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中华临床医师杂志(电子版)

中华临床医师杂志(电子版) ›› 2022, Vol. 16 ›› Issue (05) : 410 -414. doi: 10.3877/cma.j.issn.1674-0785.2022.05.007

临床研究

益生菌辅助治疗小儿支气管肺炎相关腹泻及其对肠道菌群改善的效果
刘宇1,†(), 王宁1, 李丹1, 张波1   
  1. 1. 063000　唐山，唐山市工人医院儿科
  • 收稿日期:2021-09-02 出版日期:2022-05-15
  • 通信作者: 刘宇

Probiotics for adjuvant treatment of diarrhea associated with bronchopneumonia in children: efficacy and impact on intestinal flora

Yu Liu1,†(), Ning Wang1, Dan Li1, Bo Zhang1   

  1. 1. Department of Pediatrics, Tangshan Workers Hospital, Tangshan 063000, China
  • Received:2021-09-02 Published:2022-05-15
  • Corresponding author: Yu Liu
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刘宇, 王宁, 李丹, 张波. 益生菌辅助治疗小儿支气管肺炎相关腹泻及其对肠道菌群改善的效果[J]. 中华临床医师杂志(电子版), 2022, 16(05): 410-414.

Yu Liu, Ning Wang, Dan Li, Bo Zhang. Probiotics for adjuvant treatment of diarrhea associated with bronchopneumonia in children: efficacy and impact on intestinal flora[J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(05): 410-414.

目的

探讨益生菌辅助治疗小儿支气管肺炎相关腹泻的效果及其肠道菌群改善。

方法

将2019年7月至2021年8月就诊于唐山市工人医院的148例小儿支气管肺炎相关腹泻患儿纳入本研究，按随机数字表法分为对照组和研究组。对照组74例，男39例，女35例；年龄（1.56±0.67）岁（1~3岁）。研究组74例，男40例，女34例；年龄（2.14±0.68）岁（0~3岁）。对照组采用常规治疗，即维持水电解质平衡、补液、抗感染、抗菌等对症治疗，并给予蒙脱石散口服。研究组在对照组基础上采用益生菌辅助治疗。比较两组临床疗效、症状缓解时间、肠道菌群、炎性因子、免疫功能等指标。

结果

研究组治疗总有效率为94.59%比对照组的83.78%高，差异有统计学意义（P＜0.05）。研究组大便性状恢复正常时间［（2.44±0.29）d］、大便次数恢复正常时间［（3.43±0.59）d］、止泻时间［（3.17±0.50）d］均比对照组［（3.11±0.41）d、（4.16±0.79）d、（3.92±0.62）d］低，差异均有统计学意义（均P＜0.05）。研究组治疗5d后肠道双歧杆菌、乳酸杆菌、类杆菌、粪肠球菌水平均比对照组高，肠杆菌均比对照组低（均P＜0.05）。研究组治疗5 d后血清白细胞介素-6（IL-6）、白细胞介素-17（IL-17）、C反应蛋白（CRP）水平均比对照组低，免疫球蛋白M（IgM）、免疫球蛋白A（IgA）、免疫球蛋白G（IgG）均比对照组高（均P＜0.05）。

结论

双歧杆菌三联活菌用于小儿支气管肺炎相关腹泻患儿的辅助治疗可提高治疗效果，缩短症状缓解时间，改善肠道菌群和免疫功能，缓解肠道炎症。

关键词: 支气管肺炎, 小儿, 腹泻, 益生菌, 肠道菌群, 免疫功能
Objective

To investigate the efficacy of probiotics in the adjuvant treatment of bronchopneumonia related diarrhea in children and the improvement of intestinal flora.

Methods

In this study, 148 children with infantile bronchopneumonia associated diarrhea who were admitted to Tangshan Workers Hospital from July to August 2019 were divided into either a control group or a study group according to the random number table method, with 74 cases in each group. There were 39 males and 35 females in the control group, with an average age of (1.56±0.67) years (range: 1-3 years). There were 40 males and 34 females in the study group, with an average age of (2.14±0.68) years (range: 0-3 years). The control group was treated with routine therapy, such as maintaining water-electrolyte balance, rehydration, anti-infection, and anti-bacterial therapy. The study group was treated with probiotics on the basis of the routine therapy. The clinical efficacy, time to symptom remission, intestinal flora, inflammatory factors, and immune function were compared between the two groups.

