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.

在许多社区中，腹泻的口服补液疗法（ORT）在纠正脱水方面有效地接受了。造成这种情况的一个重要原因是，常规ORT无法缩短腹泻或减少粪便损失。循环AMP抑制了短链脂肪酸（SCFA）刺激结肠Na-CI吸收的最近证明，表明结肠SCFA可以为标准ORT提供辅助功能。我们最近发现，在结肠中代谢为SCFA的抗性淀粉（即相对抗性的淀粉）可显着降低霍乱成年人的腹泻持续时间。由于儿童通常由于霍乱以外的原因而经常患有腹泻，因此拟议的研究将评估耐药性淀粉的ORT是否会减少急性腹泻儿童的粪便损失和腹泻持续时间。腹泻和轻度至中度脱水的28名儿童将被随机分配，以葡萄糖-OS的标准治疗或用含有耐药性玉米淀粉50 g/L的葡萄糖和治疗。两组将根据W.H.O.建议的标准化方案进行处理，包括在初始补液4小时后重新审核。终点将包括测量粪便体积以及从入学到最后一个未成形的凳子的时间，该粪便由对接受治疗的观察者评估。治疗失败将被分类和记录。如果发现抗性淀粉可减少粪便量和/或腹泻持续时间，则必须在社区中对这种创新的疗法进行接受测试。