蒙脱石散联合消旋卡多曲对轮状病毒肠炎患儿血清白细胞介素2、6、10及高敏C反应蛋白水平变化的影响

Influence of montmorillonite powder combined with racecadotril granules on serum IL-2,IL-6,IL-10 and hs-CRP levels in children with rotavirus enteritis

目的探讨蒙脱石散联合消旋卡多曲对轮状病毒肠炎患儿血清白细胞介素2(IL-2)、IL-6、IL-10及高敏C反应蛋白(hs-CRP)水平变化的影响。方法选取2014年6月至2016年7月浦江县人民医院76例轮状病毒肠炎患儿,采用随机数字表法分为对照组和研究组,每组38例。两组入院后均给予基础治疗,在此基础上对照组仅采用蒙脱石散,研究组采用蒙脱石散+消旋卡多曲,两组均持续治疗3d。疗程结束后统计对比两组临床疗效、临床症状(大便性状、大便次数、脱水、呕吐、发热)恢复时间、入院时及疗程结束后血清IL-2、IL-6、IL-10、hs-CRP水平变化情况及不良反应发生率。结果研究组临床疗效(轻度便秘、皮疹、恶心)优于对照组[19例(50.00%)比11例(28.95%),16例(42.11%)比15例(39.47%),3例(7.89%)比12例(31.58%)],差异有统计学意义(Z=2.358,P<0.05);研究组大便性状[(45.58±10.11)h]、大便次数[(44.96±10.03)h]、脱水[(33.15±10.27)h]、呕吐[(18.16±6.46)h]、发热[(25.51±10.32)h]改善时间均少于对照组,差异均有统计学意义(t=9.618、8.344、8.557、3.921、9.487,均P<0.05);研究组治疗前血清IL-2、IL-6、IL-10、hs-CRP水平与对照组差异均无统计学意义(均P>0.05),治疗后研究组血清IL-2、IL-10水平较对照组高,血清IL-6、hs-CRP水平较对照组低,差异均有统计学意义(t=5.545、7.705、7.090、10.352,均P<0.05);研究组与对照组不良反应发生率比较差异无统计学意义(10.52%比13.15%,χ^2=0.000,P>0.05)。结论蒙脱石散联合消旋卡多曲治疗轮状病毒肠炎可显著缓解患儿临床症状,改善血清炎性因子水平,缓解体内炎性反应,提高治疗效果,且安全性较高。

Objective To investigate the effect of montmorillonite powder combined with racecadotril granules on serum levels of interleukin-2(IL-2),interleukin-6(IL-6),interleukin-10(IL-10)and high-sensitivity C-reactive protein(hs-CRP)in children with rotavirus enteritis.MethodsFrom June 2014 to July 2016,76 children with rotavirus enteritis in the People′s Hospital of Pujiang County were selected and randomly divided into control group and study group according to the digital table,with 38 cases in each group.The two groups were given basic treatment after admission,on the basis,the control group was treated with montmorillonite powder,and the study group was treated with montmorillonite powder combined with racecadotril granules.The two groups were treated for 3 days.The clinical efficacy,clinical symptoms(stool,stool frequency,dehydration,vomiting,fever)recovery time,serum IL-2,IL-6,IL-10 and hs-CRP levels at admission and after treatment,and the incidence of adverse reactions were statistically compared between the two groups.ResultsThe clinical efficacy of the study group(mild constipation,rash,nausea)was better than the control group[19 cases(50.00%)vs.11 cases(28.95%),16 cases(42.11%)vs.15 cases(39.47%),3 cases(7.89%)vs.12 cases(31.58%)],the difference was statistically significant(Z=2.358,P<0.05).The recovery time of stool character[(45.58±10.11)h],stool frequency[(44.96±10.03)h],dehydration[(33.15±10.27)h],vomit[(18.16±6.46)h],and fever[(25.51±10.32)h]of the study group were less than those of the control group(t=9.618,8.344,8.557,3.921,9.487,all P<0.05).The serum levels of IL-2,IL-6,IL-10 and hs-CRP before treatment between the two groups had no statistically significant differences(all P>0.05).After treatment,the serum levels of IL-2 and IL-10 in the study group were higher than those in the control group,the serum levels of IL-6 and hs-CRP were lower than those in the control group,the differences were statistically significant(t=5.545,7.705,7.090,10.352,all P<0.05).The incidence rate of adverse reactions between the study group and the control group had no statistically significant difference(10.52%vs.13.15%,χ^2=0.000,P>0.05).ConclusionMontmorillonite powder combined with racecadotril granules in the treatment of rotavirus enteritis can effectively relieve the clinical symptoms,improve the serum inflammatory factors level,reduce the inflammatory reaction in vivo,improve the therapeutic effect and has high safety.