蒙脱石散联合布拉氏酵母菌散对婴幼儿急性腹泻患儿CRP水平的影响

Effects of montmorillonite powder combined with Saccharomyces boulardii sachets on CRP levels in infants with acute diarrhea

目的探究婴幼儿急性腹泻采用蒙脱石散联合布拉氏酵母菌散治疗的临床效果及对患儿C反应蛋白(CRP)水平的影响。方法62例婴幼儿急性腹泻患儿,采用双盲抽签病历号分为研究组和对照组,每组31例。两组均行基础对症治疗,在此基础上,对照组患儿增加蒙脱石散治疗,研究组患儿增加蒙脱石散联合布拉氏酵母菌散治疗。比较两组患儿临床症状改善时间、炎性因子水平、细胞免疫学指标、临床效果、不良反应发生情况。结果研究组患儿腹泻、呕吐、腹痛、大便异常改善时间分别为(2.11±0.52)、(1.19±0.38)、(2.09±0.52)、(3.28±1.05)d,均短于对照组的(4.09±0.97)、(2.25±0.64)、(3.96±0.87)、(5.74±1.73)d(P<0.05)。治疗6 d后,两组CRP、白细胞介素-6(IL-6)、降钙素原(PCT)均低于治疗前,且研究组患儿CRP(3.94±1.07)mg/L、IL-6(92.51±4.73)ng/L、PCT(1.19±0.42)μg/L均低于对照组的(11.86±2.74)mg/L、(122.86±7.96)ng/L、(1.85±0.61)μg/L(P<0.05)。治疗6 d后,研究组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于治疗前,CD8^(+)低于治疗前,且研究组患儿CD3^(+)(69.84±5.26)%、CD4^(+)(48.22±5.29)%、CD4^(+)/CD8^(+)(1.98±0.55)水平高于对照组的(65.19±3.04)%、(43.15±2.79)%、(1.42±0.26),CD8^(+)(25.68±2.05)%水平低于对照组的(29.77±3.45)%(P<0.05)。研究组患儿临床总有效率为96.8%,高于对照组的77.4%(χ^(2)=5.167,P=0.023<0.05)。两组患儿用药后均未发生无法耐受的严重不良反应,每组均有2例(6.5%)患儿发生皮疹,两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论婴幼儿急性腹泻患儿采用蒙脱石散联合布拉氏酵母菌散治疗起效迅速,可减轻炎症反应,提高免疫功能,临床疗效显著,用药安全,具有推广应用价值。

Objective To explore the clinical effect of montmorillonite powder combined with Saccharomyces boulardii sachets on C-reactive protein (CRP) levels in infants with acute diarrhea and its influence on CRP level.Methods 62 infants with acute diarrhea were divided into a study group and a control group by double-blind lottery method,with 31 cases in each group.Both groups received basic symptomatic treatment.On this basis,the control group was treated with montmorillonite powder,and the study group was treated with montmorillonite powder combined with Saccharomyces boulardii sachets.The improvement time of clinical symptoms,levels of inflammatory factors,cellular immunological indexes,clinical effects and occurrence of adverse reactions were compared between the two groups.Results The improvement time of diarrhea,vomiting,abdominal pain and abnormal stool were (2.11±0.52),(1.19±0.38),(2.09±0.52) and (3.28±1.05) d in the study group,which were shorter than (4.09±0.97),(2.25±0.64),(3.96±0.87) and (5.74±1.73) d in the control group (P<0.05).After 6 d of treatment,CRP,interleukin-6 (IL-6) and procalcitonin (PCT) in both groups were lower than those before treatment;the study group had CRP of (3.94±1.07) mg/L,IL-6 of (92.51±4.73) ng/L,and PCT of (1.19±0.42)μg/L,which were lower than (11.86±2.74) mg/L,(122.86±7.96) ng/L,and (1.85±0.61)μg/L in the control group (P<0.05).After 6 d of treatment,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in both groups were higher than those before treatment,and CD8^(+)was lower than that before treatment;the study group had CD3^(+)of(69.84±5.26)%,CD4^(+)of (48.22±5.29)%,and CD4^(+)/CD8^(+)of (1.98±0.55),which were higher than (65.19±3.04)%,(43.15±2.79)%,and (1.42±0.26) in the control group;CD8^(+)of (25.68±2.05)%in the study group was lower than (29.77±3.45)%in the control group (P<0.05).The total effective rate of the study group was 96.8%,which was higher than 77.4%of the control group (χ^(2)=5.167,P=0.023<0.05).No intolerable serious adverse reactions occurred in both groups,and 2 cases (6.5%) of skin rash occurred in each group,there was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05).Conclusion Montmorillonite powder combined with Saccharomycete boulardii sachets is effective and safe in the treatment of infants with acute diarrhea has rapid effect,and can reduce inflammation and improve immune function,which has the value of popularization and application.