Diarrhoea: a significant worldwide problem
Diarrhoea: a significant worldwide problem
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DOI：
10.1016/s0924-8579(99)00149-1
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发表时间：
2000-01-01
影响因子：
10.8
通讯作者：
Farthing, MJG
中科院分区：
文献类型：
--
作者：
Farthing, MJG
腹泻是一个问题，不仅是发展中国家的问题，也是西方世界的问题。然而，腹泻病对经济的影响在较贫穷的国家尤为明显。全世界最常见的腹泻原因是肠道感染，婴儿、学龄前儿童、老年人以及患有先天性或获得性免疫缺陷的人感染此类感染的风险很高。腹泻病可分为三种主要临床症状：急性水样腹泻、血性腹泻和持续性腹泻。根据临床环境的不同，许多不同的微生物可以引起感染性腹泻。口服补液溶液的开发为急性水样腹泻患者提供了一种简单的补水和维持补水的方法，并在世界卫生组织的主持下在世界各地实施。然而，补液并不能治疗腹泻本身，腹泻会一直持续到感染痊愈。由于目前用于治疗腹泻的药物，如阿片剂和抗生素都有局限性，因此继续寻找一种主要作用于分泌途径而不影响胃肠动力的药物。新的治疗方法包括5-HT2和5-HT3受体拮抗剂、钙-钙调蛋白拮抗剂和Sigma受体激动剂。另一种方法集中在神经递质脑啡肽的抗分泌作用上，并导致脑啡肽酶抑制剂消旋卡多曲尔的开发。该药具有真正的抗分泌活性，在临床试验中表现出良好的疗效和耐受性。(C)2000年，由爱思唯尔科学公司和国际化疗学会出版。版权所有。
Diarrhoea is a problem, not only of the developing world, but also of the Western world. However, the economic implications of diarrhoeal diseases are particularly evident in the poorer countries. The most common worldwide cause of diarrhoea is intestinal infection and infants, pre-school children, the elderly, and those with congenital or acquired immunodeficiency run a high risk of contracting such infections. Diarrhoeal disease can be classified into three major clinical syndromes: acute watery diarrhoea, bloody diarrhoea, and persistent diarrhoea. A number of different micro-organisms can cause infectious diarrhoea, depending on the clinical setting. The development of oral rehydration solution has provided a simple approach to rehydration and maintenance of hydration in patients with acute watery diarrhoea, and has been implemented worldwide under the auspices of the World Health Organization. However, rehydration does not treat the diarrhoea itself, which will persist until the infection resolves. Since the drugs currently used for the treatment of diarrhoea, such as the opiate agents and antibiotics, have limitations, the search continues for a drug that acts predominantly on secretory pathways without affecting gastrointestinal motility. Novel therapeutic approaches include 5-HT2 and 5-HT3 receptor antagonists, calcium-calmodulin antagonists, and sigma-receptor agonists. Another approach has concentrated on the antisecretory role of the neurotransmitter, enkephalin, and has resulted in the development of the enkephalinase inhibitor, racecadotril. This drug has true antisecretory activity, and has demonstrated good efficacy and tolerability in clinical trials. (C) 2000 Published by Elsevier Science B.V. and international Society of Chemotherapy. All rights reserved.