布拉氏酵母菌治疗反复呼吸道感染患儿的临床疗效

Clinical effect of Saccharomyces boulardii on treatment of children with recurrent respiratory tract infection

目的探究维生素D联合布拉氏酵母菌治疗反复呼吸道感染(RRTI)患儿的临床效果,并分析其对25-羟维生素D3[25-(OH)D3]、干扰素-γ(IFN-γ)、白介素-4(IL-4)水平的影响。方法选取2016年6月-2018年6月武汉市中心医院儿科收治的RRTI患儿322例,按照治疗方案的不同将其分为对照组(n=158)和研究组(n=164)。两组患儿均给予抗病毒、抗感染治疗。对照组给予维生素D滴剂治疗,研究组在此基础上联合布拉氏酵母菌散治疗,两组均连续治疗30 d。统计两组治疗后临床疗效及1年内呼吸道感染次数;比较两组患儿治疗前后25-(OH)D3、IFN-γ、IL-4、IgG、IgA、IgM、CD_4^+、CD_8^+和CD_4^+/CD_8^+的差异。结果治疗后研究组与对照组的临床总有效率分别为93.29%、86.08%,研究组高于对照组(P<0.05);治疗后1年内研究组与对照组平均感染次数分别为(2.21±0.46)次、(3.43±1.09)次,研究组少于对照组(P<0.01);与治疗前相比,治疗后两组25-(OH)D3、IFN-γ、IgG、IgA、IgM、CD_4^+、CD_8^+和CD_4^+/CD_8^+水平均升高,且研究组高于对照组(P<0.05),两组IL-4水平下降,研究组低于对照组(P<0.05)。结论 RRTI患儿应用维生素D联合布拉氏酵母菌可有效提高临床疗效,减少发病次数,提高患儿免疫功能,升高25-(OH)D3、IFN-γ水平,降低IL-4水平。

OBJECTIVE To explore the clinical effect of vitamin D combined with Saccharomyces boulardii on treatment of the children with recurrent respiratory tract infection(RRTI)and observe the influence on 25-hydroxyvitamin D-3[25-(OH)D3],interferon-γ(IFN-γ)and interleukin-4(IL-4).METHODS A total of 322 children with RRTI who were treated in pediatrics department of Wuhan Central Hospital Affiliated to Huazhong University of Science and Technology from Jun 2016 to Jun 2018 were enrolled in the study and divided into the control group with 158 cases and the study group with 164 cases according to the treatment programs.The two groups of children were given antiviral and anti-infection therapies,the control group was treated with vitamin D drops,the study group was given vitamin D drops combined with S.boulardii,and both groups were consecutively treated for 30 days.The clinical curative effects and the number of times of respiratory tract infection within 1 year were statistically analyzed;the levels of 25-(OH)D3,IFN-γ,IL-4,IgG,IgA,IgM,CD4+,CD8+and CD4+/CD8+were observed and compared between the two groups of children before and after the treatment.RESULTS After the treatment,the total effective rate of clinical treatment of the study group was 93.29%,significantly higher than 86.08%of the control group(P<0.05).The average times of infection of the study group was(2.21±0.46)times within 1 year after the treatment,significantly less than(3.43±1.09)times of the control group(P<0.01).The levels of 25-(OH)D3,IFN-γ,IgG,IgA,IgM,CD4+,CD8+and CD4+/CD8+of the two groups were significantly higher after the treatment than before the treatment,and the levels of the above indexes of the study group were significantly higher than those of the control group(P<0.05);the IL-4 level of the two groups was reduced,and the IL-4 level of the study group was significantly lower than that of the control group(P<0.05).CONCLUSION Vitamin D combined with S.boulardii can effectively improve the clinical curative effect of the children with RRTI,reduce the incidence of disease,boost the immune function of the children,elevate the levels of 25-(OH)D3 and IFN-γ,and reduce the IL-4 level.