联合双歧三联活菌片治疗在湿热型腹泻患者中的作用
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摘要
目的研究双歧三联活菌片联合蒙脱石散在小儿湿热型腹泻中的临床治疗效果及机制.方法取小儿湿热型腹泻患者60例,随机分为对照组(n=30)和观察组(n=30).对照组采用蒙脱石散治疗,观察组联合双歧三联活菌片治疗,比较2组临床疗效及药物机制.结果观察组体温恢复正常时间、大便恢复正常、呕吐缓解及腹痛恢复时间,显著短于对照组(P<0.05);2组治疗前CD3、CD4、CD4/CD8水平差异无统计学意义(P>0.05);观察组治疗后5 d CD3、CD4、CD4/CD8水平,高于对照组(P<0.05);2组治疗5 d后药物不良反应发生率差异无统计学意义(P>0.05).结论小儿湿热型腹泻患儿在蒙脱石散治疗基础上联合双歧三联活菌片治疗效果理想,能调节机体免疫,值得推广应用.
AIM To evaluate the clinical effects of Bifidobacterium triple viable tablets combined with montmorillonite in the treatment of damp-heat diarrhea in children and to explore the mechanism involved.METHODS Sixty pediatric patients with damp-heat diarrhea were randomly divided into either a control group(n=30) or an observation group(n=30).The control group was treated with montmorillonite alone,and the observation group was treated with Bifidobacterium triple viable tablets plus montmorillonite.Clinical efficacy was compared between the two groups.The possible immune mechanism involved was explored by detecting different subsets of T cells.The rate of adverse drug reactions was also compared between the two groups.RESULTS The times to recovery of normal body temperature,normal stool,and remission of vomiting and abdominal pain were significantly shorter in the observation group than in the control group(P<0.05).Before treatment,there were no significant differences in CD3~+ cells,CD4~+cells,or CD4~+/CD8~+ ratio between the two groups(P>0.05);however,these indexes were significantly higher in the observation group than in the control group 5 d after treatment(P<0.05).The rate of adverse drug reactions between the two groups had no statistical significance(P>0.05).CONCLUSION Bifidobacterium triple viable tablets combined with montmorillonite is more effective than montmorillonite alone in children with dampheat diarrhea,and it can regulate the body's immunity.
AIM To evaluate the clinical effects of Bifidobacterium triple viable tablets combined with montmorillonite in the treatment of damp-heat diarrhea in children and to explore the mechanism involved.METHODS Sixty pediatric patients with damp-heat diarrhea were randomly divided into either a control group(n=30) or an observation group(n=30).The control group was treated with montmorillonite alone,and the observation group was treated with Bifidobacterium triple viable tablets plus montmorillonite.Clinical efficacy was compared between the two groups.The possible immune mechanism involved was explored by detecting different subsets of T cells.The rate of adverse drug reactions was also compared between the two groups.RESULTS The times to recovery of normal body temperature,normal stool,and remission of vomiting and abdominal pain were significantly shorter in the observation group than in the control group(P<0.05).Before treatment,there were no significant differences in CD3~+ cells,CD4~+cells,or CD4~+/CD8~+ ratio between the two groups(P>0.05);however,these indexes were significantly higher in the observation group than in the control group 5 d after treatment(P<0.05).The rate of adverse drug reactions between the two groups had no statistical significance(P>0.05).CONCLUSION Bifidobacterium triple viable tablets combined with montmorillonite is more effective than montmorillonite alone in children with dampheat diarrhea,and it can regulate the body's immunity.