Results

The total effective rate of the study group was 94.59%, and it was 83.78% in the control group; the difference between them was statistically significant (P＜0.05). The time to recovery of stool characteristics [(2.44±0.29) d], time to return of stool frequency to normal [(3.43±0.59) d], and time to disappearance of diarrhea [(3.17±0.50) d] in the study group were significantly shorter than those of the control group [(3.11±0.41) d, (4.16±0.79) d, and (3.92±0.62) d, respectively; P＜0.05). After 5 days of treatment, the levels of intestinal bifidobacteria, lactobacillus, bacteroides, and enterococcus faecalis in the study group were all higher than those in the control group, and the level of enterobacter was lower than that in the control group (P＜0.05). After 5 days of treatment, the levels of serum interleukin-6, interleukin-17, and C-reactive protein in the study group were all lower than those in the control group, but the levels of immunoglobulin (Ig) M, IgA, and IgG were all higher than those in the control group (P＜0.05).

Conclusion

Bifidobacterium triple viable bacteria used in the adjuvant treatment of children with bronchopneumonia related diarrhea can improve the therapeutic effect, shorten the time to symptom relief, improve intestinal flora and immune function, and alleviate intestinal inflammation.

Key words: Bronchopneumonia, Children, Diarrhea, Probiotics, Intestinal flora, Immunity
表1 两组小儿支气管肺炎相关腹泻患儿症状缓解时间对比（n=74，
xˉ
±s，d）
组别 大便性状恢复正常时间 止泻时间 大便次数恢复正常时间
对照组 3.11±0.41 3.92±0.62 4.16±0.79
研究组 2.44±0.29 3.17±0.50 3.43±0.59
t值 11.477 8.100 6.369
P值 ＜0.001 ＜0.001 ＜0.001
表2 两组小儿支气管肺炎相关腹泻患儿治疗前后肠道菌群对比（n=74，
xˉ
±s，LogCFU/g）
组别 双歧杆菌 乳酸杆菌 肠杆菌 粪肠球菌 类杆菌
治疗前 治疗5 d后 治疗前 治疗5 d后 治疗前 治疗5 d后 治疗前 治疗5 d后 治疗前 治疗5 d后
对照组 7.02±1.24 7.51±1.28 5.84±0.70 6.02±0.74 12.16±1.68 11.87±1.60 8.87±1.32 8.52±1.27 7.41±1.22 7.83±1.18
研究组 7.10±1.21 9.36±1.55a 5.90±0.77 6.81±0.90a 12.24±1.66 8.57±1.48a 8.93±1.36 9.58±1.06a 7.37±1.18 9.49±1.41a
t值 0.397 7.917 0.496 5.833 0.291 13.025 0.272 5.512 0.203 7.767
P值 0.692 ＜0.001 0.621 ＜0.001 0.771 ＜0.001 0.786 ＜0.001 0.839 ＜0.001
表3 两组小儿支气管肺炎相关腹泻患儿血清炎性因子比较（n=74，
xˉ
±s，ng/L）
组别 IL-6 IL-17 CRP
治疗前 治疗5 d后 治疗前 治疗5 d后 治疗前 治疗5 d后
对照组 25.09±5.21 11.51±3.29a 29.98±5.30 15.67±4.03a 27.61±4.92 18.44±4.46a
研究组 24.87±5.16 9.80±2.69a 30.16±5.38 13.89±2.64a 27.82±4.88 15.22±4.09a
t值 0.258 3.461 0.205 3.178 0.261 4.577
P值 0.797 0.001 0.838 0.002 0.794 ＜0.001
表4 两组两组小儿支气管肺炎相关腹泻患儿免疫功能对比（n=74，
xˉ
±s，g/L）
组别 IgM IgA IgG
治疗前 治疗5 d后 治疗前 治疗5 d后 治疗前 治疗5 d后
对照组 1.46±0.33 1.50±0.39 0.83±0.18 1.22±0.33a 8.13±1.53 12.25±2.39a
研究组 1.43±0.34 1.74±0.46a 0.81±0.19 1.39±0.38a 8.17±1.60 14.29±2.57a
t值 0.545 3.423 0.657 2.906 0.155 5.000
P值 0.587 0.001 0.512 0.004 0.877 ＜0.001
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