匹多莫德联合酪酸梭菌活菌散治疗儿童抗生素相关性腹泻的临床疗效及对免疫功能与肠道菌群的影响

Clinical effect of Pidotimod combined with Clostridium butyricum powder on antibiotic-associated diarrhea in children and its influence on immune function and intestinal flora

目的探讨匹多莫德联合酪酸梭菌活菌散治疗儿童抗生素相关性腹泻(AAD)的临床疗效及对免疫功能与肠道菌群的影响。方法选择74例抗生素相关性腹泻患儿,随机分为观察组和对照组。两组患儿均予以常规治疗,包括:抗炎、止泻、营养支持等,并予以酪酸梭酸活菌散0.5g,2次/d,疗程2周,观察组在此治疗的基础上加用匹多莫德口服液,400mg/次,2次/d,疗程2周。观察两组患儿治疗效果及不良反应发生情况,同时在治疗前后检测患儿粪便的球/杆菌比例、sIgA含量及免疫球蛋白IgA、IgM,T淋巴细胞亚群CD3+、CD4+、CD8+数值。比较不同治疗方案对患儿免疫功能及肠道菌群的影响。结果治疗2周后,两组患儿的球/杆菌比例均较治疗前下降(t=4.27、2.15,P<0.05或P<0.01),且观察组降低幅度明显大于对照组(t=3.26,P<0.01);治疗2周后,两组患儿粪便sIgA含量均较治疗前升高(t=3.88,2.32,P<0.05或P<0.01),且观察组升高幅度大于对照组(t=2.45,P<0.05);治疗2周后,两组患儿免疫球蛋白IgA、IgM及T淋巴细胞亚群CD3+、CD4+数值均较治疗前升高(t=5.79、2.50、4.99、2.38,2.03、2.14、2.25、2.19,P<0.05或P<0.01),且观察组升高的幅度大于对照组(t=2.2762、2.1872、3.1890、2.3018,P<0.05或P<0.01),而CD8+数值均较治疗前降低(t=5.98、2.39,P<0.05或P<0.01),且观察组降低的幅度大于对照组(t=2.15,P<0.05);观察组治疗有效率明显优于对照组(χ2=5.64,P<0.05);两组患儿治疗后均未发生药物不良反应。结论匹多莫德联合酪酸梭酸活菌散治疗儿童抗生素相关性腹泻能够有效的改善儿童的肠道菌群和免疫功能,提高治疗效果,安全性佳。

Objective To discuss the clinical efficacy of Pidotimod combined with Clostridium butyricum powder on antibiotic-associated diarrhea（AAD）in children and its influence on immune function and intestinal flora.Methods 74 children with AAD were selected and divided into observation group and control group at random.Both groups were given routine medical treatment and 0.5g Bifid-Triple Viable Capsules,b.i.d.for 2weeks,while the observation group was additionally given 400 mg Pidotimod orally t.i.d.for 2weeks.The efficacy and adverse reactions in the two groups were observed,and the ratio of cocci/bacilli in stool,sIgA,immunoglobulin（IgA and IgM）and T achroacyte subgroup（CD3＋,CD4＋and CD8＋）of the children were detected before and after medical treatment.The influence of different therapies on immune function and intestinal flora were compared.Results After treatment,the ratio of cocci/bacilli in both groups declined（P〈0.05 or P〈0.01）,and the declining rate in observation group was much higher than that in control group（P〈0.01）.The sIgA level in stool of the children in both groups rose than before（P〈0.05 or P〈0.01）,and the rising rate in observation group was higher than that in control group（P〈0.05）.The levels of immunoglobulins（IgA and IgM）and T achroacyte subgroups（CD3＋and CD4＋）of children in both groups rose than before（P〈0.05 or P〈0.01）,with the rising rates in observation group higher than those in control group（P〈0.05 or P〈0.01）,while the CD8＋declined（P〈0.05 or P〈0.01）,with the declining rate in observation group higher than that in control group（P〈0.05）.The efficiency rate in observation group was much higher than that in control group（P〈0.05）.No drug adverse reactions（DARs）appeared in both groups after medical treatment.Conclusion Pidotimod combined with Clostridium butyricum powder for treatment of AAD in children can effectively improve intestinal flora.immune function,and clinical efficacy,with good safety.