匹多莫德联合酪酸梭菌活菌片治疗反复呼吸道感染患儿疗效观察

Efficacy of Pidotimod Combined with Live Clostridium Butyricum Tablets in the Treatment of Children with Recurrent Respiratory Infections

目的:观察匹多莫德联合酪酸梭菌活菌片治疗反复呼吸道感染患儿的疗效。方法:117例反复呼吸道感染患儿随机分为3组各39例。3组均给予常规治疗,对照A组加用匹多莫德颗粒0.4 g,po,bid,对照B组加用酪酸梭菌活菌片0.5 g,po,bid,研究组加用匹多莫德颗粒0.4 g,po,bid联合酪酸梭菌活菌片0.5 g,po,bid治疗。连续治疗8周后,对比3组临床疗效、药品不良反应发生率,以及治疗前后呼吸道感染症状持续时间、血清免疫球蛋白指标[免疫球蛋白(Ig)A、IgM、IgG]、外周血辅助性T17细胞/调节性T细胞(Th17/Treg)比值、血清25羟维生素D3[25-(OH)D3]、甘露聚糖结合蛋白(MBP)水平变化。结果:研究组治疗总有效率为94.87%,高于对照A组(69.23%)和对照B组(76.92%)(P<0.05)。治疗后,3组患儿呼吸道感染症状持续时间均较治疗前明显缩短(P<0.05),且研究组明显短于对照A和对照B组(P<0.05)。治疗后,3组外周血Th17、Th17/Treg比值,血清IgA、IgM、IgG水平和血清25-(OH)D3、MBP水平均较治疗前明显改善(P<0.05);且研究组各项指标均明显优于对照A和对照B组(P<0.05)。3组药品不良反应总发生率差异无统计学意义(P>0.05)。结论:采用匹多莫德联合酪酸梭菌活菌片治疗反复呼吸道感染患儿,能显著下调Th17/Treg比值,进一步促进血清25-(OH)D3、MBP水平及机体免疫功能升高,从而促进患儿康复,增强疗效,安全性较好。

Objective: To explore the efficacy of pidotimod combined with live clostridium butyricum tablets in the treatment of children with recurrent respiratory infections.Methods: Totally 117 children with recurrent respiratory infections were randomly divided into 3 groups with 39 cases in each group.The 3 groups were given the conventional treatment.The control group A was treated with pidotimod 0.4 g,po,bid,the control group B was treated with live clostridium butyricum tablets 0.5 g,po,bid,and the study group was treated with pidotimod 0.4 g,po,bid combined with live clostridium butyricum tablets 0.5 g,po,bid.After 8-week continuous treatment,the clinical efficacy,incidence of adverse drug reactions,duration of respiratory tract infection symptoms,immunoglobulin indices [immunoglobulin(Ig) A,IgM and IgG],ratio of peripheral blood helper T17 cells/regulatory T cells(Th17/Treg),serum 25-hydroxyvitamin D3[25-(OH) D3],and mannan binding protein(MBP) levels before and after treatment were compared among the three groups.Results: The total effective rate of the study group was 94.87%,which was higher than that of control group A(69.23%) and that of control group B(76.92%)(P<0.05).After treatment,the duration of respiratory tract infection symptoms in the three groups was shorter than that before treatment,and the duration of respiratory tract infection symptoms in the study group was significantly shorter than that in control groups A and B(P< 0.05).After treatment,Th17 and Th17/Treg ratios of the three groups were lower than those before treatment,and Treg was higher than that before treatment.Th17 and Th17/Treg ratios of the study group were lower than those of the control groups A and B,and Treg was higher than that of control groups A and B(P< 0.05).After treatment,the levels of IgA,IgM,and IgG in the three groups were higher than those before treatment,and the levels of IgA,IgM and IgG in the study group were higher than those in control groups A and B(P< 0.05).After treatment,the serum 25-(OH)D3 and MBP levels in the three groups were higher than those before treatment,and the serum 25-(OH)D3 and MBP levels in the study group were higher than those in control groups A and B(P< 0.05).There was no significant difference in the total incidence of adverse drug reactions among the three groups(P > 0.05).Conclusion: Pidimod combined with live clostridium butyricum tablets in the treatment of children with recurrent respiratory tract infection can significantly reduce Th17/Treg ratio,and further increase serum 25-(OH)D3 and MBP levels and improve immune function,thereby promoting the rehabilitation of children and enhancing the curative effect with certain safety.