标题：秋泻灵颗粒联合补锌疗法及益生菌对轮状病毒肠炎患儿血清HMGB-1、T细胞亚群水平变化的影响

      作者：廖建丽，刘芮杉，郭莉    内江市第二人民医院儿科，四川 内江 641000

      卷次： 2019年30卷4期

      【摘要】 目的 探讨秋泻灵颗粒联合益生菌及补锌疗法对轮状病毒肠炎(RE)患儿血清炎性因子[高迁移率族蛋白-1 (HMGB-1)、白细胞介素-6 (IL-6)、高敏C反应蛋白(hs-CRP)]、T细胞亚群水平变化的影响。方法 选取内江市第二人民医院儿科2016年2月至2017年12月收治的RE患儿86例，按随机数表法将其分为对照组和观察组各43例。在常规治疗基础上，对照组采取益生菌治疗，观察组于对照组治疗的基础上加用补锌疗法和秋泻灵颗粒，两组均治疗3 d。比较两组患儿的临床疗效、临床症状恢复(止泻时间、退热时间、止吐时间)及住院时间、治疗前及疗程结束后血清炎性因子水平、T细胞亚群指标(CD3+、CD4+、CD8+、CD4+/CD8+)水平及不良反应发生率。结果 观察组患儿的治疗总有效率为 93.02%，明显高于对照组的 76.74%，差异具有统计学意义(P<0.05)；观察组患儿的住院时间[(4.59±0.66) d]、退热时间[(1.25±0.21) d]、止泻时间[(2.84±0.56) d]、止吐时间[(2.14±0.33) d]短于对照组，差异均具有统计学意义(P<0.05)；两组疗程结束后血清HMGB-1、hs-CRP、IL-6水平低于治疗前，且观察组HMGB-1[(8.63±0.83) pg/L]、IL-6 [(22.79±4.02) μg/L]、hs-CRP [(8.28±3.31) mg/L]较对照组低，差异均有统计学意义(P<0.05)；两组患者治疗后CD8+水平较治疗前降低，CD3+、CD4+、CD4+/CD8+水平较治疗前增高，且观察组CD8+为(23.29±3.42)%，低于对照组的(27.32±4.08)%，CD3+、CD4+和CD4+/CD8+分别为(67.29±4.81)%、(36.32±3.28)%、(1.56±0.33)，明显高于对照组的(58.70±5.13)%、(32.39±3.35)%、(1.19±0.31)，差异均有统计学意义(P<0.05)；观察组患者的不良反应发生率为13.95%(6/43)，与对照组的9.30% (4/43)比较差异无统计学意义(P>0.05)。结论 采取秋泻灵颗粒联合补锌疗法及益生菌治疗RE可有效缓解患儿临床症状，降低血清炎性因子水平，调节机体免疫功能，提高疾病治疗效果，促使患儿及早康复出院，且不会增加不良反应发生风险，具有安全性。
      【关键词】 秋泻灵颗粒；益生菌；补锌疗法；轮状病毒肠炎；炎性因子；T细胞亚群；效果；安全性
      【中图分类号】 R725.7 【文献标识码】 A 【文章编号】 1003—6350（2019）04—475—04E

ffect of Qiuxieling Granule combined with zinc supplementation and probiotics on serum levels of HMGB-1and T cell subsets in children with rotavirus enteritis.
LIAO Jian-li, LIU RUI-shan, GUO Li. Department of Pediatrics,the Second People's Hospital of Neijiang, Neijiang 641000, Sichuan, CHINA
【Abstract】 Objective To explore the effect of Qiuxieling Granule combined with zinc supplementation and pro-biotics on serum levels of inflammatory factors (high mobility group histone-1 [HMGB-1], interleukin-6 [IL-6], highsensitive C reactive protein [hs-CRP]) and T cell subsets in children with rotavirus enteritis (RE). Methods Eighty-sixchildren with RE admitted to the Department of Pediatrics of the Second People's Hospital of Neijiang from February2016 to December 2017 were enrolled. The patients were divided into the control group and the observation group ac-cording to the random number table method. On the basis of routine treatment, the control group was treated with probi-otics, while the observation group was given zinc supplementation therapy and Qiuxieling Granule on the basis of thecontrol group, for 3 days. The two groups were compared on clinical effects, clinical symptoms recovery (antidiarrhealtime, antipyretic time, antiemetic time), hospitalization time, the level of serum inflammatory factors and T cell subgroupindexes (CD3+, CD4+, CD8+, CD4+/CD8+) before treatment and at the end of treatment, and the incidence of adverse reac-tions. Results The total effective rate of treatment in the observation group was 93.02%, which was significantly high-er than 76.74% in the control group (P<0.05). The length of hospital stay, antipyretic time, antidiarrheal time, antiemetictime in the observation group were (4.59±0.66) d, (1.25±0.21) d, (2.84±0.56) d, (2.14±0.33) d, respectively, which weresignificantly shorter than those in the control group (P<0.05). After treatment, serum HMGB-1, hs-CRP, IL-6 levels inthe two groups were lower than those before treatment, and the levels in the observation group were (8.63±0.83) pg/L,(22.79±4.02) μg/L, (8.28±3.31) mg/L, respectively, significantly lower the corresponding levels in the control group (P<0.05). After treatment, the CD8+ level of the two groups was lower than that before treatment, while CD3+, CD4+, CD4+/CD8+ levels were significantly higher. The CD8+ after treatment of the observation group was (23.29±3.42)%, which waslower than (27.32±4.08)% of the control group, and the CD3+, CD4+, and CD4+/CD8+ levels were (67.29±4.81)%, (36.32±3.28)%, (1.56±0.33)%, respectively, significantly higher than (58.70±5.13)%, (32.39±3.35)%, (1.19±0.31) in the controlgroup (P<0.05). The incidence of adverse reactions in the observation group was 13.95% (6/43), as compared with