维生素D辅助治疗小儿轮状病毒性肠炎的效果及对免疫功能、胃肠激素的影响

Effectiveness of Vitamin D in Adjuvant Therapy of Infantile Rotaviral Enteritis and Its Effects on Immune Function and Gastrointestinal Hormones

目的研究维生素D辅助治疗小儿轮状病毒性肠炎(RVE)的效果及对免疫功能、胃肠激素的影响。方法选择2016年7月—2020年6月收治的小儿RVE 90例,依据治疗方法不同分为观察组与对照组,每组45例。对照组给予双歧杆菌三联活菌联合消旋卡多曲治疗,观察组在对照组基础上联合维生素D辅助治疗。比较两组临床症状恢复正常时间及治疗前后血清免疫球蛋白、炎性因子和胃肠激素水平。观察两组的临床疗效及不良反应发生情况。结果观察组发热、大便性状、大便次数及恶心呕吐等临床症状恢复正常时间均短于对照组(P<0.05,P<0.01)。治疗后,两组IgA、IgG、IgM及白细胞介素-35(IL-35)水平均较治疗前升高,IL-17、血管活性肠肽(VIP)、胃动素(MOT)、胃泌素(GAS)水平均较治疗前降低,且观察组IgA、IgG、IgM及IL-35水平高于对照组,IL-17、VIP、MOT、GAS水平低于对照组(P<0.05,P<0.01)。观察组总有效率高于对照组(P<0.01)。治疗期间,两组均未出现明显不良反应。结论维生素D辅助治疗可有效调节RVE患儿的免疫功能,抑制炎症反应,降低胃肠激素水平,促进康复,且具有较高的安全性。

Objective To study effectiveness of Vitamin D in adjuvant therapy of infantile rotaviral enteritis(RVE)and its effects on immune function and gastrointestinal hormones.Methods A total of 90 infantile RVE patients admitted between July 2016 and June 2020 were selected and divided into observation group(n=45)and control group(n=45)according to different therapeutic methods.Control group was given Bifidobacterium Triple Viable Organism combined with Racecadotril treatment,while observation group was added with Vitamin D on the basis of treatment for control group.Disappearance time of clinical symptoms,levels of serum immunoglobulin,inflammatory factors and gastrointestinal hormones before and after treatment were compared between two groups.Clinical efficacy and incidence rates of adverse reactions were observed in two groups.Results Disappearance times of clinical symptoms such as fever,stool characteristics,stool frequency,nausea and vomiting in observation group were significantly lower than those in control group(P<0.05,P<0.01).After treatment,levels of serum IgA,IgG,IgM and interleukin-35(IL-35)were significantly higher,while levels of interleukin-17(IL-17),vasoactive intestinal peptide(VIP),motilin(MOT)and gastrin(GAS)were significantly lower than those before treatment in two groups;in observation group,levels of serum IgA,IgG,IgM and IL-35 were significantly higher,while levels of IL-17,VIP,MOT and GAS were significantly lower than those in control group(P<0.05,P<0.01).The total effective rate in observation group was significantly higher than that in control group(P<0.01).During the treatment,no significant adverse reactions occurred in two groups.Conclusion Vitamin D in adjuvant therapy of infantile RVE may effectively regulate immunologic function,inhibit inflammatory reaction,reduce level of gastrointestinal hormones and promote rehabilitation of children with good safety.