目的 参歧肠泰合剂联合口服补液盐散（Ⅲ）治疗儿童感染性腹泻的临床研究。方法 选取2023年1月—12月秦皇岛市妇幼保健院收治的110例感染性腹泻患儿作为研究对象，按随机数字表法将所有研究对象分为对照组和治疗组，每组各55例。对照组予以口服补液盐散（Ⅲ），先将1袋口服补液盐散（Ⅲ）溶解于250 mL温开水，根据患儿脱水情况以30～50 mL/kg剂量进行调节，4 h内服用完毕，2次/d。治疗组在对照组治疗基础上于餐前30 min口服参歧肠泰合剂，初次剂量为30 mL，维持剂量为10 mL/次，3次/d。两组患儿均持续治疗7 d。观察两组的临床疗效，比较两组临床症状消失时间、治疗前后肠道菌群变化及炎性因子[肿瘤坏死因子-α（TNF-α）、白细胞介素-10（IL-10）及白细胞介素-15（IL-15）]水平的变化情况。结果 治疗后，治疗组总有效率是98.18%，显著高于对照组的87.27%（P＜0.05）。治疗后，治疗组患者退热时间、止呕时间、止泻时间及病毒转阴时间均较对照组显著缩短（P＜0.05）。治疗后，两组乳杆菌、双歧杆菌均显著增加，而肠杆菌显著降低（P＜0.05）；治疗后，治疗组肠道菌群改善情况优于对照组（P＜0.05）。治疗后，两组TNF-α、IL-10及IL-15水平均较同组治疗前显著降低（P＜0.05）；治疗后，治疗组血清炎性因子显著低于对照组（P＜0.05）。结论 参歧肠泰合剂联合口服补液盐散（Ⅲ）治疗儿童感染性腹泻有效性和安全性均较高，可降低患儿炎性因子水平，调节肠道菌群，缩短症状消失时间。

Objective To explore the curative effect of Shenqi Changtai Mixture combined with Oral Rehydration Salts Powder (Ⅲ) in treatment of infectious diarrhea in children. Methods A total of 110 children with infectious diarrhea admitted to the Maternal and Child Health Hospital of Qinhuangdao City from January 2023 to December were selected as the study objects, and all children were divided into control group and treatment group according to random number table method, with 55 cases in each group. Patients in the control group were given Oral Rehydration Salts Powder (Ⅲ), firstly, a bag of Oral Rehydration Salts Powder (Ⅲ) was dissolved in 250 mL of warm water, adjusted at a dosage of 30 — 50 mL/kg according to the dehydration of the child, and was taken within 4 h, twice daily. Patients in the treatment group were po administered with Shenqi Changtai Mixture before meals on the basis of the control group, the initial dosage was 30 mL, and the maintenance dosage was 10 mL/time, 3 times daily. Both groups were treated for 7 d. The clinical efficacy of the two groups was observed, and the time for clinical symptoms to disappear, the changes of intestinal flora and the levels of inflammatory factors (TNF-α, IL-10, and IL-15) before and after treatment were compared between two groups. Results After treatment, the total effective rate of treatment group was 98.18%, which was significantly higher than that of control group (87.27%, P < 0.05). After treatment, the antipyretic time, antinausea time, antidiarrheal time and virus negative time in treatment group were significantly shorter than those in control group (P < 0.05). After treatment, Lactobacillus and bifidobacterium were significantly increased in both groups, but enterobacterium was significantly decreased (P < 0.05). After treatment, the improvement of intestinal flora in treatment group was better than that in control group (P < 0.05). After treatment, the levels of TNF-α, IL-10 and IL-15 in two groups were significantly decreased compared with those before treatment (P < 0.05). After treatment, the serum inflammatory factors in treatment group were significantly lower than those in control group (P < 0.05). Conclusion Shenqi Changtai Mixture combined with Oral Rehydration Salts Powder (Ⅲ) is effective and safe in treatment of infectious diarrhea in children, and can reduce the level of inflammatory factors in children, regulate intestinal flora, and shorten the time of symptom disappearance.

R985;R975

秦皇岛市市级科学技术研究与发展计划自筹经费项目(202301A081)