Barr R G, Levine M D, Watkins J B
N Engl J Med. 1979 Jun 28;300(26):1449-52. doi: 10.1056/NEJM197906283002602.
The role of lactose malabsorption was studied prospectively in 80 schoolchildren with recurrent abdominal pain. Malabsorption was documented in 40 per cent (16 of 59 whites, 12 of 16 blacks and four of five Hispanic children) on the basis of elevated levels of hydrogen in their breath. Those with lactose malabsorption, however, were not clinically distinguishable on the basis of past milk ingestion (P greater than 0.05), weekly pain frequency (median, five vs. six times), presence of diarrhea (40 vs. 27 per cent) or symptom response to lactose load. In children with malabsorption who completed a six-week diet trial, 70 per cent reported increased frequency of pain (P less than 0.002) when placed on their usual lactose-containing diet. Lactose malabsorption has a substantial role in the symptoms of children with recurrent abdominal pain, and it should be considered before performing invasive procedures or assuming a psychogenic origin.
对80名反复出现腹痛的学童进行了前瞻性研究，以探讨乳糖吸收不良的作用。根据呼出气体中氢气水平升高，59名白人中有40%（16名）、16名黑人中有12名、5名西班牙裔儿童中有4名存在吸收不良。然而，根据既往牛奶摄入情况（P>0.05）、每周疼痛频率（中位数分别为5次和6次）、腹泻情况（分别为40%和27%）或对乳糖负荷的症状反应，乳糖吸收不良者在临床上并无明显差异。在完成六周饮食试验的吸收不良儿童中，70%的儿童在恢复食用含乳糖的日常饮食后报告疼痛频率增加（P<0.002）。乳糖吸收不良在反复腹痛儿童的症状中起重要作用，在进行侵入性检查或认定为精神源性病因之前应予以考虑。
