目的 參歧腸泰合劑聯(lián)合口服補(bǔ)液鹽散（Ⅲ）治療兒童感染性腹瀉的臨床研究。方法 選取2023年1月—12月秦皇島市婦幼保健院收治的110例感染性腹瀉患兒作為研究對(duì)象，按隨機(jī)數(shù)字表法將所有研究對(duì)象分為對(duì)照組和治療組，每組各55例。對(duì)照組予以口服補(bǔ)液鹽散（Ⅲ），先將1袋口服補(bǔ)液鹽散（Ⅲ）溶解于250 mL溫開水，根據(jù)患兒脫水情況以30～50 mL/kg劑量進(jìn)行調(diào)節(jié)，4 h內(nèi)服用完畢，2次/d。治療組在對(duì)照組治療基礎(chǔ)上于餐前30 min口服參歧腸泰合劑，初次劑量為30 mL，維持劑量為10 mL/次，3次/d。兩組患兒均持續(xù)治療7 d。觀察兩組的臨床療效，比較兩組臨床癥狀消失時(shí)間、治療前后腸道菌群變化及炎性因子[腫瘤壞死因子-α（TNF-α）、白細(xì)胞介素-10（IL-10）及白細(xì)胞介素-15（IL-15）]水平的變化情況。結(jié)果 治療后，治療組總有效率是98.18%，顯著高于對(duì)照組的87.27%（P＜0.05）。治療后，治療組患者退熱時(shí)間、止嘔時(shí)間、止瀉時(shí)間及病毒轉(zhuǎn)陰時(shí)間均較對(duì)照組顯著縮短（P＜0.05）。治療后，兩組乳桿菌、雙歧桿菌均顯著增加，而腸桿菌顯著降低（P＜0.05）；治療后，治療組腸道菌群改善情況優(yōu)于對(duì)照組（P＜0.05）。治療后，兩組TNF-α、IL-10及IL-15水平均較同組治療前顯著降低（P＜0.05）；治療后，治療組血清炎性因子顯著低于對(duì)照組（P＜0.05）。結(jié)論 參歧腸泰合劑聯(lián)合口服補(bǔ)液鹽散（Ⅲ）治療兒童感染性腹瀉有效性和安全性均較高，可降低患兒炎性因子水平，調(diào)節(jié)腸道菌群，縮短癥狀消失時(shí)間。

Objective To explore the curative effect of Shenqi Changtai Mixture combined with Oral Rehydration Salts Powder (Ⅲ) in treatment of infectious diarrhea in children. Methods A total of 110 children with infectious diarrhea admitted to the Maternal and Child Health Hospital of Qinhuangdao City from January 2023 to December were selected as the study objects, and all children were divided into control group and treatment group according to random number table method, with 55 cases in each group. Patients in the control group were given Oral Rehydration Salts Powder (Ⅲ), firstly, a bag of Oral Rehydration Salts Powder (Ⅲ) was dissolved in 250 mL of warm water, adjusted at a dosage of 30 — 50 mL/kg according to the dehydration of the child, and was taken within 4 h, twice daily. Patients in the treatment group were po administered with Shenqi Changtai Mixture before meals on the basis of the control group, the initial dosage was 30 mL, and the maintenance dosage was 10 mL/time, 3 times daily. Both groups were treated for 7 d. The clinical efficacy of the two groups was observed, and the time for clinical symptoms to disappear, the changes of intestinal flora and the levels of inflammatory factors (TNF-α, IL-10, and IL-15) before and after treatment were compared between two groups. Results After treatment, the total effective rate of treatment group was 98.18%, which was significantly higher than that of control group (87.27%, P < 0.05). After treatment, the antipyretic time, antinausea time, antidiarrheal time and virus negative time in treatment group were significantly shorter than those in control group (P < 0.05). After treatment, Lactobacillus and bifidobacterium were significantly increased in both groups, but enterobacterium was significantly decreased (P < 0.05). After treatment, the improvement of intestinal flora in treatment group was better than that in control group (P < 0.05). After treatment, the levels of TNF-α, IL-10 and IL-15 in two groups were significantly decreased compared with those before treatment (P < 0.05). After treatment, the serum inflammatory factors in treatment group were significantly lower than those in control group (P < 0.05). Conclusion Shenqi Changtai Mixture combined with Oral Rehydration Salts Powder (Ⅲ) is effective and safe in treatment of infectious diarrhea in children, and can reduce the level of inflammatory factors in children, regulate intestinal flora, and shorten the time of symptom disappearance.

R985;R975

秦皇島市市級(jí)科學(xué)技術(shù)研究與發(fā)展計(jì)劃自籌經(jīng)費(fèi)項(xiàng)目(202301A081)