引文
1梁荣梅.双歧杆菌四联活菌片联合蒙脱石散治疗小儿腹泻病的临床分析.现代医药卫生2013;29:1234-1235
2刘玉玲.双歧杆菌活菌与蒙脱石散联合在小儿腹泻治疗中的近期疗效分析.中国妇幼保健2012;10:2060-2061
3 Fagon JY,Chastre J,Wolff M,Gervais C,ParerAubas S,Stephan F,Similowski T,Mercat A,Diehl JL,Sollet JP,Tenaillon A.Invasive and noninvasive strategies for management of suspected ventilatorassociated pneumonia.A randomized trial.Ann Intern Med 2000;132:621-630[PMID:10766680DOI:10.7326/0003-4819-132-8-200004180-00004]
4张丽,赵莉.酪酸梭菌、婴儿型双歧杆菌二联活菌制剂治疗儿科最常见3种不同类型腹泻的疗效观察.中国中西医结合消化杂志2014;22:104-105
5傅宏,陈新平.小儿肺炎继发腹泻应用双歧杆菌四联活菌片联合复方丁香罗勒混悬液治疗效果观察.中国综合临床2015;31:855-858
6赵倩,吴怡玲.复方嗜酸乳杆菌治疗小儿β-内酰胺相关性腹泻的临床疗效及对免疫功能的影响.中国中西医结合消化杂志2013;21:27-28
7 Grgurich PE,Hudcova J,Lei Y,Sarwar A,Craven DE.Diagnosis of ventilator-associated pneumonia:controversies and working toward a gold standard.Curr Opin Infect Dis 2013;26:140-150[PMID:23411419 DOI:10.1097/QCO.0b013e32835ebbd0]
8郑锌,霍秀玲.妈咪爱联用复方胃蛋白酶散预防小儿支气管肺炎继发性腹泻的疗效.海南医学2013;24:247-248
9杨涛,杨刚.杭州市余杭区小儿轮状病毒腹泻临床检测和流行病学特征分析.实用预防医学2014;21:557-560
10陆慧,徐明积,戴琳.双歧杆菌四联活菌片与蒙脱石散联用治疗婴幼儿腹泻的临床观察.中国医药指南2013;8:569
11赵炜,丁明辉,田文鹏.双歧杆菌乳杆菌三联活菌片与磷酸铝凝胶联用治疗婴幼儿腹泻疗效观察.中国医师进修杂志2013;36:51-52
12梁荣梅.双歧杆菌四联活菌片联合蒙脱石散治疗小儿腹泻病的临床分析.现代医药卫生2013;29:1234-1235
13卢建华,刘晓律.双歧三联活菌片联合蒙脱石散治疗小儿腹泻疗效及对患儿免疫功能的影响.临床和实验医学杂志2015;14:125-126
14 Bagchi AK,Sharma A,Dhingra S,Lehenbauer Ludke AR,Al-Shudiefat AA,Singal PK.Interleukin-10 activates Toll-like receptor 4 and requires MyD88 for cardiomyocyte survival.Cytokine 2013;61:304-314[PMID:23141143 DOI:10.1016/j.cyto.2012.10.013]
15范薇薇,夏国莲.双歧杆菌四联活菌片对ICU抗生素相关性腹泻患者细胞免疫功能的影响及疗效观察.中国微生态学杂志2014;26:66-68
2刘玉玲.双歧杆菌活菌与蒙脱石散联合在小儿腹泻治疗中的近期疗效分析.中国妇幼保健2012;10:2060-2061
3 Fagon JY,Chastre J,Wolff M,Gervais C,ParerAubas S,Stephan F,Similowski T,Mercat A,Diehl JL,Sollet JP,Tenaillon A.Invasive and noninvasive strategies for management of suspected ventilatorassociated pneumonia.A randomized trial.Ann Intern Med 2000;132:621-630[PMID:10766680DOI:10.7326/0003-4819-132-8-200004180-00004]
4张丽,赵莉.酪酸梭菌、婴儿型双歧杆菌二联活菌制剂治疗儿科最常见3种不同类型腹泻的疗效观察.中国中西医结合消化杂志2014;22:104-105
5傅宏,陈新平.小儿肺炎继发腹泻应用双歧杆菌四联活菌片联合复方丁香罗勒混悬液治疗效果观察.中国综合临床2015;31:855-858
6赵倩,吴怡玲.复方嗜酸乳杆菌治疗小儿β-内酰胺相关性腹泻的临床疗效及对免疫功能的影响.中国中西医结合消化杂志2013;21:27-28
7 Grgurich PE,Hudcova J,Lei Y,Sarwar A,Craven DE.Diagnosis of ventilator-associated pneumonia:controversies and working toward a gold standard.Curr Opin Infect Dis 2013;26:140-150[PMID:23411419 DOI:10.1097/QCO.0b013e32835ebbd0]
8郑锌,霍秀玲.妈咪爱联用复方胃蛋白酶散预防小儿支气管肺炎继发性腹泻的疗效.海南医学2013;24:247-248
9杨涛,杨刚.杭州市余杭区小儿轮状病毒腹泻临床检测和流行病学特征分析.实用预防医学2014;21:557-560
10陆慧,徐明积,戴琳.双歧杆菌四联活菌片与蒙脱石散联用治疗婴幼儿腹泻的临床观察.中国医药指南2013;8:569
11赵炜,丁明辉,田文鹏.双歧杆菌乳杆菌三联活菌片与磷酸铝凝胶联用治疗婴幼儿腹泻疗效观察.中国医师进修杂志2013;36:51-52
12梁荣梅.双歧杆菌四联活菌片联合蒙脱石散治疗小儿腹泻病的临床分析.现代医药卫生2013;29:1234-1235
13卢建华,刘晓律.双歧三联活菌片联合蒙脱石散治疗小儿腹泻疗效及对患儿免疫功能的影响.临床和实验医学杂志2015;14:125-126
14 Bagchi AK,Sharma A,Dhingra S,Lehenbauer Ludke AR,Al-Shudiefat AA,Singal PK.Interleukin-10 activates Toll-like receptor 4 and requires MyD88 for cardiomyocyte survival.Cytokine 2013;61:304-314[PMID:23141143 DOI:10.1016/j.cyto.2012.10.013]
15范薇薇,夏国莲.双歧杆菌四联活菌片对ICU抗生素相关性腹泻患者细胞免疫功能的影响及疗效观察.中国微生态学杂志2014;26:66-68