用视觉模拟量表记录临床症状严重程度，每30分钟进行一次HBT，共进行180分钟。由于是交叉设计，同一组患者分别接受乳糖酶和安慰剂测试，每次测试间有1周的洗脱期，患者自身作为对照。
47例乳糖不耐受患者（平均年龄33.6岁；男性30例）组成研究组。给予患者乳糖酶后，临床症状、平均临床评分（<0.05）和平均呼氢水平（<0.05）均有所改善。与安慰剂相比，患者服用乳糖酶后180分钟内累积呼氢水平降低了55%。
口服补充乳糖酶可显著减轻乳糖不耐受患者的临床症状并减少呼氢排泄。
