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目的探讨秋泻灵联合双歧杆菌三联活菌制剂对小儿轮状病毒性肠炎免疫系统及微炎症状态的影响。方法选择2013年5月-2016年7月期间在该院就诊的128例轮状病毒性肠炎患儿并采用随机数表法分为接受常规对症治疗的对照组以及接受常规对症联合秋泻灵、双歧杆菌三联活菌制剂治疗的观察组。观察病情转归并在治疗后3 d时测定外周血中免疫应答指标、血清中炎性因子含量、粪便中肠道菌群数量。结果观察组患儿的呕吐停止时间、退热时间、止泻时间以及住院时间均显著短于对照组,差异有统计学意义(t=7.581、7.974、8.237、6.778,均P<0.05);治疗后3 d时,观察组患儿外周血中CD3~+CD4~+T细胞的含量以及CD4~+/CD8~+细胞的比例均显著高于对照组,差异有统计学意义(t=6.782、7.581,均P<0.05),外周血中CD19~+CD5~+B细胞的含量以及血清中白细胞介素(IL-1β、IL-6、IL-8)、肿瘤坏死因子-α(TNF-α)、高迁移率族蛋白-1(HMGB-1)的含量均显著低于对照组,差异有统计学意义(t=7.972、9.393、9.772、9.182、7.876、8.784,均P<0.05),CD3~+CD8~+T细胞的含量与对照组比较差异无统计学意义(t=0.375,P>0.05);观察组患儿肠道中双歧杆菌、乳酸杆菌的拷贝数显著高于对照组,大肠杆菌的拷贝数显著低于对照组,差异有统计学意义(t=8.108、8.998、9.547,均P<0.05)。结论秋泻灵联合双歧杆菌三联活菌制剂治疗小儿轮状病毒性肠炎能够改善免疫功能、减轻炎症反应、调节肠道菌群平衡。
Objective To investigate the effect of Qiu-Ling-Ling combined with Bifidobacterium triple viable agents on immune system and micro-inflammatory state in children with rotavirus enteritis. Methods A total of 128 children with rotavirus enteritis who were treated in this hospital from May 2013 to July 2016 were randomly divided into two groups: control group receiving routine symptomatic treatment and patients receiving routine symptomatic joint diarrhea, Bifidobacterium triple viable preparations for the treatment of the observation group. The prognosis of the disease was observed and the immune response index in the peripheral blood, the level of inflammatory cytokines and the number of intestinal flora in the feces were measured 3 days after treatment. Results The stopping time, antipyretic time, antidiarrheal time and hospitalization time of the observation group were significantly shorter than those of the control group (t = 7.581, 7.974, 8.237, 6.778, all P <0.05) After 3 days, the content of CD3 ~ + CD4 ~ + T cells and the proportion of CD4 ~ + / CD8 ~ + cells in the peripheral blood of the observation group were significantly higher than those of the control group (t = 6.782, 7.581, P <0.05). The level of CD19 ~ + CD5 ~ + B in peripheral blood and the levels of IL-1β, IL-6 and TNF- ), HMGB-1 were significantly lower than those in the control group (t = 7.972,9.393,9.772,9.182,7.876,8.784, P <0.05) There was no significant difference between the control group and the control group (~ 0.375, P> 0.05). The copy number of Bifidobacterium and Lactobacillus in the intestinal tract of the observation group was significantly higher than that of the control group and the large intestine Bacillus copy number was significantly lower than the control group, the difference was statistically significant (t = 8.108,8.998,9.547, all P <0.05). Conclusions Qiu-Ling-Ling combined with Bifidobacterium triple viable agents in treating children with rotavirus enteritis can improve immune function, reduce inflammation and regulate the balance of intestinal flora.