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口服乳糖酶治疗婴儿绞痛:一项随机双盲安慰剂对照试验。

Oral lactase for infantile colic: a randomized double-blind placebo-controlled trial.

机构信息

Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital, Delhi, India.

出版信息

BMC Pediatr. 2022 Aug 3;22(1):468. doi: 10.1186/s12887-022-03531-8.

Abstract

BACKGROUND

Infantile colic is a common problem during the first three months of life. This randomized, double-blind, placebo-controlled trial conducted in an urban hospital in Delhi, India evaluated the efficacy and safety of oral lactase in management of infantile colic.

METHODS

One hundred sixty-two clinically healthy infants aged < 5 months age [mean (SD) = 63.5 (30.5) days] fulfilling the Rome-IV diagnostic criteria for infantile colic were enrolled. Eligible children were randomly allocated to receive 5 drops of lactase (600 FCC units/mL) (n = 80) or placebo (n = 82) mixed with breast milk or formula feed four times a day for a duration of 4 weeks. Primary outcomes were duration of crying or fussing (min/d), and number of days with colic lasting > 3 h/d; secondary outcomes were parental satisfaction and adverse events.

RESULTS

At the end of four weeks, mean (SD) crying or fussing time (min/d) was significantly shorter in infants receiving lactase in comparison to placebo [89.9 (115.2) vs.178.5 (153.2); P = 0.001]. The mean (SD) number of days with colic was also significantly less in the lactase group as compared to placebo group at the end of the treatment [12.1 (7.8) vs 17.6 (8.4); P < 0.001]. By the end of 4 week, parental satisfaction in terms of infant's mood, activity, alertness, comfort and oral intake was better in intervention group. The adverse event profile was comparable between two groups.

CONCLUSIONS

Oral lactase treatment in infantile colic results in symptomatic relief in terms of shortening of duration of crying or fussing, and better parental satisfaction.

TRIAL REGISTRATION

Clinical trial registry of India (CTRI/2017/12/010930) registered on 20/12/2017.

摘要

背景

婴儿绞痛是生命最初三个月的常见问题。这项在印度德里市一家城市医院进行的、随机、双盲、安慰剂对照试验评估了口服乳糖酶治疗婴儿绞痛的疗效和安全性。

方法

162 名年龄<5 个月(平均[标准差]为 63.5[30.5]天)符合婴儿绞痛罗马-IV 诊断标准的临床健康婴儿入组。合格的儿童被随机分配接受 5 滴乳糖酶(600 FCC 单位/mL)(n=80)或安慰剂(n=82),与母乳或配方奶混合,每天 4 次,持续 4 周。主要结局为哭泣或烦躁持续时间(分钟/天)和每天绞痛持续>3 小时的天数;次要结局为父母满意度和不良事件。

结果

在四周结束时,接受乳糖酶治疗的婴儿哭泣或烦躁时间(分钟/天)明显短于安慰剂组[89.9(115.2)与 178.5(153.2);P=0.001]。治疗结束时,乳糖酶组的绞痛天数也明显少于安慰剂组[12.1(7.8)与 17.6(8.4);P<0.001]。在四周结束时,干预组婴儿的情绪、活动、警觉、舒适度和口服摄入方面的父母满意度更好。两组的不良事件谱相似。

结论

口服乳糖酶治疗婴儿绞痛可缩短哭泣或烦躁持续时间,改善父母满意度,从而缓解症状。

试验注册

印度临床试验注册中心(CTRI/2017/12/010930)于 2017 年 12 月 20 日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97c1/9347088/c33f66b45f89/12887_2022_3531_Fig1_HTML.jpg

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