细菌溶解产物治疗小儿反复呼吸道感染疗效观察及机制探讨

Effect and Mechanism of Broncho-Vaxom in the Treatment of Recurrent Respiratory Tract Infections in Children

目的:观察细菌溶解产物(泛福舒)对小儿反复呼吸道感染临床症状与免疫功能的影响,探讨其作用机制。方法:选择我院2010-2011年收治的96例反复呼吸道感染患儿,按随机数字表法分为观察组和对照组各48例。对照组给予常规治疗,包括抗感染(抗生素或抗病毒药物)及退热、止咳、化痰等对症治疗;观察组在对照组治疗基础上再给予细菌溶解产物(泛福舒)治疗,每次3.5 mg,每天1次,连服10 d,间断20 d,3个月为1疗程。观察症状体征缓解时间、抗生素使用时间,空腹抽血检测治疗前和治疗1疗程后血清免疫球蛋白水平,评价疗效。治疗后随访1年,观察随访期间呼吸道感染复发情况,统计复发次数。结果:(1)观察组和对照组总有效率分别为95.83%和52.08%(P<0.01);(2)观察组咳嗽、发热、喘息、肺部啰音消失时间和抗生素使用时间、随访期间复发次数均少于对照组(P<0.05或P<0.01);(3)治疗后观察组血清IgA、IgG、IgM均升高,且高于对照组(P<0.05),而对照组无明显变化。结论:细菌溶解产物可提高反复呼吸道感染患儿的免疫功能,改善症状,降低复发次数,减轻病情,缩短病程,减少抗生素使用时间,是防治反复呼吸道感染的有效安全药物。

Objective： To observe the effect of bacteria lysate （Broncho-Vaxom） in the treatment of children with recurrent respiratory tract infections, and to investigate its mechanism. Methods： Ninty-six cases of children with recurrent respiratory tract infections according to random number table was divided into an observation group （n = 48 ） and a control group （n = 48 ）. Both groups were given conventional treatment, including antivirals or anti-infection, antipyretic, antitussive and expectorant; the observation group was given bacteria lysate （Broncho-Vaxom） additionally, 3.5 mg, once a day for 10 days, 20-day interval. The treatment course was three months. Alleviation of symptoms and signs, treatment course of antibiotics, serum immunoglobulin levels before and after treatment for one course were observed. The curative effect was evaluated. Recurrent respiratory tract infections were observed during follow-up for one year, and recurrence rate was calculated. Results： （ 1 ） The total effective rate of the observation group and the control group were 95.83% and 52.08%, respectively （P〈0. 01 ）; （2） The disappearance time of cough, fever, rales and wheezing, the treatment course of antibiotics, and recurrence times in the observation group during follow-up were less than those in the control group （P〈O.05 or P〈0. O1 ）; （3） After treatment serum IgA, IgG and IgM in the observation group were higher than those of the control group （P〈0.05）, while those in the control group had no significant change. Conclusions： Bacterial lysate can improve the immune function of children with recurrent respiratory tract infections, reduce the recurrence rate, and shorten the course of the disease and the treatment course of antibiotics. It is effective and safe for prevention and treatment of recurrent respiratory tract infections.