目的 探讨枫蓼肠胃康合剂联合双歧杆菌三联活菌治疗小儿腹泻的临床疗效。方法 纳入2023年1月—2025年1月山西省儿童医院（山西省妇幼保健院）收治的166例腹泻患儿，按随机数字表法平均分为对照组和治疗组，每组各83例。对照组口服双歧杆菌三联活菌散，6个月～1岁者0.5 g/次，1～5岁者1 g/次，＞5岁者2 g/次，3次/d。在对照组基础上，治疗组口服枫蓼肠胃康合剂，6个月～3岁者3 mL/次，3～6岁者5 mL/次，6～14岁者10 mL/次，3次/d。两组患儿疗程5 d。比较两组临床疗效、临床表现缓解时间，以及治疗前后Bristol粪便性状量表（BSFS）评分、大便次数及肠道菌群和血清D-乳酸（D-Lac）、锌（Zn）、白细胞介素-6（IL-6）、淀粉样蛋白A（SAA）水平。结果 治疗后，治疗组总有效率为96.39%，明显高于对照组（87.95%，P＜0.05）。治疗后，治疗组腹泻、腹痛、食欲不振等各项临床表现的缓解时间明显早于对照组（P＜0.05）。治疗后，两组BSFS评分明显降低，大便次数显著减少（P＜0.05），且治疗组BSFS评分和大便次数明显少于对照组（P＜0.05）。治疗后，两组双歧杆菌、乳杆菌明显增多，而肠杆菌减少（P＜0.05），且治疗组比对照组变化更明显（P＜0.05）。治疗后，两组血清D-Lac、IL-6和SAA水平显著下降，而Zn显著上升（P＜0.05），且治疗组血清水平变化比对照组更明显（P＜0.05）。结论 枫蓼肠胃康合剂联合双歧杆菌三联活菌治疗小儿腹泻能有效维持患儿肠道菌群稳态，控制炎症损害，提高免疫力，促进肠道黏膜修复及腹泻症状缓解。

Objective To investigate the clinical efficacy of Fengliao Changweikang Mixture combined with Live Combined Bifidobacterium, Lactobacillus and Enterococcus Powder, Oral in treatment of infantile diarrhea. Methods A total of 166 children with diarrhea admitted to Shanxi Children’s Hospital (Shanxi Women and Children Health Hospital) from January 2023 to January 2025 were enrolled and equally divided into a control group and a treatment group using a random number table method, with 83 cases in each group. The control group received oral Live Combined Bifidobacterium, Lactobacillus and Enterococcus Powder, Oral: 0.5 g per time for children aged 6 months to 1 year, 1 g per time for those aged 1 — 5 years, and 2 g per time for those older than 5 years, three times a day. On the basis of the control group, the treatment group was additionally given oral Fengliao Changweikang Mixture: 3 mL per time for children aged 6 months to 3 years, 5 mL per time for those aged 3 — 6 years, and 10 mL per time for those aged 6 — 14 years, three times a day. Both groups were treated for 5 days. The clinical efficacy, remission time of clinical manifestations, Bristol Stool Form Scale (BSFS) score, stool frequency, intestinal flora, and serum levels of D-lactate (D-Lac), zinc (Zn), interleukin-6 (IL-6), and serum amyloid A (SAA) before and after treatment were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 96.39%, which was significantly higher than 87.95% in the control group (P < 0.05). The remission time of diarrhea, abdominal pain, loss of appetite and other clinical manifestations in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the BSFS scores and stool frequency in both groups were significantly decreased (P < 0.05), and the treatment group had significantly lower BSFS scores and fewer stools than the control group (P < 0.05). After treatment, the counts of Bifidobacterium and Lactobacillus in both groups were significantly increased, while the count of Enterobacter was decreased (P < 0.05), and the changes in the treatment group were more significant than those in the control group (P < 0.05). After treatment, the serum levels ofD-Lac, IL-6 and SAA in both groups were significantly decreased, while the serum Zn level was significantly increased (P < 0.05), and the changes in the treatment group were more obvious than those in the control group (P < 0.05). Conclusion Fengliao Changweikang Mixture combined with Live Combined Bifidobacterium, Lactobacillus and Enterococcus Powder, Oral can effectively maintain intestinal flora homeostasis, reduce inflammatory injury, improve immunity, promote intestinal mucosal repair and alleviate diarrhea symptoms in children with diarrhea.

R985

山西省高等学校科技创新计划项目（2022L197）