目的 探讨双歧杆菌三联活菌肠溶胶囊联合碱式水杨酸铋治疗小儿反复腹泻的临床疗效。方法 选取2019年1月—2021年1月在河北中石油中心医院儿科住院治疗的150例腹泻患儿，按照随机数字表法分为对照组和治疗组，每组各75例。对照组患儿口服碱式水杨酸铋干混悬剂，1包/次，3次/d。治疗组患者在对照组基础上口服双歧杆菌三联活菌肠溶胶囊，3粒/次，2次/d。两组连续用药7 d。观察两组的临床疗效、症状缓解时间，比较两组治疗前后肠道菌群数量、血清细胞因子水平。结果 治疗后，治疗组总有效率98.67%，显著高于对照组的86.67%（P＜0.05）。治疗后，治疗组出现发热、乏力、食欲不振、大便次数增多缓解时间均显著短于对照组（P＜0.05）。治疗后，两组乳杆菌属、肠球菌属数量均较治疗前显著提高，酵母样真菌数量显著降低（P＜0.05）；治疗后，治疗组患儿肠道菌群数量改善优于对照组（P＜0.05）。治疗后，两组白细胞介素-10（IL-10）、白细胞介素-6（IL-6）、肿瘤坏死因子-α水平均较治疗前显著降低（P＜0.05）；治疗后，治疗组血清炎性因子水平低于对照组（P＜0.05）。结论 双歧杆菌三联活菌肠溶胶囊联合碱式水杨酸铋治疗小儿反复腹泻疗效确切，可有效改善患儿腹泻症状，改善肠道菌群数量，减弱肠道内炎症反应，且安全有效，值得临床推广应用。

Objective To investigate the therapeutic effect of Bifid Triple Viable Capsules Dissolving at Intestines combined with bismuth subsalicylate in treatment of recurrent diarrhea in children. Methods A total of 150 children with diarrhea hospitalized in Hebei Central Hospital of Petrochina from January 2019 to January 2021 were selected and divided into control group and treatment group according to random number table method, with 75 cases in each group. Patients in the control group were po administered with Bismuth Subsalicylate for Oral Suspension, 1 bag/time, three times daily. Patients in the treatment group were po administered with Bifid Triple Viable Capsules Dissolving at Intestines on the basis of the control group, 3 grains/time, twice daily. Both groups were treated continuously for 7 d. The clinical efficacy and symptom remission time of the two groups were observed, and the number of intestinal flora and serum cytokine levels were compared before and after treatment. Results After treatment, the total effective rate of the treatment group was 98.67%, which was significantly higher than that of the control group (86.67%, P < 0.05). After treatment, the remission time of fever, fatigue, loss of appetite, and increased frequency of stool in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the number of Lactobacillus and Enterococcus in both groups was significantly increased, while the number of yeastlike fungi was significantly decreased (P < 0.05). After treatment, the improvement of intestinal flora in the treatment group was better than that in the control group (P < 0.05). After treatment, the levels of interleukin-10 (IL-10), interleukin-6 (IL-6), and tumor necrosis factor-α in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the serum inflammatory factor level in the treatment group was lower than that in the control group (P < 0.05). Conclusion Bifid Triple Viable Capsules Dissolving at Intestines combined with bismuth subsalicylate has exact curative effect in treatment of recurrent diarrhea in children, and can effectively improve the diarrhea symptoms of children, improve the number of intestinal flora, reduce intestinal inflammatory reaction, and is safe and effective, which is worthy of clinical application.

R985

廊坊市科学技术研究与发展计划（第一批）自筹经费项目（2019013007）