布拉氏酵母菌散剂预防婴幼儿抗菌药物相关性腹泻临床观察

Observation on the clinical effects of Saccharomyces boulardii sachets in preventing antibiotic-associated diarrhea in children

目的观察布拉氏酵母菌散剂预防婴幼儿抗菌药物相关性腹泻(antibiotic-associated diarrhea,AAD)的临床疗效。方法将168例应用抗菌药物治疗的支气管肺炎患儿随机分为两组,对照组78例,给予常规抗感染治疗;预防组90例,在对照组常规抗感染治疗基础上加服布拉氏酵母菌散剂,服用剂量:年龄<6月,0.25 g/d;~1岁,0.5 g/d;~3岁,0.5 g/d,均分为2次服用,疗程7~10 d。比较两组腹泻的发生率,观察两组患儿治疗1周后唾液分泌型免疫球蛋白A含量的变化。结果对照组78例发生腹泻34例(43.59%),预防组90例发生腹泻17例(18.89%),两组比较差异有统计学意义(χ2=8.041,P<0.01);对照组发生腹泻次数为(5.38±1.50)次/d,预防组为(3.68±1.10)次/d,两组比较差异有统计学意义(t=3.239,P<0.01);对照组腹泻平均持续时间为(4.84±1.32)d,预防组(3.73±1.33)d,两组比较差异有统计学意义(t=2.245,P<0.05)。1周治疗后,对照组的唾液s Ig A治疗后较治疗前显著降低(t=2.769,P<0.01),而预防组的治疗后与治疗前比较差异无统计学意义(t=0.488,P>0.05)。结论布拉氏酵母菌散剂能有效预防婴幼儿AAD。

Objective To observe the clinical effects of Saccharomyces boulardii sachets in preventing antibi- otic-associated diarrhea （AAD） . Methods 168 child inpatients with bronchopneumonia receiving antibiotic therapy were randomly divided into two groups. The 78 patients in the control group were treated with con- ventional anti-infection therapy, while the 90 patients in the prevention group, based on the above therapy, were given Saccharomyces boulardii sachets, 0.25 g/day for children aged〈6 months, 0.5 g/day for those aged from 6 months to 1 year, 0.5 g/daY for those aged from〉1 year to 3 years, taken orally in 2 times each day for 7 to 10 days. Then the incidence rates of diarrhea in the two groups were compared and the lev- els of salivary secretary IgA （sIgA） at 1 week after treatment were examined. Results 34 patients （43.59%） in the control group vs 13 patients （18.89%） in the prevention group suffered from diarrhea （X^2 = 8. 041, P%0.01） . The diarrhea frequency in control group was 5.38 ± 1.50 times each day while that in prevention group was 3.68±1.10 times each day （t=3. 239, P%O. 01） . The average duration of diar- rhea was 4.84±1.32 days in the control groupvs3.73±l. 33 days in the prevention group （t=2.435, P% 0.05） . After one week of treatment, the level of salivary slgA reduced significantly in control group （t= 2. 769, P〈0.01）, but there was no significant change in prevention group （t = 0. 488, P〈0.05） . Conclusion Saccharomvces boulardii sachets can be used to prevent AAD in infants.