深度水解蛋白配方奶联合酪酸梭菌对改善婴儿湿疹的作用观察

Curative effect of extensively hydrolyzed protein formula combined with clostridium butyricum on infant eczema

目的观察深度水解蛋白配方奶(e HPF)联合酪酸梭菌改善婴儿湿疹的临床疗效。方法将2014年6月至2016年3月期间,广州市海珠区妇幼保健院门诊收治的90例非母乳喂养的湿疹婴儿随机分为联合治疗组(即在常规治疗基础上以e HPF替代普通配方奶粉,并联合酪酸梭菌)、e HPF治疗组(常规治疗基础上以e HPF替代普通配方奶粉)和对照组(常规治疗且服用普通配方奶粉)各30例,共治疗4周,于治疗1、2周末及4周末各随访1次,使用SCORAD评分方法对婴儿湿疹的严重程度进行评估,并于3个月后测定血清总Ig E。结果治疗1周末,3组SCORAD积分均有改善,但比较差异无统计学意义(P>0.05)。治疗2周末和4周末,3组SCORAD积分均下降,比较差异有统计学意义(F值分别为2.518、3.917,均P<0.05);治疗2周末,联合治疗组与e HPF治疗组SCORAD积分比较,t=-2.399,P>0.05,差异无统计学意义,联合治疗组与对照组比较,t=-4.795,P<0.05,差异有统计学意义;治疗4周末,联合治疗组与e HPF治疗组比较,t=-4.236,P<0.05,差异有统计学意义,联合治疗组与对照组比较,t=-9.014,P<0.05,差异有统计学意义,联合治疗组下降最明显。治疗3个月后,3组血清总Ig E值均下降,比较差异有统计学意义(F=5.827,P<0.05),联合治疗组血清总Ig E平均值比e HPF治疗组和对照组均低(t值分别为-7.489、-9.48,均P<0.05),差异均有统计学意义。结论 e HPF联合酪酸梭菌能有效治疗婴儿湿疹,减轻湿疹症状,且能下调患儿血清Ig E水平。

Objective To observe the curative effect of extensively hydrolyzed protein formula（ e HPF） combined with clostridium butyricum on infant eczema. Methods Altogether 90 infants with eczema not fed with human breast were chosen,and assigned into three groups randomly with 30 cases in each group,combined treatment group（ e HPF replacing general formula milk powder combined with clostridium butyricum on basis of routine treatment）,e HPF treatment group（ e HPF replacing general formula milk powder on basis of routine treatment） and control group（ routine treatment with general formula milk powder）. All infants were treated for 4 weeks. Follow-up was conducted at the end of week 1,week 2 and week 4 after treatment. Severity of infant eczema was assessed with SCORAD score.Total serum Ig E level was detected after 3 months. Results SCORAD scores in three groups were all improved at the end of week 1,and difference had no statistical significance（ P〈0. 05）. SCORAD scores in 3 groups were all lowered at the end of week 2 and week 4,and the differences had statistical significance（ F value was 2. 518 and 3. 917,respectively,both P〈0. 05）. At the end of week 2,difference in SCORAD score between combined treatment group and e HPF treatment group had no statistical significance（ t =-2. 399,P〈0. 05）,but difference between combined treatment group and control group had statistical significance（ t =-4. 795,P〈0. 05）. At the end of week 4,difference between combined treatment group and e HPF group had statistical significance（ t =-4. 236,P〈0. 05） and difference between combined treatment group and control group had statistical significance（ t =-9. 014,P〈0. 05）. SCORAD score in combined treatment group was lowered most significantly. Total serum Ig E levels in three groups declined after 3 months of treatment,and the difference among three groups had statistical significance（ F = 5. 827,P〈0. 05）. Mean serum Ig E in combined treatment group was lower than that in e HPF group and control group,and difference had statistical significance（ t value was-7. 489 and-9. 48,respectively,both P〈0. 05）. Conclusion Treatment of e HPF combined with clostridium butyricum can effectively cure infant eczema,relieve eczema symptoms,and downregulate serum Ig E level.