葡萄糖酸锌口服液联合蒙脱石散治疗小儿迁延性慢性腹泻的临床效果

Clinical Effect of Zinc Gluconate Oral Liquid Combined with Montmorillonite Powder on Persistent and Chronic Diarrhea in Children

目的探讨葡萄糖酸锌口服液联合蒙脱石散治疗小儿迁延性慢性腹泻(PCD)的临床效果。方法将102例迁延性慢性腹泻患儿按随机数字表法分为研究组(n=51例)与对照组(n=51例),对照组采用蒙脱石散治疗,研究组采用葡萄糖酸锌口服液联合蒙脱石散治疗。比较2组临床疗效、临床症状(包括大便形状、次数恢复时间及日均大便次数等)改善情况及治疗前后血锌水平、胃肠功能指标[包括胃动素(MTL)、二胺氧化酶(DAO)、血管活性肠肽(VIP)、D-乳酸(D-LA)、胰高血糖素(GUU)等]、红细胞免疫功能指标[包括红细胞免疫抑制因子(PFIR)、复合物花环率(RICR)、黏附促进因子(RFER)、红细胞C3b花环率(RC3bRR)]水平,观察2组治疗期间不良反应发生情况。结果研究组治疗总有效率显著高于对照组(94.12%比80.39%,P=0.037)。治疗后,研究组大便形状、次数恢复时间较对照组显著缩短(P<0.001),日均大便次数较对照组显著减少(P<0.001),MTL、DAO、VIP、D-LA、GUU、PFIR水平较对照组显著降低(P<0.05或P<0.001),血锌、RFER、RICR、RC3bRR水平较对照组显著升高(P<0.05或P<0.001)。治疗期间2组不良反应发生率比较差异无统计学意义(P>0.05)。结论葡萄糖酸锌口服液联合蒙脱石散治疗小儿PCD效果显著,能改善患儿临床症状,升高机体血锌水平,修复胃肠功能,改善免疫功能。

Objective To investigate clinical effect of zinc gluconate oral liquid combined with montmorillonite powder on persistent and chronic diarrhea(PCD)in children.Methods A total of 102 children with PCD were randomly treated with montmorillonite powder alone(control group,n=51)or in combination with zinc gluconate oral liquid(study group,n=51).The total effective rate,clinical symptoms(recovery time of stool shape and defecation frequency,daily defecation frequency,etc.),blood zinc level,gastrointestinal function indicators(motilin(MTL),diamine oxidase(DAO),vasoactive intestinal peptide(VIP),D-lactic acid(D-LA),glucagon(GUU),etc.),erythrocyte immune function parameters(erythrocyte immunosuppressive factor(PFIR),complex rosette rate(RICR),adhesion promoting factor(RFER)and red blood cell C3b rosette rate(RC3bRR)),and adverse reactions were compared between the two groups.Results The total effective rate in the study group(94.12%)was higher than that in the control group(80.39%)(P=0.037).Compared with the control group,the recovery time of stool shape and defecation frequency was shortened,average daily defecation frequency and MTL,DAO,VIP,D-LA,GUU and PFIR levels were reduced,and blood zinc,RFER,RICR and RC3bRR levels were increased in the study group after treatment(P<0.05 or P<0.001).There was no significant difference in the incidence of adverse reactions between the groups(P>0.05).Conclusion Zinc gluconate oral liquid combined with montmorillonite powder is an effective treatment that can relieve clinical symptoms,increase blood zinc level,restore gastrointestinal function and improve immune function in children with PCD.