Briet F, Pochart P, Marteau P, Flourie B, Arrigoni E, Rambaud J C
INSERM U290, Hôpital Saint-Lazare, Paris, France.
Gut. 1997 Nov;41(5):632-5. doi: 10.1136/gut.41.5.632.
Uncontrolled studies of lactose intolerant subjects have shown that symptom severity decreases after chronic lactose consumption. Adaptation of the colonic flora might explain this improvement.
To compare the effects of regular administration of either lactose or sucrose on clinical tolerance and bacterial adaptation to lactose.
Forty six lactose intolerant subjects underwent two 50 g lactose challenges on days 1 and 15. Between these days they were given 34 g of lactose or sucrose per day, in a double blind protocol. Stool samples were obtained on days 0 and 14, to measure faecal beta-galactosidase and pH. Symptoms, breath H2 excretion, faecal weight and electrolytes, and orofaecal transit time were assessed.
Except for faecal weight, symptoms were significantly milder during the second challenge in both groups, and covariance analysis showed no statistical difference between them. In the lactose group, but not in the sucrose group, faecal beta-galactosidase activity increased, pH dropped, and breath H2 excretion decreased.
Bacterial adaptation occurred when lactose intolerant subjects ingested lactose for 13 days, and all symptoms except diarrhoea regressed. Clinical improvement was also observed in the control group which displayed no signs of metabolic adaptation. This suggests that improved clinical tolerance may be just a placebo effect.
对乳糖不耐受受试者的非对照研究表明，长期摄入乳糖后症状严重程度会降低。结肠菌群的适应性变化可能解释了这种改善情况。
比较定期给予乳糖或蔗糖对临床耐受性以及细菌对乳糖适应性的影响。
46名乳糖不耐受受试者在第1天和第15天接受了两次50克乳糖激发试验。在这期间，他们按照双盲方案每天摄入34克乳糖或蔗糖。在第0天和第14天采集粪便样本，以测量粪便β-半乳糖苷酶和pH值。评估症状、呼气氢气排泄量、粪便重量和电解质以及口-粪转运时间。
除粪便重量外，两组在第二次激发试验期间症状均明显减轻，协方差分析显示两组之间无统计学差异。在乳糖组中，粪便β-半乳糖苷酶活性增加、pH值下降且呼气氢气排泄量减少，而蔗糖组未出现这些变化。
乳糖不耐受受试者摄入乳糖13天后出现了细菌适应性变化，除腹泻外的所有症状均有所缓解。在未显示出代谢适应性迹象的对照组中也观察到了临床改善。这表明临床耐受性的改善可能只是一种安慰剂效应。
