Chronic diarrhea: Causes,presentation, and mangement

Important inroads are being made into understanding the pathophysiology of diarrhea. Clear understanding of key mechanisms should suggest new approaches to combat disease. Exciting developments are occurring in terms of super-ORS solutions, particularly with the promise of short chained glucose polymers and glutamine. Perhaps the most important development is the prospect of a good rotavirus vaccine being available before the end of the decade. Chronic diarrhea seems to be on the increase globally, probably because of the success of ORS. The mechanisms that lead to mucosal injury are elusive, and therapy still largely supportive and empiric. Celiac disease continues to be a puzzle, because of the uncomfortable feeling that a majority of cases may be missed because of atypical presentations. The successful use of long term parenteral nutrition has allowed survival and better charaterization of cases that otherwise would have perished as ‘lethal protracted diarrhea’. Microvillus inclusion disease may be the commonest congenital secretory diarrhea. The role of the recently reported high prevalence of glucoamlase deficiency may be important. Lastly, attention to micronutrients, particularly low vitamin A and probably zinc may prove to be important in prevention and amelioration of diarrhea and growth failure.     

Loperamide

In castor oil challenged rats, low doses of loperamide inhibit diarrhea and normalize intestinal propulsion. Unlike other opioids, loperamide is devoid of central opiate-like effects, including blockade of intestinal propulsion, up to the highest subtoxic oral dose. Nevertheless, the antidiarrheal action of loperamide can be considered to be -opiate receptor mediated, only a fewin vitro effects at rather high concentrations being not naloxone-reversible. There is little evidence that interactions with intestinal opiate receptors directly change epithelial cell function. When secretory stimuli increase mucosal tension, however, loperamide may reverse the elevated hydrostatic tissue pressure that opposes normal absorption. This antisecretory effect at the mucosal level is accompanied by motor effects when loperamide reaches the myenteric -opiate receptors. At therapeutic doses for the treatment of acute diarrhea, it is likely that the mucosal effect prevails.     

合生元治疗肝硬化腹泻疗效观察

目的　观察合生元治疗肝硬化腹泻的疗效。 方法　74例病人随机分成两组 ,治疗组 37例 ,用合生元 1粒 ,po ,bid ;对照组 37例 ,用黄连素 0 .3g ,po ,tid ,疗程均为 2周。 结果　 治疗组临床有效率为 83.78% ,对照组为 4 3.2 4 % ;两组间有显著性差异 (P <0 .0 1)。 结论　合生元是治疗肝硬化合并腹泻的有效药物。     

整肠生治疗胃癌根治术后腹泻的临床观察

目的：从微生态角度现察胃癌根治术后腹泻临床治疗。方法：治疗组：27例胃癌根治术后腹泻患者用整肠生胶囊，2粒／次、3次／日口服。对照组：27例胃癌根治术后腹泻患者用吡哌酸0．58／次，3次／日口服。治疗前后观察粪便球杆菌比变化。结果：治疗组总有效率93％，以及恢复正常菌群高于对照组，有显著差异。结论：整肠生有效治疗胃癌根治术后腹泻。     

小儿腹泻的营养疗法研究

目的　探讨复方营养合剂对腹泻患儿的辅助治疗效果。方法　采用询问法对 10 2例腹泻患儿进行膳食调查 ,将患儿随机分为 2组 ,对照组予常规治疗 ,治疗组在常规治疗基础上加用复方营养合剂 ,观察两组疗效。结果　在改善患儿体温、体质量、精神状态、大便性状、纠正脱水等方面两组均无显著性差异 ,但治疗组腹泻次数明显减少 ,病程明显缩短 ,与对照组比较有显著性差异 (P <0 .0 5,P <0 .0 1)。结论　复方营养合剂对儿童腹泻有辅助治疗效果     

Fifty- four infantile intractable diarrhea patients treated with integrated traditional chinese and western medicine

Ｉｎｆａｎｔｉｌｅｉｎｔｒａｃｔａｂｌｅｄｉａｒｒｈｅａ（ＩＩＤ）ｗａｓｕｓｕａｌｌｙｃｏｍｐｌｉｃａｔｅｄｗｉｔｈｍａｌｎｕｔｒｉｔｉｏｎ,ｇｒｏｗｔｈｒｅｔａｒｄａｔｉｏｎａｎｄｐｕｌｍｏｎａｒｙｉｎｆｅｃｔｉｏｎ,ｅｔｃ．Ｉｔｉｓｄｉｆｆｉｃｕｌｔｔｏｃｕｒｅ,ａｎｄｍｏｒｔａｌｉｔｙｉｓｒａｔｈｅｒｈｉｇｈ．ＴｈｅａｕｔｈｏｒｓｕｓｅｄｉｎｔｅｇｒａｔｅｄｔｒａｄｉｔｉｏｎａｌＣｈｉ ｎｅｓｅａｎｄｗｅｓｔｅｒｎｍｅｄｉｃｉｎｅｔｈｅｒａｐｙｔｏｔｒｅａｔｉｔ,ａｎｄｓａｔｉｓｆａｃｔｏ…     

脾胃康口服液健脾止泻作用的药理研究

脾胃康口服液对生大黄冷浸液灌胃引起的小鼠腹泻有较好止泻作用，并能对抗甲基新斯的明引起的小肠推进机能亢进，改善小鼠脾虚体征，促进血清溶血素形成，对于ＤＮＣＢ诱导小鼠ＤＴＨ反应具有增强作用。     

马鞍山、苏州两所医院5a以下急性腹泻患儿A组轮状病毒感染特征

目的 研究马鞍山和苏州两所医院5a以下急性腹泻患儿轮状病毒感染情况。方法 采用酶联免疫吸附试验对两市5a以下儿童的急性腹泻粪便标本1267份进行轮状病毒病原检测。结果 1267份标本中轮状病毒阳性378例，阳性率为29．83％。发病年龄主要在3a以下，流行季节高峰为11月份至次年1月份。结论 轮状病毒感染是两市5a以下儿童急性腹泻的主要致病原因之一。     

思密达联合左氧氟沙星治疗成人急性感染性腹泻60例临床观察

目的：观察恩密达联合左氧氟沙星治疗成人急性感染性腹泻的疗效。方法：所选病例分成A组(60例)、B组(27例)和C组(30例)。给予A组患者恩密达每次1袋(3g)，每日3次，左氧氟沙星每次0.2g，每日2次；给予B组患者恩密达每次一袋(3g)，每日3次；给予C组患者左氧氟沙星，每次0.2g，每日2次。3组疗程均为3天。结果：A组显效51例，有效8例，总有效率达98．30％；B组显效19例，有效3例，总有效率达81．48％；C组显效20例，有效5例，总有效率达86．66％。结论：思密达联合左氧氟沙星治疗成人急性腹泻，疗效高，安全，且不影响抗生素吸收。     

玉露散加味临床治疗小儿泄泻150例体会

目的探讨在祖国医学理论的指导下辨证施治，运用玉露散加味临床治疗小儿泄泻（火泻）。方法通过对近几年临床积累的小儿泄泻（火泻）病例150例（男93例，女57例）进行临床资料综合分析。结果临床150例病例中，服用1剂痊愈21例，占14％；服用2剂痊愈97例，占65％；服用3剂痊愈29例，占19％；服用4剂痊愈3例，占2％。结论玉露散加味对临床因湿热蕴结尤以热盛所致的小儿泄泻（火泻），能达到清热泻火，利水渗湿的治疗作用，疗效佳，为治泻选方提供范例。