小儿肠胃康颗粒联合蒙脱石散剂辅助治疗儿童急性细菌性腹泻病的疗效

Efficacy of Xiao’er Changweikang Granules Combined with Montmorillonite Powder in the Treatment of Children with Acute Bacterial Diarrhea

目的:探讨小儿肠胃康颗粒联合蒙脱石散剂辅助治疗儿童急性细菌性腹泻病的临床疗效。方法:选取2021年3月至2022年2月我院门诊收治的96例急性细菌性腹泻病患儿按简单随机化分组法分为对照组和联合组各48例。两组患儿均给予对症治疗(依据细菌培养及药敏试验结果选择敏感性抗菌药物、调整饮食结构、纠正电解质紊乱及菌群失调等),在此基础上,对照组给予蒙脱石散剂治疗,联合组在对照组治疗基础上给予小儿肠胃康颗粒,疗程为2周。比较两组患儿胃肠道不适症状改善时间,检测治疗前后两组患儿血清胃肠激素及免疫功能变化情况,统计不良反应发生情况。结果:治疗后,联合组治疗总有效率高于对照组(100.00%vs.91.67%),但差异无统计学意义(P>0.05),联合组疗效等级优于对照组(Z=2.691,P<0.05)。治疗后,两组患儿大便次数较同组治疗前减少(P均<0.01),联合组大便次数较对照组更少(t=5.771,P<0.05),且联合组腹泻、脱水、食欲减退、腹痛、腹胀缓解时间及大便性状改变时间均较对照组更短(P均<0.05)。治疗后,联合组胃动素(MOT)、胃泌素(GAS)水平低于对照组,生长抑素(SS)、P物质(SP)水平高于对照组,差异均有统计学意义(P均<0.05)。治疗后,联合组CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平高于对照组(P均<0.05)。两组患儿不良反应发生率比较差异无统计学意义(χ^(2)=0.546,P=0.460)。结论:小儿肠胃康颗粒联合蒙脱石散剂治疗儿童急性细菌性腹泻病整体价值优于单用蒙脱石散剂治疗,可缩短患儿胃肠道不适症状缓解时间,改善胃肠道动力学及免疫功能,安全性较高。

Objective:To explore the clinical efficacy of Xiao’er Changweikang granules combined with montmorillonite powder in the treatment of children with acute bacterial diarrhea.Methods:A total of 96 children with acute bacterial diarrhea admitted into the Outpatient Department of our hospital from Mar.2021 to Feb.2022 were divided into the control group and combined group according to the simple randomization method of coin flipping,with 48 cases in each group.Both groups were given symptomatic treatment(sensitive antibiotics according to bacterial culture and drug sensitivity results,adjustment of diet structure,correction of electrolyte disorders and bacterial flora disorders).The control group was treated with montmorillonite powder additionally,and the combined group received Xiao’er Changweikang granules on the basis of control group,with treatment course of 2 weeks.The improvement time of gastrointestinal symptoms was compared between two groups.Changes of serum gastrointestinal hormones and immune function were measured before and after treatment.The incidence of adverse drug reactions was analyzed.Results:After treatment,the total effective rate of combined group was higher than that of control group(100.00%vs.91.67%),with no statistically significant difference(P>0.05).The efficacy grade in the combined group was better than that in the control group(Z=2.691,P<0.05).After treatment,the number of stools in two groups decreased compared with that before treatment(P<0.01),and the number of stools in the combined group was less than that in the control group(t=5.771,P<0.05).The relief time of diarrhea,dehydration,poor appetite,abdominal pain,abdominal distension and change time of stool traits were shorter than those in the control group(P<0.05).After treatment,motilin(MOT)and gastrin(GAS)in the combined group were lower than those in the control group,somatostatin(SS)and substance P(SP)in the combined group were higher than those in the control group,with statistically significant differences(P<0.05).After treatment,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the combined group were higher than those in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse drug reactions between two groups(χ^(2)=0.546,P=0.460).Conclusion:The overall value of Xiao’er Changweikang granules combined with montmorillonite powder in the treatment of children with acute bacterial diarrhea is superior to that of montmorillonite powder alone,which can shorten the relief time of gastrointestinal symptoms,improve gastrointestinal dynamics and immune function with higher safety.