酪酸梭菌二联活菌对儿童抗菌药物相关性腹泻的预防作用及肠道菌群的影响

Effect of clostridium butyricum duplex viable on prevention and intestinal flora of antibiotic-associated diarrhea in children

目的探讨酪酸梭菌二联活菌对儿童抗菌药物相关性腹泻(AAD)的预防作用及肠道菌群的影响。方法选取2019年12月至2021年12月恩施州中心医院儿科接受抗菌药物治疗的患儿作为研究对象,按随机数字表法分为对照组和观察组。对照组给予常规抗感染药物治疗,观察组在对照组基础上加用酪酸梭菌二联活菌治疗。比较两组患儿住院时间、抗菌药物使用时间、AAD发生率、排便次数、腹泻持续时间、肠道菌群、炎症因子及不良反应发生情况。结果共纳入患儿120例,对照组与观察组各60例。对照组患儿住院时间和抗菌药物使用时间均长于观察组,分别为(9.32±0.64)d比(7.32±0.56)d和(9.17±0.61)d比(7.28±0.54)d(均P<0.05)。对照组AAD发生率高于观察组(31.67%比11.67%)(χ^(2)=7.070,P=0.008)。对照组治疗第1、4、7天排便次数均多于观察组,腹泻持续时间长于观察组,腹泻发生时间早于观察组(均P<0.05)。两组患儿治疗1周后真杆菌、双歧杆菌、乳杆菌数量均升高,且与对照组相比观察组更高(t值分别为8.868、13.633和7.221,均P<0.001);两组患儿大肠埃希菌、肠球菌数量均降低,且与对照组相比观察组更低(t值分别为22.533、12.230,均P<0.001);两组患儿血清TNF-α、IL-2、IL-6水平均降低,且与对照组相比观察组更低(均P<0.001)。结论酪酸梭菌二联活菌能够有效降低住院抗菌药物治疗儿童AAD发生率,减轻其临床症状,同时改善患儿肠道菌群、降低炎症反应。

Objective To investigated the preventive effect of clostridium butyricum duplex viable on children with antibiotic-associated diarrhea(AAD)and the effect of intestinal flora.Methods Children who received antibiotic treatment in the Pediatrics Department of Enshi Central Hospital from December 2019 to December 2021 were selected as the research subjects,and divided into the control group and the observation group by random number table method.The control group was given conventional anti-infective treatment,and the observation group was additionally treated with clostridium butyricum dual viable bacteria powder.The length of hospital stay,antibiotic application time,AAD incidence,defecation frequency,diarrhea duration,intestinal flora,inflammatory factors and adverse reactions were compared in two groups.Results A total of 120 children were observed,60 in the control group and to 60 in the observation group.The length of hospital stay and antibiotic application time in the control group were longer compared with observation group of each group was(9.32±0.64)d vs(7.32±0.56)d,(9.17±0.61)d vs(7.28±0.54)d(all P<0.05).The incidence of AAD in the control group was significantly higher compared with the observation group(31.67%vs 11.67%)(χ^(2)=7.070,P=0.008).The number of bowel movements in the control group on the 1st,4th and 7th days of treatment were more than those in the observation group,and the duration of diarrhea was longer than that in the observation group,the time of diarrhea occurred earlier than that in the observation group(all P<0.05).One week after treatment,the numbers of Eubacterium,Bifidobacterium and Lactobacillus in the two groups were increased,and compared with the control group,the numbers of the observation group were higher(t=8.868,13.633,7.221,all P<0.001).The numbers of Escherichia coli and Enterococcus decreased after treatment,and that were lower in the observation group compared with the control group(t=22.533,12.230,all P<0.001).One week after treatment,the serum levels of TNF-α,IL-2 and IL-6 in the two groups were decreased,and compared with the control group,the TNF-α,IL-2 and IL-6 in the observation group were lower(all P<0.001).Conclusion Clostridium butyricum duplex viable can effectively reduce the incidence of AAD in hospitalized children treated with antibacterial drugs,alleviate their clinical symptoms,improve the intestinal flora,and reduce inflammatory response.