益生菌辅助治疗腹型过敏性紫癜的临床疗效及对免疫平衡的影响

Clinical efficacy of probiotics in the treatment of abdominal Henoch-Schonlein purpura and its effect on immune balance

目的探讨口服益生菌辅助治疗腹型过敏性紫癜(Henoch?Schonlein purpura,HSP)的临床疗效及对患儿免疫平衡的影响。方法选取就诊我院的腹型HSP患儿80例,按入院先后顺序随机分为两组,益生菌组(40例)和对照组(40例),对照组给予甲强龙、西米替丁、钙剂、维生素C及抗过敏药物,益生菌组在对照组的基础上给予口服酪酸梭菌二联活菌散(常乐康)4周。比较两组患儿腹痛缓解时间、住院时间及1月、3月、6月紫癜复发的情况;比较两组患儿出院1月后的免疫功能、淋巴细胞亚群的情况。结果两组患儿腹痛缓解时间无明显差异(P>0.05);益生菌组患儿住院时间短于对照组,差异有统计学意义(P<0.05);两组患儿1月时的复发率无明显差异(P>0.05);3月、6月复发率低于对照组,差异有统计学意义(P<0.05)。出院1月后益生菌组患儿的IgA、IgG、IgM、CD8^+、CD19^+均低于对照组,CD3^+、CD4^+、CD4^+/CD8^+均高于对照组,差异有统计学意义(P<0.05)。结论口服益生菌辅助治疗腹型HSP,可以促进受损肠粘膜的修复及维持正常肠道粘模的生物屏障,从而缩短住院时间,减少患儿紫癜的复发次数,调节患儿的免疫平衡。

Objective To investigate the clinical efficacy of oral probiotics in children with abdominal Henoch?Schonlein purpura and its effect on immune balance.Methods Eighty children with abdominal Henoch?Schonlein purpura were enrolled in our hospital.They were randomly divided into two groups according to the order of admission.Probiotics group(40 cases)and control group(40 cases).The control group was given with methyl?prednisolone sodium succinate,Cimetidine,calcium,vitamin C and anti?allergic drugs,the probiotic group was given with Clostridium butyricum double active powder(Chang Le Kang)for 4 weeks on the basis of the control group.The remission time of abdominal pain,hospitalization time and recurrence of purpura after one month,after three months,and after six months were compared between the two groups.The immune function and lymphocyte subsets of the two groups were compared after one month of discharge.Results There was no significant difference in the time of abdominal pain relief between the two groups(P>0.05).The hospitalization time of the probiotics group was shorter than that of the control group,and the difference was statistically significant(P<0.05).The recurrence rate of the two groups after one month was no statistically significant(P>0.05);the recurrence rate after three months and six months was lower than that in the control group,and the difference was statistically sig?nificant(P<0.05).After one month of discharge,IgA,IgG,IgM,CD8^+ and CD19^+ were lower in the probiotic group than that in the control group;CD3^+,CD4^+ and CD4^+/CD8^+ were higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Oral probiotics for the treatment of abdominal Henoch?Schonlein purpura can promote the repair of damaged intestinal mucosa and maintain the biological barrier of normal intestinal adhesion mold,thereby shortening the hospital stay,reducing the number of recurrences of children with purpura and regulating the immune balance of the child.