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目的:观察蒙脱石散(思密达)、双歧三联活菌散(培菲康)、丙种球蛋白三联治疗小儿迁延性慢性腹泻的疗效及对免疫功能、炎症因子的影响。方法:将136例迁延性慢性腹泻患儿随机分为观察组和对照组各68例。对照组给予蒙脱石散联合双歧三联活菌散治疗:双歧三联活菌散1粒/次,每天3次,以温开水冲服;蒙脱石散<1岁每次1/3包,1～2岁每次2/3包,2岁以上每次1包,每天3次。观察组在对照组治疗基础上静脉滴注丙种球蛋白400 mg/kg,每天1次,连用4 d为1疗程。观察两组患儿治疗前后血清免疫球蛋白、TNF-α、IL-6、内毒素的变化,比较两组患儿症状恢复正常时间与住院时间。结果:(1)观察组总有效率(89.71%)高于对照组(77.94%),两组比较差异有统计学意义(P<0.05);(2)观察组症状恢复正常时间、平均住院时间较对照组均缩短(P<0.01);(3)两组患儿治疗后内毒素、TNF-α、IL-6均较治疗前降低,IgA、IgG较治疗前升高,但观察组较对照组改善更明显(P<0.05)。结论:蒙脱石散、双歧三联活菌散、丙种球蛋白三联治疗小儿迁延性慢性腹泻疗效确切,能有效提高患儿免疫功能,调节内毒素和炎症因子水平,保护、修复受损粘膜,双向调节肠道菌群失调,多途径达到治愈目的。
Objective: To observe the effect of montmorillonite powder (Smecta), bifid triple termites (Peifukang) and gamma globulin triple therapy on persistent chronic diarrhea in children and its effects on immune function and inflammatory factors. Methods: 136 children with persistent chronic diarrhea were randomly divided into observation group and control group, 68 cases each. The control group was treated with montmorillonite powder and bifid triple triptolide powder: bifid triple triptolide powder 1 capsule per time, 3 times per day, with warm boiled water; montmorillonite powder <1 year old, 1 ~ 2 years old each 2/3 package, 1 package for 2 years and above, 3 times a day. The observation group was given intravenous gamma globulin 400 mg / kg on the basis of the control group once a day for 4 days for 1 course of treatment. The changes of serum immunoglobulin, TNF-α, IL-6, and endotoxin before and after treatment in both groups were observed. The symptoms recovery time and hospital stay were compared between the two groups. Results: (1) The total effective rate (89.71%) in the observation group was higher than that in the control group (77.94%), the difference was statistically significant (P <0.05); (2) The recovery of symptoms, average length of stay (3) The endotoxin, TNF-α and IL-6 in both groups were lower than those before treatment, and the levels of IgA and IgG were higher than those before treatment in the two groups Group improved more significantly (P <0.05). CONCLUSIONS: Montmorillonite powder, Bifidobacterium triple viable powder and gamma globulin triple therapy are effective in treating pediatric persistent chronic diarrhea, which can effectively improve children’s immune function, regulate endotoxin and inflammatory cytokines, protect and repair damaged mucosa, Two-way regulation of intestinal flora, many ways to achieve the purpose of cure.