双歧杆菌乳杆菌三联活菌片联合蒙脱石散治疗小儿病毒感染性肠炎对炎症水平及肠道菌群的影响

目的探讨双歧杆菌乳杆菌三联活菌片联合蒙脱石散治疗小儿病毒感染性肠炎对炎症水平及肠道菌群的影响。方法选择2019年1月至2020年1月在湖北科技学院附属浠水县人民医院治疗的轮状病毒感染性肠炎患儿120例,以随机数表法将其分为对照组和观察组,每组60例。对照组服用蒙脱石散,观察组在对照组基础上给予双歧杆菌乳杆菌三联活菌片治疗。两组均在用药7 d后评价疗效,记录患儿的临床症状,抽取空腹静脉血,检测血清指标,采集患儿治疗前及治疗3 d后粪便,检测样本中双歧杆菌、乳杆菌及大肠埃希菌DNA,并记录两组不良反应发生率。结果对照组和观察组临床疗效总有效率分别为86.67%和68.33%,差异有统计学意义(P<0.05)。两组止吐时间及腹痛消失时间比较,差异无统计学意义(P>0.05);观察组退热时间、止泻时间、病毒转阴时间及住院时间与对照组比较显著缩短,差异有统计学意义(P<0.05)。观察组治疗后与治疗前及与对照组治疗后比较,白细胞介素(IL)-6、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)、天门冬氨酸氨基转移酶(AST)、α-羟丁酸脱氢酶(α-HBDH)水平显著降低,差异有统计学意义(P<0.05),免疫球蛋白(Ig)A、IgG、IgM显著增高,差异有统计学意义(P<0.05)。两组治疗前后乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)水平比较,差异无统计学意义(P>0.05)。观察组治疗后双歧杆菌、乳杆菌、大肠埃希菌数量与治疗前及与对照组治疗后比较显著增高,差异有统计学意义(P<0.05)。观察组出现2例咳嗽,1例发热,均为轻微不良反应,肝肾功能检查无异常,患者可自行缓解。结论双歧杆菌乳杆菌三联活菌片联合蒙脱石散治疗小儿病毒感染性肠炎有较好的临床疗效,可降低炎症水平,增强免疫能力,对肠道菌群有一定的纠正作用,安全性较高,值得临床推荐。

Effect of bifidobacterium lactobacillus triple live bacteria tablets combined with montmorillonite powder on inflammatory level and intestinal flora in the treatment of children′s viral infectious enteritis

Objective To explore the effect of Bifidobacterium Lactobacillus triple live bacteria tablets combined with Montmorillonite powder on the inflammation level and intestinal flora in the treatment of pediatric viral infectious enteritis.Methods A total of 120 pediatric patients with rotavirus infection enteritis were selected from Xishui County People′s Hospital Affiliated to Hubei University of Science and Technology from January 2019 to January 2020,then divided equally into observation group and control group by random number table method.The control group was given montmorillonite powder,and the observation group was given treatment with Bifidobacterium Lactobacillus triple viable tablets on the basis of the control group.The curative effect was evaluated 7 days after the treatment of the two groups.The clinical symptoms of children were recorded,fasting venous blood was drawn for serum indexes detecting,feces of the children were collected before treatment and 3 days after treatment,the DNA of Bifidobacterium,Lactobacillus and Escherichia coli in the samples were detected.The incidence of adverse reactions in the two groups was recorded.Results The total effective rate of clinical curative effect in the observation group was 86.67%compared with 68.33%in the control group,the difference was statistically significant(P<0.05).Comparison of antiemetic time and abdominal pain disappearance time between the two groups was significantly different,the difference was statistically significant(P<0.05);the observation group′s antipyretic time,antidiarrheal time,virus conversion time and hospital stay were significantly lower than those of the control group,the difference was statistically significant(P<0.05).After treatment,IL-6,TNF-α,CRP,AST,α-HBDH of the observation group were significantly decreased compared with those before and after treatment,the difference was statistically significant(P<0.05),while IgA,IgG,IgM were significantly increased,the difference was statistically significant(P<0.05).There was no significant difference in the levels of lactate dehydrogenase(LDH),creatine kinase(CK)and creatine kinase isoenzyme(CK-MB)between the two groups before and after treatment,the difference was not statistically significant(P>0.05).The number of bifidobacteria,Lactobacillus,and Escherichia coli in the observation group after treatment was significantly bigger than that before treatment and after treatment in the control group,the difference was statistically significant(P<0.05).In the observation group.There were 2 cases of cough and 1 case of fever,both of which were mild adverse reactions.The liver and kidney function tests were normal,and the patients could relieve themselves.Conclusion Bifidobacterium Lactobacillus triple live bacteria tablets combined with montmorillonite powder has a good clinical effect on the treatment of pediatric viral infectious enteritis,which could decrease inflammation levels,enhance immunity,and have a certain corrective effect on intestinal flora with better security,worthy of more clinic attention.