酪酸梭菌活菌散联合乳果糖对小儿功能性便秘的疗效

Curative effect of Clostridium butyricum powder combined with Lactulose on children with functional constipation

目的探讨酪酸梭菌活菌散联合乳果糖对小儿功能性便秘(FC)的疗效。方法将92例儿童FC患儿随机分为实验组和对照组各46例。两组患儿均予以多饮水、纠正不良饮食习惯、训练排便习惯和进行适量活动等基础治疗。实验组患儿加用口服酪酸梭菌活菌散(0.5g/次,2次/d,温水冲服)联合乳果糖口服液(5mL/次,2次/d,口服)治疗;对照组患儿予以相同用法及剂量的乳果糖口服液治疗,均连用6周。记录两组患儿治疗前后便秘症状评分和粪便性状分级的变化,并评估其临床效果,并检测治疗前后血清一氧化氮(NO)和血管活性肠肽(VIP)水平的变化。结果治疗6周后,实验组和对照组患儿便秘症状评分均较治疗前明显下降(t值分别为2.97、2.16,均P<0.05),粪便性状分级均较治疗前明显上升(t值分别为3.67、2.42,均P<0.05),且实验组便秘症状评分、粪便性状分级的变化幅度明显大于对照组(t值分别为2.18、2.43,均P<0.05);总有效率实验组患儿明显高于对照组(X^2=5.06,P<0.05)。实验组和对照组治疗中分别出现不良反应5例(10.87%)和3例(6.52%),症状均较轻,两组患儿不良反应发生率比较差异无统计学意义(X^2=0.14,P>0.05);治疗6周后,两组患儿血清NO和VIP水平均较治疗前明显下降(实验组:t值分别为2.89、3.27,均P<0.05;对照组t值分别为2.19、2.39;均p<0.05),且实验组下降程度较对照组更明显(t值分别为2.21、2.32,均P<0.05)。结论口服酪酸梭菌活菌散联合乳果糖治疗儿童FC的临床效果较显著,能明显改善其粪便性状,降低便秘症状评分,降低血清NO和VIP水平,改善肠动力障碍,且安全性亦较好。

Objective To discuss the curative effect and influence on intestinal neurotransmitters of Clostridium butyricum powder combined with lactulose on children with functional constipation （ FC） .Methods Ninety-two cases of children with FC were divided into experimental group and control group randomly with 46 cases in both groups .Two groups were given basic medical treatment , including plenty of water , adjustment of unhealthy eating habit , training stool habit and suitable activities .Children in the experimental group were additionally given oral Clostridium butyricum powder （0.5g per time, twice a day with warm boiled water ） and Lactulose oral liquid （5ml per time, twice a day taken orally ） , while children in the control group were given Lactulose oral liquid with same method and dose for 6 weeks .The changes of constipation symptom score and stool classification of children in two groups were recorded , and the clinical curative effects were evaluated as well .The changes of serum nitric oxide （ NO ） and vasoactive intestinal peptide （ VIP ） levels before and after medical treatment were detected .Results After 6 weeks ’ medical treatment , constipation symptom score of children in two groups declined obviously than before （t value was 2.97 and 2.16, respectively, both P〈0.05）, while stool classification rose obviously than before （t value was 3.67 and 2.42, respectively, both P〈0.05）.The declining or rising degree of children in the experimental group were much greater than those in the control group （t value was 2.18 and 2.43, respectively, both P〈0.05）.Meanwhile, the total clinical efficiency of the experimental group was much higher than the control group （χ2 =5.06,P〈0.05）.There were 5 and 3 cases with adverse reactions in the experimental group （10.87%） and the control group （6.52%）, respectively with light symptoms, and no statistical differences appeared between two groups （χ2 =0.14, P〉0.05）.After 6 weeks’ medical treatment, serum NO and VIP levels of children in two groups declined obviously than before （t value was 2.89 and 3.27, respectively in the experimental group , both P〈0.05;t value was 2.19 and 2.39, respectively in the control group , both P〈0.05）, and the declining degree of the experimental group was much greater than the control group （t value was 2.21 and 2.32, respectively, both P 〈0.05）.Conclusion Clostridium butyricum powder combined with Lactulose has significant clinical effect on children with FC .It can improve stool classification obviously , reduce constipation symptom score, reduce serum NO and VIP levels , and improve intestinal motility with favorable security .