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目的 :探讨匹多莫德联合布拉氏酵母菌散治疗小儿抗生素相关性腹泻(antibictic-associoted diarrhea,AAD)的疗效及对患儿肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及T细胞亚群水平的影响。方法:2014年1月至2016年4月安阳市妇幼保健院106例AAD患儿,依据治疗方法不同分为联合组与单一组,各53例。单一组予以匹多莫德治疗,联合组予以布拉氏酵母菌散联合匹多莫德治疗,两组均予以补液、补充水电解质及抗炎等常规治疗。统计两组临床效果、复发率、临床症状缓解及留院观察时间,并比较治疗前后TNF-α、IL-6及T细胞亚群水平。结果:联合组临床总有效率(96.23%)明显高于单一组(81.13%),且复发率(3.77%)显著低于单一组(20.75%),差异均具有统计学意义(P<0.05);与单一组相比,联合组临床症状缓解及留院观察时间均较短,差异具有统计学意义(P<0.05);治疗前,两组TNF-α、IL-6水平比较,差异无统计学意义(P>0.05),治疗后两组TNF-α、IL-6水平均较治疗前明显降低,且联合组TNF-α、IL-6水平降低幅度更显著,差异具有统计学意义(P<0.05);治疗前,两组T细胞亚群水平差异均无统计学意义(P>0.05),治疗后,两组T细胞亚群水平均明显改善,且与单一组相比,联合组CD3~+、CD4~+/CD8~+、CD4~+水平均明显较高,差异具有统计学意义(P<0.05)。结论:匹多莫德与布拉氏酵母菌散联合应用于小儿AAD治疗效果显著,可促进患儿临床症状缓解,改善患儿T细胞亚群水平,降低TNF-α、IL-6水平,缩短留院观察时间,降低复发率,在临床治疗中具有重要意义。
OBJECTIVE: To investigate the curative effect of Pidotimod and Bradyrhizobacter on infantile antibiotic-associated diarrhea (AAD) and to evaluate the effect of combined therapy on tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and T cell subsets. Methods: From January 2014 to April 2016, 106 children with AAD in Anyang MCH hospital were divided into combined group and single group according to different treatment methods, with 53 cases in each group. A single group was treated with Pidotimod. The combination group was treated with the combination of Pasteurella brassicae and Pidotimod. The two groups were given fluid replacement, supplemented with water, electrolyte, anti-inflammatory and other conventional treatments. The clinical effect, relapse rate, clinical symptom relief and stay in hospital were observed. The levels of TNF-α, IL-6 and T cell subsets were compared before and after treatment. Results: The total effective rate (96.23%) in the combined group was significantly higher than that in the single group (81.13%), and the recurrence rate was significantly lower than that of the single group (3.77%, 3.75%, P <0.05) ; Compared with the single group, the combination group clinical symptoms and stay in hospital observation time are shorter, the difference was statistically significant (P <0.05); before treatment, the two groups of TNF-α, IL-6 levels, no difference (P> 0.05). After treatment, the levels of TNF-α and IL-6 in both groups were significantly lower than those before treatment, and the levels of TNF-α and IL-6 in the combination group were significantly decreased (P <0.05). Before treatment, there was no significant difference in the level of T cell subsets between the two groups (P> 0.05). After treatment, the levels of T cell subsets in both groups were significantly improved. Compared with the single group, the level of CD3 ~ +, CD4 ~ + / CD8 ~ +, CD4 ~ + levels were significantly higher, the difference was statistically significant (P <0.05). Conclusion: Pidotimod and Bradygenin combined with Bradyrhizobium are effective in treating pediatric AAD, which can promote the clinical symptoms, improve the level of T cell subsets and decrease the levels of TNF-α and IL-6 in children Stay in hospital observation time, reduce the recurrence rate, in clinical treatment is of great significance.