酪酸梭菌活菌散联合醒脾养儿颗粒治疗小儿消化不良性腹泻的效果观察

Curative Effect of Clostridium Butyricum Powder Combined with Xingpi yanger Granule on Treatment of Pediatric Lienteric Diarrhea

目的探讨酪酸梭菌活菌散联合醒脾养儿颗粒治疗小儿消化不良性腹泻的疗效。方法将2014年7月至2015年7月保定市儿童医院收治的140例消化不良性腹泻患儿采用随机数字表法分为联合组（70例）和对照组（70例）。对照组口服醒脾养儿颗粒治疗（〈1岁儿童每次1袋，每日2次；1～3岁儿童每次2袋，每日2次；〉3岁儿童每次3～4袋，每次2次），联合组在对照组基础上口服酪酸梭菌活菌散治疗（每次1袋，每日2次），两组患儿均治疗3d。比较两组患儿体温、腹胀、腹泻、大便次数、大便性状好转时间，疗效及不良反应发生率，分别于治疗前、治疗后第1、2、3日采用放射免疫吸附法检测两组患儿血清生长抑素、胃动素、胃泌素水平。结果联合组患儿发热[（1．4±0．2）d]、腹胀[（2．4±O．5）d]、腹泻[（2．6±0．7）d]、大便性状[（3．2±0．6）d]等临床症状好转时间、大便次数[（1．7±0．4）次]与对照组[（2．3±0．6）d、（3．7±0．8）d、（4．5±1．0）d、（5．4±1．1）d、（2．9±0．6）次]比较，差异有统计学意义（P〈0．05）；联合组的总有效率为91．4％（64／70），对照组为78．6％（55／70），比较差异有统计学意义（P〈0．05），且联合治疗组的疗效显著优于对照组（P〈0．05）。联合组的不良反应发生率为8．6％（6／70），对照组为4．3％（3／70），比较差异无统计学意义（P〉0．05）。两组患儿血清生长抑素、胃动素、胃泌素水平在组间、不同时点间以及组间·不同时点间比较，差异均有统计学意义（P〈0．05）。治疗后，两组患儿血清生长抑素的水平呈上升趋势，胃动素、胃泌素水平呈下降趋势，其中联合组各时段血清生长抑素水平高于对照组，胃动素、胃泌素水平低于对照组。结论醒脾养儿颗粒联合酪酸梭菌活菌散治疗小儿消化不良性腹泻临床疗效好、安全性高，其作用机制可能与调节患儿胃肠激素有关。

Objective To explore the curative effect of clostridium butyricum powder combined with xingpi yanger granule on pediatric lienteric diarrhea, Methods Total of 140 cases of lienteric diarrhea patients treated in Banding Children＇s Hospital from Jul. 2014 to Jul. 2015 were divided into combined group（70 cases） and control group（70 cases） according to the random number table method. The control group was given xingpi yanger granule（ 〈 1 year old 1 bag per time,twice a day, I to 3 years old 2 bags per time,twice a day, 〉3 years old 3-4 bags per time,twice a day）. The combined group was given elostridium butyricum powder（ 1 bag per time, twice a day） by oral on the basis of the control group＇s regimen, both- groups were treated for 3 days. The turnaround time of body temperature, abdominal distension, diarrhea, stool frequency, stool characteristics, the incidence of adverse reactions of the two groups were compared, and serum somatostatin, motilin and gastrin levels before and 1 d, 2 d and 3 d after treatment were compared. Results The turnaround time of body temperature [ （ 1.4 ± 0. 2 ） d ], abdominal distension [ （ 2. 4 ± 0. 5 ） d ], diarrhea [ （2. 6 ± 0. 7 ） d ], stool characteristics [ （3.2 ± 0. 6 ） d ] and stool frequency [ （ 1.7 ± 0.4 ） time ] of the combined group were earlier than the control group [ （ 2. 3 ± 0. 6 ） d, （ 3.7 ± 0. 8 ） d, （4. 5 ± 1.0 ） d, （5.4 ± 1.1 ） d, （2.9 ± 0. 6） times ] （ P 〈 0. 05 ）. The total effective rate of the combined group was 91.4% （64/70） and of the control group was 78.6% （55/70）, the curative effect was significantly better than the control group （P 〈 0. 05 ）. The adverse reaction incidence of the combined group was 8.6% （6/ 70 ）, of the control group was 4. 3 % （ 3/70 ）, there was no statistically significant difference （ P 〉 0. 05 ）. After treatment,the serum somatostatin, motilin and gastrin levels of the two groups, different time points and interaction of groups ~ different time points were statistically significantly different （ P 〈 0. 05 ）. The serum somatostatin levels of both groups showed upward trend, motilin and gastrin levels were decreased after treatmerit, and the somatostatin level of the combined group was higher than the control group ,the motilin and gastrin levels were lower than the control group during different time periods. Conclusion The curative effect and safety of clostridium butyricum powder combined with xingpi yanger granule on treatment of lienteric diarrhea are good, and the mechanism may be related to the regulation of gastrointestinal hormones.