Walike B C, Walike J W
JAMA. 1977 Aug 29;238(9):948-51. doi: 10.1001/jama.238.9.948.
A relative intolerance of lactose was demonstrated in 14 of 16 patients receiving nasogastric tube feedings following surgery for head or neck carcinoma. Two liquid diets differing only in the presence or absence of lactose, were administered for eight to 20 days per patient in a double-blind crossover study. Increased stool frequency, decreased stool consistency, and more frequent flatulence, borborygmi, and distention were found with the lactose diet, although classic lactose intolerance (plasma glucose rise of less than 26 mg/dl) was indicated in only two patients. Differences between amounts and times of peak rise following the glucose tolerance test and lactose tolerance test for each patient indicated the advisability of locating patients on a continuum of ability to hydrolyze lactose. The results indicate that lactose should be reduced or eliminated from tube-feeding diets to improve patient tolerance and comfort and to reduce diarrhea.
在16例接受头颈部癌手术后经鼻胃管喂食的患者中，有14例表现出对乳糖的相对不耐受。在一项双盲交叉研究中，为每位患者提供了两种仅在有无乳糖方面存在差异的流质饮食，每种饮食持续8至20天。食用含乳糖饮食时，发现患者排便频率增加、大便稠度降低，肠胃胀气、腹鸣和腹胀更为频繁，不过只有两名患者出现了典型的乳糖不耐受（血糖升高低于26mg/dl）。每位患者葡萄糖耐量试验和乳糖耐量试验后峰值升高的量和时间差异表明，根据水解乳糖能力的连续体来定位患者是可取的。结果表明，应减少或消除管饲饮食中的乳糖，以提高患者的耐受性和舒适度，并减少腹泻。
