嗜热淀粉酶消化大米电解质溶液治疗小儿急性腹泻

Thermophilic amylase-digested rice-electrolyte solution in the treatment of acute diarrhea in children.

作者信息

Lebenthal E, Rolston D D, Jirapinyo P, Visitsuntorn N, Firmansyah A, Sunoto S

机构信息

Department of Pediatrics, International Institute for Infant Nutrition and Gastrointestinal Disease, Mount Scopus, Hadassh-Hebrew University Medical Center, Israel.

出版信息

Pediatrics. 1995 Feb;95(2):198-202.

PMID:7530834

Abstract

OBJECTIVE

To compare the efficacy of an oral rehydration solution (ORS) containing short polymers of glucose derived from rice (Amylyte-ORS) and five times the caloric density of current ORS to the standard glucose-ORS (World Health Organization [WHO] = ORS) in the treatment of acute diarrhea in children.

METHODS

The rice ORS (Amylyte-ORS) was obtained by adding thermophilic amylase (252,500 MW units) and salts (1.5 g NaCl, 600 mg KCl, and 150 mg CaCl2) to 100 g rice and boiling for 10 minutes in 500 mL water. This yields 250 mL Amylyte-ORS, which contains 92% to 96% short-chain glucose polymers, three to nine molecules in length, and provides 425 kcal/L, compared to 80 kcal/L for the WHO-ORS. One hundred forty-four male children, 4 months to 3 years of age, presenting with acute diarrhea and mild, moderate, or severe dehydration, were assigned by random allocation to receive either WHO-ORS or Amylyte-ORS. Data from 127 children were analyzed (57 received the WHO-ORS and 70 the Amylyte-ORS). Two children given Amylyte-ORS and 15 given the WHO-ORS were not included in the analysis because of improperly collected data or lost urine or fecal specimens. None were given antibiotics during the study. Free water and feeding were allowed after the children were rehydrated.

RESULTS

The clinical characteristics of the children in the two treatment groups were comparable. Five children who received the WHO-ORS and three children given Amylyte-ORS were treatment failures. Amylyte-ORS reduced diarrhea duration by 15% (41.4 +/- 2.5 vs 34.7 +/- 1.8 hours; P < .03) compared to the WHO-ORS, regardless of the severity of dehydration. In the Amylyte-treated group, ORS requirements were significantly less (234 +/- 15.2 vs 295 +/- 17.6 mL/kg; P < .01) and weight gain was significantly more (367.7 +/- 45.1 vs 199.2 +/- 38.2 g; P < .01) than in those given the WHO-ORS. The net intestinal fluid balance and total body fluid balance were similar in the two groups.

CONCLUSIONS

Amylyte-ORS effectively rehydrates children with acute diarrhea, reduces diarrhea duration, decreases ORS requirements, and improves weight gain compared to the WHO-ORS.

摘要

目的

比较含源自大米的短链葡萄糖聚合物的口服补液盐（ORS）（Amylyte-ORS），其热量密度是目前ORS的五倍，与标准葡萄糖ORS（世界卫生组织[WHO]标准ORS）在治疗儿童急性腹泻方面的疗效。

方法

大米ORS（Amylyte-ORS）是通过将嗜热淀粉酶（252,500分子量单位）和盐（1.5克氯化钠、600毫克氯化钾和150毫克氯化钙）加入100克大米中，并在500毫升水中煮沸10分钟制得。这可得到250毫升Amylyte-ORS，其含有92%至96%的短链葡萄糖聚合物，长度为三至九个分子，提供425千卡/升，而WHO-ORS为80千卡/升。将144名4个月至3岁、患有急性腹泻且有轻度、中度或重度脱水的男童随机分配接受WHO-ORS或Amylyte-ORS治疗。分析了127名儿童的数据（57名接受WHO-ORS，70名接受Amylyte-ORS）。两名接受Amylyte-ORS和15名接受WHO-ORS的儿童因数据收集不当或尿液或粪便标本丢失未纳入分析。研究期间均未给予抗生素。儿童补液后允许自由饮水和进食。

结果

两个治疗组儿童的临床特征具有可比性。接受WHO-ORS的5名儿童和接受Amylyte-ORS的3名儿童治疗失败。与WHO-ORS相比，无论脱水严重程度如何，Amylyte-ORS使腹泻持续时间缩短了15%（41.4±2.5小时对34.7±1.8小时；P<.03）。在接受Amylyte治疗的组中，ORS需求量显著更少（234±15.2对295±17.6毫升/千克；P<.01），体重增加显著更多（367.7±45.1对199.2±38.2克；P<.01）。两组的肠道净液体平衡和总体液平衡相似。