双歧三联活菌片联合蒙脱石散对腹泻患儿临床症状、免疫指标及不良反应的影响

Probiotics combined with montmorillonite for treatment of diarrhea in children: Effect on clinical symptoms, immune function, and adverse reactions

目的分析小儿腹泻患儿采用蒙脱石联合双歧三联活菌片治疗效果,并分析免疫指标变化,为临床治疗提高参考.方法选取浙江永康市妇幼保健院在2014-09/2015-08收治小儿腹泻患者124例为研究对象,随机分为观察组和对照组各62例,对照组患儿给予降温、补液、纠正电解质平衡等常规治疗,观察组患儿在此治疗基础上,采用蒙脱石散联合双歧三联活菌片治疗,两组患儿均治疗2疗程,观察两组患儿治疗效果,记录两组患儿临床症状缓解时间,并比较治疗前后免疫功能指标变化.结果观察组患儿临床治疗总有效率显著高于对照组(93.6%vs 79.1%,P<0.05).观察组患儿大便性状、退热、呕吐消失、腹痛缓解及粪便常规恢复正常时间均显著短于对照组(2.1 d±1.0 d vs 4.7 d±2.0 d;1.3 d±0.6 d vs2.7 d±0.8 d;1.2 d±0.4 d vs 2.5 d±0.9 d;1.2d±0.4 d vs 2.3 d±0.8 d;2.5 d±1.0 d vs 4.5d±1.3 d,P<0.05).经过治疗,两组患儿免疫功能各指标均得到改善(P<0.05),治疗后观察组IgA、IgG及CD4^+/CD8^+均显著高于对照组(1.76 g/L±0.39 g/L vs 1.31 g/L±0.52 g/L;15.72 g/L±0.63 g/L vs 10.95 g/L±0.64 g/L;1.73±0.25 vs 1.38±0.25,P<0.05).在治疗中均未出现明显不良反应.结论蒙脱石散联合双歧三联活菌片治疗小儿腹泻能够提高治疗效果,缩短临床症状改善时间,并能够改善患儿免疫功能,具有使用价值.

AIM To evaluate the effect of probiotics combined with montmorillonite on clinical symptoms, immune function, and adverse reactions in children with diarrhea, in order to provide reference for clinical treatment of this disease in children.METHODS One hundred and twenty-four children with diarrhea treated at our hospital from September 2014 to August 2015 were randomly divided into either an observation group or a control group. The control group received conventional treatments including cooling, rehydration, and correction of electrolyte balance, and the observation group patients were treated with montmorillonite powder combined with probiotics. Time to clinical remission, indicators of immune functions, and adverse reactions were compared between the two groups. RESULTS The total effective rate was significantly higher in the observation group than in the control group （93.6% vs 79.1%, P 〈 0.05）. Times to stool character recovery, fever remission, vomiting disappearance, abdominal pain relief, and fecal routine indicator recovery were significantly short in the observation than in the control group （2.1 d ± 1.0 d vs 4.7 d ± 2.0 d; 1.3 d ±0.6 d vs 2.7 d ±0.8 d;1.2 d ±0.4 d vs 2.5 d ± 0.9 d; 1.2 d ± 0.4 d vs 2.3 d± 0.8 d, 2.5 d ± 1.0 d vs 4.5 d± 1.3 d, P 〈 0.05）. After treatment, immune function indexes were improved in both groups （P 〈 0.05）, and IgA, IgG, and CD4＊/CD8＊ ratio were significantly higher in the observation group than in the control group （1.76 g/L ± 0.39 g/L vs 1.31 g/L ± 0.52 g/L; 15.72 g/L ± 0.63 g/L vs 10.95 g/L± 0.64 g/L, 1.73 ± 0.25 vs 1.38 ± 0.25. P 〈 0.05）. There were no significant adverse reactions observed in the treatment.CONCLUSION Montmorillonite powder combined with probiotics in the treatment of diarrhea in children can improve the therapeutic effect, shorten the time to disappearance of clinical symptoms, and improve immune function.