目的 探討雙歧桿菌三聯(lián)活菌腸溶膠囊聯(lián)合堿式水楊酸鉍治療小兒反復(fù)腹瀉的臨床療效。方法 選取2019年1月—2021年1月在河北中石油中心醫(yī)院兒科住院治療的150例腹瀉患兒，按照隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各75例。對(duì)照組患兒口服堿式水楊酸鉍干混懸劑，1包/次，3次/d。治療組患者在對(duì)照組基礎(chǔ)上口服雙歧桿菌三聯(lián)活菌腸溶膠囊，3粒/次，2次/d。兩組連續(xù)用藥7 d。觀察兩組的臨床療效、癥狀緩解時(shí)間，比較兩組治療前后腸道菌群數(shù)量、血清細(xì)胞因子水平。結(jié)果 治療后，治療組總有效率98.67%，顯著高于對(duì)照組的86.67%（P＜0.05）。治療后，治療組出現(xiàn)發(fā)熱、乏力、食欲不振、大便次數(shù)增多緩解時(shí)間均顯著短于對(duì)照組（P＜0.05）。治療后，兩組乳桿菌屬、腸球菌屬數(shù)量均較治療前顯著提高，酵母樣真菌數(shù)量顯著降低（P＜0.05）；治療后，治療組患兒腸道菌群數(shù)量改善優(yōu)于對(duì)照組（P＜0.05）。治療后，兩組白細(xì)胞介素-10（IL-10）、白細(xì)胞介素-6（IL-6）、腫瘤壞死因子-α水平均較治療前顯著降低（P＜0.05）；治療后，治療組血清炎性因子水平低于對(duì)照組（P＜0.05）。結(jié)論 雙歧桿菌三聯(lián)活菌腸溶膠囊聯(lián)合堿式水楊酸鉍治療小兒反復(fù)腹瀉療效確切，可有效改善患兒腹瀉癥狀，改善腸道菌群數(shù)量，減弱腸道內(nèi)炎癥反應(yīng)，且安全有效，值得臨床推廣應(yīng)用。

Objective To investigate the therapeutic effect of Bifid Triple Viable Capsules Dissolving at Intestines combined with bismuth subsalicylate in treatment of recurrent diarrhea in children. Methods A total of 150 children with diarrhea hospitalized in Hebei Central Hospital of Petrochina from January 2019 to January 2021 were selected and divided into control group and treatment group according to random number table method, with 75 cases in each group. Patients in the control group were po administered with Bismuth Subsalicylate for Oral Suspension, 1 bag/time, three times daily. Patients in the treatment group were po administered with Bifid Triple Viable Capsules Dissolving at Intestines on the basis of the control group, 3 grains/time, twice daily. Both groups were treated continuously for 7 d. The clinical efficacy and symptom remission time of the two groups were observed, and the number of intestinal flora and serum cytokine levels were compared before and after treatment. Results After treatment, the total effective rate of the treatment group was 98.67%, which was significantly higher than that of the control group (86.67%, P < 0.05). After treatment, the remission time of fever, fatigue, loss of appetite, and increased frequency of stool in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the number of Lactobacillus and Enterococcus in both groups was significantly increased, while the number of yeastlike fungi was significantly decreased (P < 0.05). After treatment, the improvement of intestinal flora in the treatment group was better than that in the control group (P < 0.05). After treatment, the levels of interleukin-10 (IL-10), interleukin-6 (IL-6), and tumor necrosis factor-α in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the serum inflammatory factor level in the treatment group was lower than that in the control group (P < 0.05). Conclusion Bifid Triple Viable Capsules Dissolving at Intestines combined with bismuth subsalicylate has exact curative effect in treatment of recurrent diarrhea in children, and can effectively improve the diarrhea symptoms of children, improve the number of intestinal flora, reduce intestinal inflammatory reaction, and is safe and effective, which is worthy of clinical application.

R985

廊坊市科學(xué)技術(shù)研究與發(fā)展計(jì)劃（第一批）自籌經(jīng)費(fèi)項(xiàng)目（2019013007）