Razafindrakoto O, Ravelomanana N, Randriamiharisoa F, Rasoarivao V, Ramialimanana V, Rakotoarimanana D R, Razanamparany M
Service de Pédiatrie A, Hôpital Général de Befelatanana Antananarivo, Madagascar.
Arch Fr Pediatr. 1993 Feb;50(2):101-5.
Although malnutrition is frequently associated with diarrhea, most oral rehydration solutions have been tested in well-nourished children. The study tests efficacy of rice, a traditional treatment for diarrhea in Madagascar.
150 severely malnourished children, aged 6 months to 3 years, took part in this randomized trial. All the children were given oral rehydration solution, (100 ml/kg) in the first 6 hours. The first group (68 children) was given a solution containing glucose, (20 g/l). The second group (82 children) was given a solution containing rice powder (50 g/l). Treatment was then continued according to WHO recommendations, including feeding after rehydration (mixture of milk, oil and sugar).
The age, weight, height, duration of diarrhea before admission, degree of dehydration and pathogens in stools of the two groups were comparable on admission. Only 2 patients were withdrawn from the trial. The percentage of death was the same in both groups: 16% of those given glucose and 15% of those given rice-based rehydration solution. The weight gains were similar in both groups; the duration of diarrhea was 89 +/- 6 hours in the glucose-fed groups and 68 +/- 4 hours for those given the rice-based rehydration solution (p < 0.02).
Both glucose and rice-based rehydration solutions are equally effective for rehydrating severely malnourished children with acute diarrhea. The rice-based rehydration solution also reduces the duration of diarrhea.
尽管营养不良常与腹泻相关，但大多数口服补液溶液都是在营养良好的儿童中进行测试的。本研究测试了大米（马达加斯加治疗腹泻的传统疗法）的疗效。
150名年龄在6个月至3岁的重度营养不良儿童参与了这项随机试验。所有儿童在最初6小时内均给予口服补液溶液（100毫升/千克）。第一组（68名儿童）给予含葡萄糖的溶液（20克/升）。第二组（82名儿童）给予含米粉的溶液（50克/升）。然后根据世界卫生组织的建议继续进行治疗，包括补液后喂养（牛奶、油和糖的混合物）。
两组儿童入院时的年龄、体重、身高、入院前腹泻持续时间、脱水程度和粪便中的病原体情况具有可比性。只有2名患者退出试验。两组的死亡率相同：接受葡萄糖治疗的患者中有16%死亡，接受大米基补液溶液治疗的患者中有15%死亡。两组的体重增加情况相似；葡萄糖喂养组的腹泻持续时间为89±6小时，接受大米基补液溶液治疗的患者为68±4小时（p<0.02）。
葡萄糖和大米基补液溶液在为重度营养不良的急性腹泻儿童补液方面同样有效。大米基补液溶液还可缩短腹泻持续时间。
