布拉氏酵母菌联合蒙脱石散对小儿急性腹泻的疗效及T细胞亚群的影响

目的 探讨布拉氏酵母菌联合蒙脱石散对急性腹泻患儿治疗效果及T细胞亚群的影响。方法 选取2018年8月— 2019年5月在亳州市人民医院治疗的急性腹泻患儿64例为研究对象，根据就诊顺序将患者分为对照组和观察组，每组各32例。对照组患儿口服蒙脱石散，1岁以内：1.5 g/次，2次/d；1～2岁：3.0 g/次，2次/d；2岁以上3.0 g/次，3次/d，观察组在服用蒙脱石散后2 h口服布拉氏酵母菌散治疗，1岁以内：0.125 g/次，2次/d；1岁以上：0.25 g/次，2次/d。两组均根据患儿症状改善情况治疗4～7 d。比较两组的治疗总有效率、症状改善情况、治疗前后T细胞亚群指标变化及用药安全性。结果 治疗后，观察组治疗总有效率为93.75%，明显高于对照组的75.00%，两组比较差异具有统计学意义（P<0.05）。治疗后3 d，观察组的大便频次及大便性状评分、止泻时间均显著少于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组的CD3⁺、CD4⁺及CD4⁺/CD8⁺均明显升高（P<0.05），且观察组T淋巴细胞亚群水平显著高于对照组（P<0.05）。两组均未出现药物不良反应。结论 布拉氏酵母菌联合蒙脱石散可有效缓解腹泻症状，提高患儿机体免疫力，疗效安全可靠，值得在小儿急性腹泻治疗中推广应用。

Effects of Saccharomyces boulardii combined with Montmorillonite Powder on acute diarrhea in children and T-cell subsets

Objective To explore effect of Saccharomyces boulardii combined with Montmorillonite Powder on the treatment effect and T cell subsets in children with acute diarrhea. Methods 64 children with acute diarrhea in Bozhou people''s hospital from August 2018 to May 2019 were devided into control and observation groupe according to the order of treatment, each group had 32 cases. Children in the control group were po administered with Montmorillonite Powder, children within 1 year old:1.5 g/time, twice daily; 1-2 years old:3.0 g/time, twice daily; over 2 years old:3.0 g/time, three times daily. Children in the observation group were po administered with Saccharomyces boulardii sachets 2 h after taking Montmorillonite Powde, children within 1 year old:0.125 g/ time, twice daily, over 2 years old:0.25 g/time, twice daily. Both groups were treated for 4 to 7 days according to the improvement of the children''s symptoms. After treatment, the total therapeutic efficiency, symptom improvement, changes of T cell subsets before and after treatment, and drug safety in two groups were compared. Results After treatment, the total effective rate in the observation group was 93.75%, significantly higher than 75.00% of the control group, and the difference between two groups was statistically significant (P<0.05). After treatment, the stool frequency and character score, and antidiarrhea time of the observation group were significantly lower than those of the control group, and the difference between two groups was statistically significant (P<0.05). After treatment, the levels of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ in two groups were significantly increased (P<0.05), and the Tlymphocyte subsets in the observation group were significantly higher than those in the control group (P<0.05). No adverse drug reactions occurred in two groups. Conclusion Saccharomyces boulardii sachets combined with Montmorillonite Powder can effectively relieve the symptoms of diarrhea, improve the immunity of children, and the efficacy is safe and reliable, which is worth popularizing and applying in the treatment of acute diarrhea in children.