双歧杆菌四联活菌联合头孢克洛对小儿细菌性肠炎的疗效观察

doi:10.11958/20241587

摘要/Abstract

摘要：

目的探究在使用头孢克洛治疗小儿细菌性肠炎的基础上联用双歧杆菌四联活菌的疗效和对肠道菌群的影响。方法纳入96例患有细菌性肠炎的儿童为研究对象，随机将患儿分为单药组和联合组，各48例。单药组患儿单用头孢克洛进行治疗，联合组给予双歧杆菌四联活菌联合头孢克洛治疗，对2组患儿的临床疗效、菌群数量、治疗后炎症因子水平[肿瘤坏死因子（TNF）-α、C反应蛋白（CRP）、白细胞介素（IL）-8、IL-2]、T淋巴细胞亚群和不良反应发生情况进行比较。结果联合组治疗总有效率高于单药组，症状体征改善时间较单药组更短（P<0.05）。治疗后，2组患儿大肠杆菌、TNF-α、CRP、IL-8均降低，联合组低于单药组（P<0.05）；双歧杆菌、乳酸杆菌、IL-2、T淋巴细胞亚群（CD3⁺、CD4⁺、CD4⁺/CD8⁺）升高，且联合组高于单药组（P<0.05）；2组各发生2例不良反应。结论在使用头孢克洛的基础上加双歧杆菌四联活菌治疗小儿细菌性肠炎可提高治疗有效率，改善肠道菌群和炎症反应，安全性好。

关键词: 肠炎, 头孢克洛, 胃肠道微生物组, 小儿细菌性肠炎, 双歧杆菌四联活菌

Abstract:

Objective To explore the effect of bifidobacterium quadruple viable bacteria on intestinal flora based on the use of cefaclor in the treatment of infantile bacterial enteritis. Methods A total of 96 children with bacterial enteritis admitted in our hospital were selected as the research objects, and the patients were divided into the combined group (n=48) and the single drug group (n=48). The single drug group was treated with cefaclor alone, while the combined group was treated with a combination of live combined bifidobacterium, lactobacillus, enterococcus and bacillus cereus tablets and cefaclor. The clinical effects, numbers of microbiota, levels of inflammatory factors [tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), interleukin-8 (IL-8), interleukin-2 (IL-2)], T lymphocyte subsets and adverse reactions were compared between the two groups. Results The total effective rate of the combined group was higher than that of the single drug group, and the improvement time of symptoms and signs was shorter than that of the single drug group (P<0.05). After treatment, levels of Escherichia coli, TNF-α, CRP and IL-8 decreased in both groups, which were lower in the combined group than those of the single drug group (P<0.05). Bifidobacterium, Lactobacillus, IL-2, and T lymphocyte subsets (CD3⁺, CD4⁺, CD4⁺/CD8⁺) were increased in both groups, and those were higher in the combined group than the single drug group (P<0.05). Adverse reactions occurred in two patients of each groups (P>0.05). Conclusion On the basis of using cefaclor and adding bifidobacterium quadruple viable bacteria in the treatment of bacterial enteritis in children can improve the treatment efficiency, improve the intestinal flora and inflammatory response, and have good safety.

Key words: enteritis, cefaclor, gastrointestinal microbiome, pediatric bacterial enteritis, live combined bifidobacterium, lactobacillus, enterococcus and bacillus cereus tablets

中图分类号:

R725.74

图/表 6

参考文献 20

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组别	性别（男/女）		年龄/岁		病程/d
单药组	26/22		4.65±0.60		5.40±0.49
联合组	25/23		4.58±0.50		5.44±0.50
χ²或t	0.042		0.555		0.410
组别		大便次数/（次/d）		大便白细胞/（个/HPF）
单药组		6.50±0.85		12.48±1.35
联合组		6.46±0.90		12.54±1.38
t		0.233		0.224

组别	性别（男/女）		年龄/岁		病程/d
单药组	26/22		4.65±0.60		5.40±0.49
联合组	25/23		4.58±0.50		5.44±0.50
χ²或t	0.042		0.555		0.410
组别		大便次数/（次/d）		大便白细胞/（个/HPF）
单药组		6.50±0.85		12.48±1.35
联合组		6.46±0.90		12.54±1.38
t		0.233		0.224

组别	显效	有效	无效	总有效
单药组	21（43.75）	17（35.42）	10（20.83）	38（79.17）
联合组	26（54.17）	20（41.67）	2（4.17）	46（95.83）
χ²				6.095^＊

组别	显效	有效	无效	总有效
单药组	21（43.75）	17（35.42）	10（20.83）	38（79.17）
联合组	26（54.17）	20（41.67）	2（4.17）	46（95.83）
χ²				6.095^＊

组别	双歧杆菌			乳酸杆菌			大肠杆菌
组别	治疗前	治疗后	t	治疗前	治疗后	t	治疗前	治疗后	t
单药组	6.25±0.66	7.41±0.78	7.997^＊＊	6.51±0.68	7.04±0.74	3.243^＊＊	7.65±0.80	6.78±0.71	5.886^＊＊
联合组	6.22±0.65	8.68±0.91	14.144^＊＊	6.54±0.69	7.99±0.84	11.131^＊＊	7.62±0.81	5.99±0.63	10.728^＊＊
t	0.228	7.356^＊＊		0.145	5.939^＊＊		0.124	5.838^＊＊