High‐calorie, rice‐derived, short‐chain, glucose polymer‐based oral rehydration solution in acute watery diarrhea
High‐calorie, rice‐derived, short‐chain, glucose polymer‐based oral rehydration solution in acute watery diarrhea
复制标题
高热量、大米衍生、短链葡萄糖聚合物口服补液溶液用于治疗急性水样腹泻
作者：
E. Lebenthal;Khin;Khin;Tin;Thein‐Thein‐Myint;P. Jirapinyo;N. Visitsuntorn;R. Ismail;A. Bakri;A. Firmansyah;S. Sunoto;K. Shin;H. Takita
在这项研究中，我们在五个中心的随机、开放标签、对照临床试验中，比较了世界卫生组织口服补液液(WHO ORS)和含有葡萄糖短聚合物的ORS(Amylyte ORS)在高热量密度(5倍)和类似渗透压下对粪便排出量、腹泻持续时间、体重增加和液体和电解质平衡的影响。共有198名患有急性腹泻(发病72小时后)的男性儿童(4个月至10岁)被随机分配到亚洲五个中心的WHO ORS或Amylyte ORS。根据脱水程度(轻度、中度或重度)和前6h的初始净化率(低(2ml/kg/h)、中(2-5ml/kg/h)和高(5ml/kg/h))对儿童进行分层。两组患儿的临床特点相似。Amyyte ORS显著减少严重脱水患儿的粪便容量(285.4±74.2vs75.5±20.0ml/kg；p；0.05)和初始排泄率高的患儿(200.3±42.8vs130.5±9.1ml/kg；p0.05)。同时，Amylyte ORS治疗组的ORS需求显著减少(276.4±14.6vs 227.6±11.8ml/kg；p<0.01)，在严重脱水(491.5±108.5 vs155.7±27.3ml/kg；p<0.01)或高初始排泄率(394.2±66.2vs316.8±34.8ml/kg；p<0.05)的儿童中效果最大。在轻度或中度脱水和轻度或中度泻药中，使用Amylyte ORS治疗的儿童腹泻持续时间没有缩短。严重脱水(56.4±1.8对34.0±5.6 h)或高排泄率(51.5±7.1对38.2±4.8 h)患儿腹泻持续时间显著缩短(p<；0.05)。与服用世卫组织口服避孕药的儿童相比，服用淀粉酸类口服避孕药的儿童体重增加(520.3±48.5g比228.5±42.1g)和体重增加百分比(4.8±0.4%比2.3±0.4%)显著增加(p<；0.0001)。Amylyte ORS补充急性腹泻儿童的水分，减少严重脱水或初始排泄率高的儿童的粪便容量、腹泻持续时间和ORS需求，并改善体重增加。Amylyte ORS的优点是含有葡萄糖的短聚合物，每升提供的卡路里是以葡萄糖为基础的WHO ORS的五倍以上。
In this study, we have compared the effects of the World Health Organization oral rehydration solution (WHO ORS) and an ORS containing short polymers of glucose (Amylyte ORS) at a high caloric density (five times) and comparable osmolality, on stool output, duration of diarrhea, weight gain and fluid and electrolyte balance, in randomized, open‐labeled, controlled clinical trials in five centers. A total of 198 male children (4 months to 10 years) with acute diarrhea (<72 h after onset) were assigned by random allocation to either WHO ORS or Amylyte ORS at five centers in Asia. Children were stratified according to grade of dehydration (mild, moderate or severe) and the initial purging rates during the first 6h (low (<2ml/kg/h), moderate (2–5ml/kg/h) and high (>5ml/kg/h) purgers). The clinical characteristics of the children in the two treatment groups were comparable. Amylyte ORS reduced stool volumes significantly in children with severe dehydration (285.4 ± 74.2 versus 75.5 ±20.0 ml/kg; p < 0.05) and in children with a high initial purging rate (200.3 ±42.8 versus 130.5 ± 9.1 ml/kg; p < 0.05). This was accompanied by a significant (276.4 ±14.6 versus 227.6 ± 11.8 ml/kg; p < 0.01) reduction in ORS requirements in the Amylyte ORS treated group, the effect being greatest in children with severe dehydration (491.5 ± 108.5 versus 155.7 ± 27.3 ml/kg; p < 0.01) or high initial purging rates (394.2 ± 66.2 versus 316.8 ± 34.8 ml/kg; p < 0.05). In mild or moderate dehydration and low or moderate purgers, duration of diarrhea in children treated with Amylyte ORS was not reduced. A significant (p < 0.05) reduction in duration of diarrhea was found in children with severe dehydration (56.4 ± 1.8 versus 34.0 ± 5.6h) or high purging rates (51.5 ± 7.1 versus 38.2 ± 4.8 h). Significantly (p < 0.0001) greater weight gain (520.3 ± 48.5 g versus 228.5 ± 42.1 g) and percent gain in weight (4.8 ± 0.4% versus 2.3 ± 0.4%) were found in children given Amylyte ORS compared with those given WHO ORS. Amylyte ORS rehydrated children with acute diarrhea, reduced stool volume, duration of diarrhea and ORS requirements in children with severe dehydration or high initial purging rates, and improved weight gain. Amylyte ORS has the advantage of containing short polymers of glucose that provide over five times the calories per liter than the glucose‐based WHO ORS.