锌-益生菌与锌治疗儿童急性水样腹泻的疗效比较

Rumy Tabrez Hyder, Shafi Ahmed, ATM Faruque Ahmed
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摘要

背景:急性水样腹泻仍然是全世界5岁以下儿童的主要健康问题。除了口服补液、持续喂养和口服锌疗法外,服用足量的益生菌似乎对发展中国家儿童的急性腹泻发作有益。目的:比较锌-益生菌联合治疗与单用锌治疗儿童急性水样腹泻的疗效。材料与方法:这是一项基于医院的随机对照临床试验(RCT),于2019年7月至2021年6月在赫瓦贾尤努斯阿里医学院和医院儿科进行。本研究共纳入70名6个月至5岁住院的急性水样腹泻(AWD)患儿,患儿伴有严重脱水或部分脱水并难治性呕吐。患者平均分为两组。A组患者口服硫酸锌20 mg/天,连用10天,同时口服克劳杆菌益生菌400万孢子/天,连用5天。B组仅给予与a组相同剂量的口服硫酸锌。我们还研究了母亲的教育程度、ORS制剂知识、儿童的喂养习惯和营养状况与儿童腹泻发生的关系。结果:B组(仅锌)腹泻频率明显高于A组(锌和益生菌)。B组(锌组)平均腹泻次数、平均腹泻持续时间和平均住院时间显著高于A组(锌+益生菌组)。结论:与单纯口服锌治疗相比;口服锌和益生菌联合治疗在临床上对降低5岁以下儿童急性水样腹泻的发生率更为有效。KYAMC学报第13卷第4期,2023年1月:218-222
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Compare the Effect of Zinc–Probiotic versus Zinc Therapy in Acute Watery Diarrhea in Children
Background: Acute watery diarrhea still remains a major health problem among under 5 children worldwide. Apart from oral rehydration solution, continued feeding and oral zinc therapy the administration of adequate amounts of probiotics seems beneficial for acute diarrheal episodes in children in the developing world. Objective: To compare the efficacy of zinc-probiotic combination therapy versus zinc-only therapy in children with acute watery diarrhea. Materials and Methods: This was a hospital based randomized controlled clinical trial (RCT) conducted from July 2019 to June 2021 in the Department of Pediatrics, Khwaja Yunus Ali Medical College & Hospital. Total 70 children aged 6 months to 5 years admitted in hospital with acute watery diarrhea (AWD) with severe dehydration or some dehydration with intractable vomiting were included in this study. Patients were equally divided into 2 groups. Group A received oral zinc sulfate 20 mg/day for 10 days combined with oral Bacillus clausii probiotic 4million spores/day for 5 days. Group B received only oral zinc sulfate at the same dosage as group A. We also studied the relationship between mother`s education, knowledge of ORS preparation and child’s feeding practices and nutritional status with the occurrence of diarrhea in children. Results: Frequency of diarrhoea was significantly higher in group B (Zinc only) in comparison to group A (Zinc and probiotic). Mean frequency of diarrhea, Mean duration of diarrhea and Mean length of hospital stay was significantly higher in group B (Zinc) than group A (Zinc+Probiotic). Conclusion: Compared to oral Zinc therapy only; the combination of oral zinc and probiotic therapy is clinically more effective in reducing the frequency of acute watery diarrhea in under 5 years children. KYAMC Journal Vol. 13, No. 04, January 2023: 218-222
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