目的 探討珠芽蓼止瀉顆粒聯(lián)合布拉氏酵母菌散治療小兒功能性腹瀉的臨床療效。方法 選取2018年1月—2020年1月在鄭州頤和醫(yī)院治療的小兒功能性腹瀉患兒264例，隨機(jī)分為對(duì)照組（132例）和治療組（132例）。對(duì)照組口服布拉氏酵母菌散，1袋/次，2次/d。治療組在對(duì)照組基礎(chǔ)上口服珠芽蓼止瀉顆粒，1袋/次，3次/d。兩組患者均連續(xù)服用14 d。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者臨床癥狀緩解時(shí)間、大便性狀、大便次數(shù)、血清腫瘤壞死因子-α（TNF-α）、白細(xì)胞介素-6（IL-6）、超敏C反應(yīng)蛋白（hs-CRP）、二胺氧化酶（DAO）、IgA和IgG水平。結(jié)果 治療后，對(duì)照組臨床有效率為84.09%，顯著低于治療組的96.97%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，治療組患兒腹脹、嘔吐、腹瀉、腹痛癥狀緩解時(shí)間均明顯短于對(duì)照組患兒（P<0.05）。治療后，兩組大便性狀評(píng)分明顯好轉(zhuǎn)（P<0.05），大便次數(shù)明顯降低（P<0.05），且治療組患兒大便性狀評(píng)分和大便次數(shù)顯著好于對(duì)照組（P<0.05）。治療后，兩組血清TNF-α、IL-6、hs-CRP、DAO明顯低于治療前，而IgA和IgG水平均明顯高于治療前（P<0.05），且治療組患者顯著好于對(duì)照組同期水平（P<0.05）。結(jié)論 珠芽蓼止瀉顆粒聯(lián)合布拉氏酵母菌散治療小兒功能性腹瀉的療效顯著，可明顯改善患兒大便次數(shù)及大便性狀，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the curative effect of Zhuyaliao Zhixie Granules combined with Saccharomyces boulardii sachets in treatment of children with functional diarrhea. Methods Children (264 cases) with functional diarrhea in Zhengzhou Yihe Hospital from January 2018 to January 2020 were randomly divided into control (132 cases) and treatment (132 cases) groups. Children in the control group were po administered with Saccharomyces boulardii sachets, 1 bag/time, twice daily. Children in the treatment group were po administered with Zhuyaliao Zhixie Granules on the basis of the control group, 1 bag/time, three times daily. Children in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the relief time of clinical symptom, stool traits and frequency, and the serum level of TNF-α, IL-6, hs-CRP, DAO, IgA and IgG in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 84.09%, which was significantly lower than 96.97% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the relief time of abdominal distension, vomiting, diarrhea, abdominal pain in the treatment group was significantly earlier than that in the control group (P<0.05). After treatment, stool traits in two groups was significantly improved, stool frequency was significantly decreased (P<0.05), and the stool traits and frequency in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the serum levels of TNF-α, IL-6, hs-CRP, DAO in two groups were significantly decreased, but the levels of IgA and IgG were significantly increased (P<0.05), and these indexes levels in the treatment group were significantly higher than those in the control group (P<0.05). Conclusion Zhuyaliao Zhixie Granules combined with Saccharomyces boulardii sachets in treatment of children with functional diarrhea is significant, and the improvement of stool frequency and stool characteristics in children is obvious, which has a certain clinical application value.

R985

河南省醫(yī)學(xué)科技攻關(guān)項(xiàng)目（201602351）