双歧杆菌联合肤痔清软膏治疗儿童湿疹的疗效及对患儿肠道菌群、免疫功能的影响

Effect of Bifidobacterium combined with Fuzhiqing Ointment on children with eczema and its influence on intestinal flora and immune function

目的研究双歧杆菌联合肤痔清软膏治疗儿童湿疹的疗效及对患儿肠道菌群、免疫功能的影响。方法选取2018年12月至2020年6月期间在上海市松江区妇幼保健院就诊的100例湿疹患儿作为研究对象,按照随机数表法分为研究组和对照组各50例。对照组患儿采用双歧杆菌三联活菌散治疗,研究组患儿采用肤痔清软膏联合双歧杆菌三联活菌散治疗。两组均治疗15 d,15 d后比较两组患儿的治疗效果及治疗前后的肠道菌群(大肠埃希菌、乳酸杆菌、双歧杆菌)、免疫功能指标[辅助性T细胞1(Th1)/辅助性T细胞2(Th2)值、γ干扰素(IFN-γ)、白细胞介素4(IL-4)、IFN-γ/IL-4、白细胞介素10(IL-10)]水平。结果研究组患儿的治疗总有效率为98.0%,明显高于对照组的80.0%,差异有统计学意义(P<0.05);治疗前,两组患儿的大肠埃希菌、乳酸杆菌、双歧杆菌比较差异均无统计学意义(P>0.05),治疗后,研究组患儿的乳酸杆菌、双歧杆菌分别为(8.09±1.49)log coppies/g湿粪、(8.29±1.49)log coppies/g湿粪,对照组分别为(7.09±1.46)log coppies/g湿粪、(7.32±1.34)log coppies/g湿粪,两组均明显升高,且研究组明显高于对照组,差异均有统计学意义(P<0.05),但两组患儿的大肠埃希菌比较差异无统计学意义(P>0.05);治疗前,两组患儿的Th1/Th2、IFN-γ/IL-4比较差异均无统计学意义(P>0.05),治疗后,研究组患儿的Th1/Th2、IFN-γ/IL-4值分别为6.89±1.49、1.64±0.58,对照组分别为5.79±1.34、1.06±0.54,两组均明显升高,且研究组明显高于对照组,差异均有统计学意义(P<0.05);治疗前,两组患儿的IFN-γ、IL-4、IL-10水平比较差异均无统计学意义(P>0.05),治疗后,两组患儿的IFN-γ水平明显升高,且研究组患儿明显高于对照组,治疗后,两组患儿的IL-4、IL-10水平均明显降低,且研究组明显低于对照组,差异均有统计学意义(P<0.05)。结论双歧杆菌三联活菌散结合肤痔清软膏治疗儿童湿疹可明显改善患儿湿疹、肠道菌群及临床症状,提高患儿的免疫功能,调节免疫平衡,具有临床应用价值。

Objective To study the effect of Bifidobacterium combined with Fuzhiqing Ointment in the treatment of children with eczema and its influence on intestinal flora and immune function.Methods One hundred children with eczema treated in Shanghai Songjiang District Maternal and Child Health Hospital from December 2018 to June 2020 were selected as the research objects and randomly divided into study group and control group according to the random number table method,with 50 children in each group.The control group was treated with Bifidobacterium triple viable powder,and the study group was treated with Fuzhiqing Ointment combined with Bifidobacterium triple viable powder,both for 15 days.After 15 days,the therapeutic effect,intestinal flora(Escherichia coli,Lactobacillus,Bifidobacterium)and immune function indexes[helper T cell 1(Th1)/helper T cell 2(Th2)value,interleukin-4(IL-4),IFN-γ/IL-4,and IL-10]of the two groups before and after treatment were compared.Results The total effective rate of the study group was 98.0%,which was significantly higher than 90.0%of the control group(P<0.05).Before treatment,there was no significant difference in Escherichia coli,Lactobacillus,and Bifidobacterium between the two groups(P>0.05);after treatment,Lactobacillus and Bifidobacterium in the study group were(8.09±1.49)log copies/g wet feces and(8.29±1.49)log copies/g wet feces,while those in the control group were(7.09±1.46)log copies/g wet feces and(7.32±1.34)log copies/g wet feces;the levels in two groups were significantly increased,and the level in the study group was significantly higher than that in the control group(P<0.05);but there was no significant difference in Escherichia coli between the two groups(P>0.05).Before treatment,there was no significant difference in Th1/Th2 and IFN-γ/IL-4 between the two groups(P>0.05);after treatment,Th1/Th2 and IFN-γ/IL-4 in the study group were 6.89±1.49,1.64±0.58,which were significantly higher than 5.79±1.34,1.06±0.54 in the control group(P<0.05).Before treatment,the levels of IFN-γ,IL-4,and IL-10 of the two groups showed no significant difference(P>0.05);after treatment,the level of IFN-γin the two groups were significantly increased,and the level in the study group was significantly higher than that in the control group;after treatment,the levels of IL-4 and IL-10 in the two groups were significantly lower,and the levels in the study group were significantly lower than those in the control group(P<0.05).Conclusion Bifidobacterium triple viable powder combined with Fuzhiqing Ointment in the treatment of children with eczema can significantly improve children’s eczema,intestinal flora,clinical symptoms,and immune function,and also regulate immune balance,which has clinical application value.