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作 者:钱敏燕 金佩丽 纪小艺 江素丽[1] 王朵梅 QIAN Minyan;JIN Peili;JI Xiaoyi;JIANG Suli;WANG Duomei(Department of Pediatrics,Jiaxing Maternal and Child Health Hospital,Jiaxing 314000,Zhejiang Province,China)
出 处:《药学前沿》2025年第3期451-457,共7页China Pharmacist
基 金:浙江省医药卫生科技计划项目(2021KY1122)。
摘 要:目的观察双歧杆菌三联活菌联合阿奇霉素治疗对百日咳患儿的临床疗效。方法回顾性分析2022年7月至2024年9月在嘉兴市妇幼保健院儿科就诊的百日咳患儿临床资料。根据治疗方法分为常规治疗组(仅使用阿奇霉素)和联合治疗组(阿奇霉素联合应用双歧杆菌三联活菌)。观察指标包括临床疗效、血清炎症因子[白细胞介素-10(IL-10)、反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]、免疫功能(CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞和CD4^(+)/CD8^(+)T细胞比值)水平及不良反应。结果研究共纳入103例患者,常规治疗组48例,联合治疗组55例。治疗14 d后,两组总有效率差异无统计学意义(P>0.05)。与常规治疗组相比,联合治疗组血清IL-10、TNF-α、CRP、CD8^(+)细胞水平显著低于常规治疗组(P<0.05);CD3^(+)T、CD4^(+)T细胞水平和CD4^(+)/CD8^(+)T细胞比值显著高于常规治疗组(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论联合应用双歧杆菌三联活菌不影响阿奇霉素治疗小儿百日咳的临床疗效和安全性,且可通过调节免疫炎症反应发挥协同治疗作用。Objective To investigate the clinical efficacy of combined therapy with bifidobacterium triple viable bacteria and azithromycin in children with pertussis.Methods Clinical data of children with pertussis treated at the Department of Pediatrics,Jiaxing Maternal and Child Health Hospital from July 2022 to September 2024 were retrospectively analyzed.Patients were divided into the conventional treatment group(azithromycin alone)and the combination treatment group(azithromycin combined with bifidobacterium triple viable bacteria).Observation indicators included clinical efficacy,serum inflammatory factors(IL-10,CRP and TNF-α),immune function levels(CD3^(+)T cells,CD4^(+)T cells,CD8^(+)T cells,and CD4^(+)/CD8^(+)T cells ratio),and adverse reactions.Results A total of 103 patients were included in the study,with 48 in the conventional treatment group and 55 in the combination treatment group.After 14 d of treatment,there was no statistically significant difference in total effective rate between the two groups(P>0.05).Compared with the conventional treatment group,the serum IL-10,TNF-α,CRP and CD8^(+)cell levels of the combination treatment group were significantly lower than those of the conventional treatment group(P<0.05);the CD3^(+)T,CD4^(+)T cell levels and CD4^(+)/CD8^(+)T cell ratio were significantly higher than those of the conventional treatment group(P<0.05).There was no significant difference in the occurrence of adverse reactions between the two groups(P>0.05).Conclusion The combined application of bifidobacterium triple viable bacteria does not affect the clinical efficacy and safety of azithromycin in treating pediatric pertussis,and exerts a synergistic therapeutic effect through regulating immune inflammatory responses.
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