标题：布拉氏酵母菌散联合赖氨葡锌颗粒治疗小儿腹泻的疗效及对肠道微生态、胃肠激素的影响

      作者：周银，熊超，王胜刚，李洪    安康市安康人民医院儿科，陕西 安康 752000

      卷次： 2023年34卷5期

      【摘要】 目的 探讨布拉氏酵母菌散、赖氨葡锌颗粒联合治疗小儿腹泻的疗效及对患儿肠道微生态、胃肠激素的影响。方法 选取2019年1月至2021年12月在安康市安康人民医院治疗的364例小儿腹泻患者为研究对象，依据随机数表法分为对照组和联合组，每组182例。两组患儿均接受常规治疗，对照组在常规治疗的基础上使用赖氨葡锌颗粒治疗，联合组在常规治疗的基础上联合使用布拉氏酵母菌散、赖氨葡锌颗粒治疗。治疗3 d后，比较两组患儿的临床疗效，治疗前后的肠道微生态、胃肠激素水平[包括血管活性肠肽(VIP)、胰高血糖素(Glu)、神经肽Y(NPY)]和不良反应发生情况。结果 联合组患儿的临床治疗总有效率为91.76%，明显高于对照组的73.63%，差异有统计学意义(P<0.05)；治疗前，两组患儿的真杆菌、乳杆菌、肠球菌属比较差异均无统计学意义(P>0.05)；治疗后，联合组患儿的真杆菌为(2.85±0.20) CFU/g，明显低于对照组的(3.41±0.18) CFU/g，乳杆菌、肠球菌属分别为(10.31±1.21) CFU/g、(12.40±1.13) CFU/g，明显高于对照组的(9.28±1.08) CFU/g、(11.03±1.17) CFU/g，差异均有统计学意义(P<0.05)；治疗前，两组患儿的VIP、Glu、NPY水平比较差异均无统计学意义(P>0.05)；治疗后，联合组患儿的VIP、Glu水平分别为(25.92±7.09) pg/mL、(86.95±7.64) pg/mL，明显低于对照组的(31.30±5.81) pg/mL、(93.51±9.57) pg/mL，差异均有统计学意义(P<0.05)；治疗后，联合组患儿的NPY水平为(187.97±25.50) pg/mL，与对照组的(189.52±23.89) pg/mL比较差异无统计学意义(P>0.05)；治疗期间联合组患儿的总不良反应发生率为12.64%，略高于对照组的10.44%，但差异无统计学意义(P>0.05)。结论 布拉氏酵母菌散联合赖氨葡锌颗粒治疗小儿腹泻可明显改善患儿的肠道微生态环境及胃肠激素VIP、Glu水平，临床治疗效果显著，且安全性较高。
      【关键词】 小儿腹泻；布拉氏酵母菌散；赖氨葡锌颗粒；临床疗效；肠道微生态；胃肠激素
      【中图分类号】 R725.7 【文献标识码】 A 【文章编号】 1003—6350（2023）05—0672—04

Therapeutic effect of Saccharomyces boulardii powder combined with Lysine Hydrochloride and Zinc GluconateGranules on infantile diarrhea and its effect on intestinal microecology and gastrointestinal hormones.
ZHOU Yin,XIONG Chao, WANG Sheng-gang, LI Hong. Department of Pediatrics, Ankang People's Hospital, Ankang 752000, Shaanxi,CHINA
【Abstract】 Objective To investigate the curative effect of Saccharomyces boulardii powder combined with Ly-sine Hydrochloride and Zinc Gluconate Granules in the treatment of infantile diarrhea and their effects on intestinal mi-croecology and gastrointestinal hormones. Methods A total of 364 patients of pediatric diarrhea who were treated inAnkang People's Hospital from January 2019 to December 2021 were selected as the research objects. According to therandom number table method, they were divided into the control group and the combined group, with 182 patients ineach group. Based on conventional treatment, the control group received Lysine Hydrochloride and Zinc Gluconate Gran-ules, and the combined group received Saccharomyces boulardii powder combined with Lysine Hydrochloride and ZincGluconate Granules. After 3 days of treatment, the clinical efficacy, intestinal microecology, gastrointestinal hormonelevels [including vasoactive intestinal peptide (VIP), glucagon (Glu), neuropeptide Y (NPY)] before and after treatment,and the occurrence of adverse reactions in the two groups were compared. Results The total clinical effective rate ofchildren in the combined group was 91.76%, which was significantly higher than 73.63% in the control group (P<0.05);after treatment, the Eubacterium in the combined group was (2.85±0.20) CFU/g, which was significantly lower than(3.41±0.18) CFU/g in the control group; lactobacillus, enterococcus were (10.31±1.21) CFU/g, (12.40±1.13) CFU/g,which were significantly higher than (9.28±1.08) CFU/g, (11.03±1.17) CFU/g in the control group (P<0.05). Beforetreatment, there were no significant difference in the levels of VIP, Glu, and NPY between the two groups (P>0.05); aftertreatment, the levels of VIP and Glu in the combined group were (25.92±7.09) pg/mL and (86.95±7.64) pg/mL, whichwere significantly lower than (31.30±5.81) pg/mL and (93.51±9.57) pg/mL of the control group (P<0.05); after treat-ment, the NPY level of the combined group was (187.97±25.50) pg/mL, which was not statistically significant from(189.52±23.89) pg/mL in the control group (P>0.05). The total adverse reactions in the combined group was 12.64%,slightly higher than 10.44% in the control group (P>0.05). Conclusion In the treatment of children with diarrhea, Sac-charomyces boulardii powder combined with Lysine Hydrochloride and Zinc Gluconate Granules can significantly im-prove the intestinal microecological environment and the levels of gastrointestinal hormones VIP and Glu, with signifi-cant clinical therapeutic effect and high safety.
      【Key words】 Diarrhea in children; Saccharomyces boulardii powder; Lysine Hydrochloride and Zinc GluconateGranules; Clinical efficacy; Intestinal microecology; Gastrointestinal hormones