重组人干扰素α-1b联合沙棘干乳剂治疗儿童病毒性腹泻疗效观察

Effect of recombinant human interferon α-1b combined with Shaji Ganruji in the treatment of children with viral diarrhea

目的探讨重组人干扰素α-1b联合沙棘干乳剂治疗儿童病毒性腹泻的临床效果。方法选择2017年3月至2019年2月漯河医学高等专科学校第二附属医院收治的88例病毒性腹泻患儿为研究对象,按照治疗方法将患儿分为观察组和对照组,每组44例。2组患儿均给予积极纠正酸中毒、静脉补液纠正脱水、无乳糖饮食、蒙脱石散、双歧杆菌四联活菌片等常规治疗措施,观察组患儿在常规治疗基础上给予重组人干扰素α-1b和沙棘干乳剂联合治疗。观察并比较2组患儿脱水纠正时间、腹泻停止时间、住院时间及不良反应;对2组患儿治疗前后血清肌酸激酶(CK)、乳酸脱氢酶(LDH)、天门冬氨酸氨基转移酶(AST)、α-羟丁酸脱氢酶(α-HBD)、肌酸激酶同工酶MB(CK-MB)、二胺氧化酶(DAO)水平及粪便钙卫蛋白(Fcp)水平、肠道菌群进行比较;治疗后判定2组患儿临床疗效。结果观察组患儿脱水纠正时间、腹泻停止时间、住院时间显著短于对照组(P<0.05)。治疗前2组患儿血清CK、LDH、AST、α-HBD、CK-MB水平比较差异无统计学意义(P>0.05);2组患儿治疗后血清CK、LDH、AST、α-HBD、CK-MB水平显著低于治疗前(P<0.05);治疗后,观察组患儿血清CK、LDH、AST、α-HBD、CK-MB水平显著低于对照组(P<0.05)。治疗前2组患儿粪便中肠球菌、大肠埃希菌、双歧杆菌和乳酸杆菌的菌落数比较差异无统计学意义(P>0.05);2组患儿治疗后粪便中肠球菌、大肠埃希菌的菌落数显著少于治疗前,双歧杆菌和乳酸杆菌的菌落数显著多于治疗前(P<0.05);治疗后,观察组患儿粪便中肠球菌、大肠埃希菌的菌落数显著少于对照组,双歧杆菌和乳酸杆菌的菌落数显著多于对照组(P<0.05)。治疗前2组患儿血清DAO和Fcp水平比较差异无统计学意义(P>0.05);治疗后2组患儿血清DAO和Fcp水平显著低于治疗前(P<0.05);治疗后,观察组患儿血清DAO和Fcp水平显著低于对照组(P<0.05)。观察组和对照组患儿治疗总有效率分别为95.45%(42/44)、79.55%(35/44);观察组患儿治疗总有效率显著高于对照组(χ^(2)=5.091,P<0.05)。观察组和对照组患儿不良反应发生率分别为6.82%(3/44)、2.27%(1/44),2组患儿不良反应发生率比较差异无统计学意义(χ^(2)=0.262,P>0.05)。结论重组人干扰素α-1b和沙棘干乳剂联合治疗可有效改善病毒性腹泻患儿的临床症状、肠道菌群,减轻肠黏膜损伤和心肌损害。

Objective To investigate the effect of recombinant human interferon α-1b combined with Shaji Ganruji in the treatment of children with viral diarrhea.Methods A total of 88 children with viral diarrhea treated in the Second Affiliated Hospital of Luohe Medical College from March 2017 to February 2019 were selected as the research subjects,and the patients were divided into observation group and control group according to the treatment methods,with 44 cases in each group.All patients were given routine treatment measures such as correcting acidosis,intravenous rehydration to correct dehydration,lactose free diet,smectite powder and Bifidobacterium tetrad viable tablets.The patients in the observation group were treated with recombinant human interferon α-1b and Shaji Ganruji on the basis of routine treatment.The dehydration correction time,diarrhea offtime,hospitalization time and adverse reactions were observed and compared between the two groups.The levels of serum creatine kinase(CK),lactate dehydrogenase(LDH),aspartate aminotransferase(AST),α-hydroxybutyrate dehydrogenase(α-HBD),creatine kinase MB(CK-MB),diamine oxidase(DAO)and fecal calprotectin(Fcp),intestinal flora were compared.The clinical efficacy of patients in the two groups was determined after treatment.Results The dehydration correction time,diarrhea offtime and hospitalization time in the observation group were significantly shorter than those in the control group(P<0.05).There was no significant difference in the levels of serum CK,LDH,AST,α-HBD and CK-MB between the two groups before treatment(P>0.05).The levels of serum CK,LDH,AST,α-HBD and CK-MB after treatment were significantly lower than those before treatment in the two groups(P<0.05).The levels of serum CK,LDH,AST,α-HBD and CK-MB in the observation group were significantly lower than those in the control group after treatment(P<0.05).There was no significant difference in the colony numbers of Enterococcus,Escherichia coli,Bifidobacterium and Lactobacillus in faeces of patients between the two groups before treatment(P>0.05).The colony numbers of Enterococcus and Escherichia coli in faeces after treatment were significantly less than those before treatment,and the colony numbers of Bifidobacterium and Lactobacillus in faeces were significantly more than those before treatment(P<0.05).After treatment,the colony numbers of Enterococcus and Escherichia coli in faeces of patients in the observation group were significantly less than those in the control group,and the colony numbers of Bifidobacterium and Lactobacillus were significantly more than those in the control group(P<0.05).There was no significant difference in the levels of serum DAO and Fcp between the two groups before treatment(P>0.05).The levels of serum DAO and Fcp after treatment were significantly lower than those before treatment in the two groups(P<0.05).The levels of serum DAO and Fcp in the observation group were significantly lower than those in the control group after treatment(P<0.05).The total effective rate of patients in the observation group and the control group was 95.45%(42/44)and 79.55%(35/44),respectively;the total effective rate of patients in the observation group was significantly higher than that in the control group(χ^(2)=5.091,P<0.05).The incidence of adverse reactions of patients in the observation group and the control group was 6.82%(3/44)and 2.27%(1/44),respectively;there was no significant difference in the incidence of adverse reactions of patients between the two groups(χ^(2)=0.262,P>0.05).Conclusion Recombinant human interferon α-1b combined with Shaji Ganruji can effectively improve the clinical symptoms and intestinal flora of children with viral diarrhea,and reduce intestinal mucosal injury and myocardial damage.