乳糖酶缺乏症和乳糖不耐受症:当前认识和未来方向

K. Rachwał, Karol Wielgus, Piotr Bator, Wiktor Razik, Grzegorz Łyko, Maria Antos, Julia Furgalska, Maria Pawłowska, A. Wawryszuk
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摘要

简介和目的:乳糖是牛奶中的主要碳水化合物,需要乳糖酶来消化。乳糖酶活性不足会导致乳糖不耐症,引起胃肠道症状。了解影响乳糖酶表达和活性的遗传和环境因素至关重要。此外,还需要准确的诊断方法和有效的治疗手段来控制乳糖不耐受症。本综述旨在探讨有关乳糖酶缺乏症、乳糖不耐受症、诊断方法和治疗方案的现有知识。知识现状: 乳糖酶缺乏症包括先天性、原发性和继发性三种形式,每种形式都有不同的病因。虽然乳糖酶缺乏症和乳糖不耐受症经常被互换使用,但两者是不同的。然而,乳糖酶缺乏症和乳糖不耐症之间的关系很复杂,受饮食习惯、肠道微生物群和胃肠道蠕动等多种因素的影响。诊断方法有限,治疗策略主要包括调整饮食、补充乳糖酶和益生菌。 结论乳糖不耐受症给临床带来了巨大挑战,常常被低估和误诊。尽管诊断技术不断进步,但仍需进一步研究以提高诊断的准确性。治疗重点在于调整饮食、补充酶和益生菌。在缓解症状与营养充足之间取得平衡至关重要。未来的研究应通过临床试验探索肠道微生物组调节在乳糖不耐受治疗中的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Lactase Deficiency and Lactose Intolerance: Current Understanding and Future Directions
Introduction and purpose: Lactose, the primary carbohydrate in milk, requires the enzyme lactase for digestion. Deficiency in lactase activity leads to lactose intolerance, causing gastrointestinal symptoms. Understanding the genetic and environmental factors influencing lactase expression and activity is crucial. Moreover, accurate diagnostic methods and effective treatments are needed to manage lactose intolerance. This review aims to explore the current knowledge on lactase deficiency, lactose intolerance, diagnostic methods, and treatment options. State of knowledge:  Lactase deficiency encompasses congenital, primary, and secondary forms, each with distinct etiologies. Although often used interchangeably, lactase deficiency and lactose intolerance differ. However, the association between lactase deficiency and lactose intolerance is complex, influenced by various factors including dietary habits, gut microbiota, and gastrointestinal motility. Diagnostic methods are limited, and treatment strategies primarily involve dietary modifications, lactase supplementation, and probiotics.  Conclusion: Lactose intolerance presents significant clinical challenges, often underrecognized and misdiagnosed. Despite diagnostic advancements further research is needed to refine diagnostic accuracy. Treatment focuses on dietary adjustments, enzyme supplementation, and probiotics. Balancing symptom relief with nutritional adequacy is essential. Future studies should explore the role of gut microbiome modulation in lactose intolerance management through clinical trials. 
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