参苓白术颗粒联合布拉氏酵母菌散对抗生素相关性腹泻患儿肠道菌群、黏膜功能及炎症因子的影响  

The effects of Shenling Baizhu granule combined with Saccharomyces boulardii powder on intestinal flora,mucosal function and inflammatory factors in children with antibiotic associated diarrhea

作　　者：景宇倩 王方玥 符兆英[1] Jing Yuqian;Wang Fangyue;Fu Zhaoying(Medical school of Yan'an University,Yan'an,Shanxi,727400,China)

机构地区：[1]延安大学医学院,陕西延安727400

出　　处：《齐齐哈尔医学院学报》2023年第5期428-432,共5页Journal of Qiqihar Medical University

摘　　要：目的评估参苓白术颗粒联合布拉氏酵母菌散对抗生素相关性腹泻(AAD)患儿肠道菌群、黏膜功能及炎症因子的影响。方法选择2021年2月—2022年4月本院收治的AAD患儿208例作为研究对象,随机分为对照组(给予布拉氏酵母菌散治疗)与联合组(给予参苓白术颗粒联合布拉氏酵母菌散治疗)两组,每组各104例。评价两组患儿的临床疗效、临床症状改善时间、肠道菌群变化(粪便内双歧杆菌、大肠埃希菌、肠球菌以及乳杆菌数目)、肠粘膜功能指标[血清二胺氧化酶(Diamine oxidase,DAO)、D-乳酸(D-Lactic acid,D-LC)、细菌内毒素(Bacterial endotoxin,BT)水平]、炎症因子水平[血清肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、降钙素原(Procalcitonin,PCT)、白细胞介素-6(Interleukin-6,IL-6)以及超敏C反应蛋白(Hypersensitive C-reactive protein,hs-CRP)水平]、治疗期间不良反应及复发情况。结果联合组治疗总有效率为98.08%(102/104),显著高于对照组的76.92%(80/104),差异具有统计学意义(χ^(2)=21.275,P<0.001)。联合组呕吐改善时间[(1.29±0.43)天]、退热时间[(2.78±0.64)天]、腹痛改善时间[(3.57±0.61)天]、止泻时间[(3.06±0.75)天]以及住院时间[(5.13±1.16)天]均明显短于对照组(均P<0.05)。联合组治疗后粪便内双歧杆菌[(8.56±1.45)lgcfu/g]、大肠埃希菌[(6.59±0.92)lgcfu/g]、肠球菌[(6.71±1.25)lgcfu/g]及乳杆菌[(8.39±1.18)lg cfu/g]水平均高于对照组(P<0.05)。联合组治疗后血清DAO[(8.29±1.71)U/L]、D-LC[(11.16±1.39)mg/L]以及BT[(4.96±0.92)U/L]均低于对照组(P<0.05)。联合组治疗后血清TNF-α[(53.02±6.34)ng/L]、PCT[(2.05±0.43)μg/L]、IL-6[(2.13±0.49)μg/L]以及hs-CRP[(1.99±0.31)mg/L]均低于对照组(P<0.05)。联合组不良反应总发生率为17.31%(18/104),略高于对照组的9.62%(10/104),差异无统计学意义(P=0.104);而联合组复发率为5.77%(6/104),明显低于对照组的21.15%(22/104)(P=0.001)。结论参苓白术颗粒联合Objective To discuss the effects of Shenling Baizhu granule combined with Saccharomyces boulardii powder on intestinal flora,mucosal function and inflammatory factors in children with antibiotic associated diarrhea(AAD).Methods 208 children with AAD those were admitted to our hospital from Feb 2021 to Apr 2022 were selected as the research objects,and they were divided into the control group(treated with Saccharomyces boulardii powder)and the combined group(treated with Shenling Baizhu granule combined with Saccharomyces boulardii powder)according to random number table method,104 cases in each group.The clinical efficacy,clinical symptom improvement time,intestinal flora changes(the number of bifidobacteria,escherichia coli,enterococcus and lactobacillus in feces),intestinal mucosal function indexes(levels of serum Diamine oxidase,DAO;D-Lactic acid,D-LC;Bacterial endotoxin,BT),inflammatory factor levels(levels of serum Tumor necrosis factor-α,TNF-α;Procalcitonin,PCT;Interleukin-6,IL-6;Hypersensitive C-reactive protein,hs-CRP),adverse reactions and recurrence during treatment were evaluated.Results The total effective rate of the combination group(98.08%,102/104)was significantly higher than that(76.92%,80/104)of the control group(χ^(2)=21.275,P<0.001).The vomiting improvement time(1.29±0.43)d,fever relief time(2.78±0.64)d,abdominal pain improvement time(3.57±0.61)d,diarrhea cessation time(3.06±0.75)d and hospitalization time(5.13±1.16)d of the combined group were significantly shorter than those of the control group(all,P<0.05).After treatment,the number of fecal bifidobacterium(8.56±1.45)lg cfu/g,escherichia coli(6.59±0.92)lg cfu/g,enterococcus(6.71±1.25)lg cfu/g and lactobacillus(8.39±1.18)lg cfu/g of the combined group were significantly higher than the control group(all,P<0.05).After treatment,the serum DAO(8.29±1.71)U/L,D-LC(11.16±1.39)mg/L and BT(4.96±0.92)U/L of the combined group were significantly lower than the control group(all,P<0.05).After treatment,the serum TNF-α(53.02±6.34)ng/L,P

关 键 词：抗生素相关性腹泻 参苓白术颗粒 肠道菌群 黏膜功能 炎症因子 

分 类 号：R725.7[医药卫生—儿科]