Bhandari N, Bahl R, Sazawal S, Bhan M K
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
J Nutr. 1997 Jan;127(1):59-63. doi: 10.1093/jn/127.1.59.
Vitamin A administration in children reduces the incidence of severe diarrhea during the subsequent few months. We therefore examined the effect of treatment with vitamin A during acute diarrhea on the episode duration and severity. In a double-blind controlled field trial, 900 children 1 to 5 y of age with acute diarrhea of < or = 7 d duration were randomly assigned to receive vitamin A (60 mg) or a placebo. Children were followed up at home every alternate day until they recovered from the diarrheal episode. In all study children, those treated with vitamin A had a significantly lower risk of persistent diarrhea [odds ratio (OR) 0.30, 95% confidence interval (CI) 0.07-0.97], but there was no effect on the mean diarrheal duration or the mean stool frequency, in the subgroup of children who were not breast-fed, the mean diarrheal duration [ratio of geometric means (GM) 0.84, 95% CI 0.72-0.97], mean number of stools passed after the intervention (ratio of GM 0.73, 95% CI 0.56-0.95), the proportion of episodes lasting > or = 14 d (P = 0.002) and the percentage of children who passed watery stools on any study day (OR 0.40, 95% CI 0.21-0.77) were significantly lower in those treated with vitamin A. We conclude that administration of vitamin A during acute diarrhea may reduce the severity of the episode and the risk of persistent diarrhea in non-breast-fed children. Similar benefit was not seen in breast-fed children.
给儿童补充维生素A可降低随后几个月内严重腹泻的发生率。因此，我们研究了急性腹泻期间补充维生素A治疗对病程和严重程度的影响。在一项双盲对照现场试验中，将900名1至5岁、急性腹泻持续时间≤7天的儿童随机分为两组，分别给予维生素A（60 mg）或安慰剂。每隔一天对儿童进行家访随访，直至腹泻痊愈。在所有研究儿童中，补充维生素A的儿童持续性腹泻风险显著降低[比值比（OR）0.30，95%置信区间（CI）0.07 - 0.97]，但对平均腹泻持续时间或平均排便次数无影响。在未母乳喂养的儿童亚组中，补充维生素A的儿童平均腹泻持续时间[几何均数比（GM）0.84，95% CI 0.72 - 0.97]、干预后平均排便次数（GM比0.73，95% CI 0.56 - 0.95）、病程持续≥14天的比例（P = 0.002）以及在任何研究日排水样便的儿童百分比（OR 0.40，95% CI 0.21 - 0.77）均显著降低。我们得出结论，急性腹泻期间补充维生素A可能会降低未母乳喂养儿童腹泻的严重程度和持续性腹泻的风险。母乳喂养儿童未观察到类似益处。
