RESISTANT STARCH: ADJUNCT TO ORAL REHYDRATION SOLUTION

抗性淀粉：口服补液的辅助剂

• 批准号: 6177684
• 负责人: HENRY J BINDER
• 金额: $ 7.16万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-30 至 2003-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6177684
• 关键词: amylases; body fluid balance therapy; body fluids; carbohydrate metabolism; clinical research; clinical trials; diarrhea; feces analysis; gastrointestinal nutrient absorption; human subject; human therapy evaluation; infant human (0-1 year); oral administration; preschool child (1-5); short chain fatty acid; starch; water solution

Oral rehydration therapy (ORT) of diarrhea, while effective in correcting dehydration, is poorly accepted in many communities. One significant reason for this is the inability of conventional ORT to shorten diarrhea or reduce fecal fluid losses. The recent demonstration that short chain fatty acid (SCFA) stimulation of colonic Na-CI absorption is not inhibited by cyclic AMP suggested the possibility that colonic SCFA could provide an adjunct to standard ORT. We have recently found that resistant starch (i.e. starch that is relatively resistant to amylase), which is metabolized to SCFA in the colon, significantly reduces duration of diarrhea in adults with cholera. Since children often have diarrhea due to causes other than cholera, the proposed study will evaluate whether ORT with resistant starch will reduce fecal fluid losses and the duration of diarrhea in children with acute diarrhea. Two hundred and fifty-eight children with diarrhea and mild to moderate dehydration will be randomized to receive either standard treatment with glucose-ORS or treatment with glucose-ORS containing resistant maize starch 50 g/l. Both groups will be treated according to a standardized protocol recommended by the W.H.O., including refeeding after 4 hours of initial rehydration. The end-points will include measurement of fecal volumes and the time from admission to the last unformed stool, assessed by an observer who is blinded to the treatment received. Treatment failures will be categorized and recorded. If resistant starch is found to reduce fecal volumes and/or duration of diarrhea, this innovative therapy must then be tested in the community for acceptance.

腹泻的口服补液疗法（ORT）虽然可以有效纠正脱水，但在许多社区中的接受度很低。造成这种情况的一个重要原因是传统的 ORT 无法缩短腹泻或减少粪便液体流失。最近的研究表明，短链脂肪酸 (SCFA) 对结肠 Na-CI 吸收的刺激不受环 AMP 的抑制，这表明结肠 SCFA 可以作为标准 ORT 的辅助手段。我们最近发现，抗性淀粉（即对淀粉酶具有相对抵抗力的淀粉）在结肠中代谢为 SCFA，可显着缩短霍乱成人腹泻的持续时间。由于儿童经常因霍乱以外的原因而腹泻，因此拟议的研究将评估抗性淀粉口服补剂是否会减少急性腹泻儿童的粪便液体流失和腹泻持续时间。 258 名患有腹泻和轻度至中度脱水的儿童将被随机分配接受葡萄糖-ORS 标准治疗或含有 50 g/l 抗性玉米淀粉的葡萄糖-ORS 治疗。两组都将根据世界卫生组织推荐的标准化方案进行治疗，包括在初始补液 4 小时后重新进食。终点将包括粪便量的测量以及从入院到最后一次不成形粪便的时间，由对所接受治疗不知情的观察者进行评估。治疗失败将被分类并记录。如果发现抗性淀粉可以减少粪便量和/或腹泻持续时间，则必须在社区中测试这种创新疗法是否被接受。