Abstract: The metabolism of lactose primarily relies on the hydrolytic action of lactase, whose activity is regulated by genetic factors and developmental stages.Lactose intolerance can be classified into four types: primary, secondary, congenital, and developmental, with diverse clinical manifestations.Diagnostic methods include hydrogen breath test, lactose tolerance test, and genetic testing, but there is currently no simple and reliable standardized diagnostic approach.Treatment strategies encompass dietary modifications, enzyme replacement therapy, and probiotic supplementation.This article summarizes the metabolic mechanisms of lactose in the intestine, as well as recent advances in the pathophysiology, diagnosis, and treatment of lactose intolerance.A deeper understanding of lactose metabolism is crucial for improving the management of lactose intolerance.

Key words: lactose metabolism, lactose intolerance, lactase, intestinal flora

摘要： 乳糖代谢主要依赖于乳糖酶的水解作用,其活性受基因调控和发育阶段影响。乳糖不耐受症可分为原发性、继发性、先天性和发育性4类,临床表现多样。诊断方法包括氢呼气试验、乳糖耐量试验和基因检测等,但尚无简便可靠的方法学诊断标准。治疗策略涵盖饮食调整、酶替代疗法和益生菌应用等。本文总结了乳糖在肠道的代谢机制及乳糖不耐受症的病理生理、诊断和治疗进展,对深入了解乳糖代谢机制及改善乳糖不耐受症管理具有重要意义。

关键词: 乳糖代谢, 乳糖不耐受症, 乳糖酶, 肠道菌群