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赖氨葡锌颗粒联合蒙脱石散和双歧杆菌乳杆菌三联活菌颗粒治疗小儿腹泻的效果摘要】目的：探究赖氨葡锌颗粒联合蒙脱石散和双歧杆菌乳杆菌三联活菌颗粒治疗小儿腹泻的临床效果。
方法：抽取120例小儿腹泻患儿中随机作为本次的研究对象，按照治疗方式的不同将他们分为对照组和研究组，对照组采用蒙脱石散和双歧杆菌乳杆菌三联活菌颗粒的治疗方法，研究组采用赖氨葡锌颗粒联合蒙脱石散和双歧杆菌乳杆菌三联活菌颗粒的治疗方法，对比分析两组患儿的临床效果。
结果：对照组的治疗总有效率为78.33%，研究组的治疗总有效率为95.00%，研究组的治疗效果明显优于对照组；两组患儿不良反应发生率间的比较差异无统计学意义（P>0.05）。
结论：赖氨葡锌颗粒联合蒙脱石散和双歧杆菌乳杆菌三联活菌颗粒治疗小儿腹泻的疗效显著，值得在临床应用中推广。
【关键词】赖氨葡锌颗粒；蒙脱石散；双歧杆菌乳杆菌三联活菌颗粒；小儿腹泻【中图分类号】R722.1 【文献标识码】A 【文章编号】1007-8231（2017）33-0094-01小儿腹泻作为儿科的一种常见疾病，又被称为小儿消化不良，主要的临床表现为腹泻、呕吐。
其诱因之一为病毒感染，病毒除了对患儿的肠胃功能造成影响外，还会损害患儿的中枢神经系统。
如果未对患儿采取及时有效的治疗措施，那么极有可能导致电解质紊乱，威胁患者的生命安全。
1.资料与方法1.1 一般资料在我院2016年1月至2017年1月间收治的小儿腹泻患儿中随机抽取120例作为本次的研究对象。
采用单双数随机分组的方法将他们分为对照组和研究组，每组各60例。
对照组中，男38例，女22例；年龄在0.6～6.3岁之间，平均年龄为（3.2±1.4）岁；病程在2～10天之间，平均病程为（5.0±1.8）天；轻度脱水28例，中度脱水24例，重度脱水8例；研究组中，男34例，女26例；年龄在0.5～7.1岁之间，平均年龄为（3.8±1.2）岁；病程在2～10天之间，平均病程为（4.8±2.6）天；轻度脱水30例，中度脱水24例，重度脱水6例；所有患儿菌符合小儿急性腹泻的临床诊断标准，并且所有家属均签署研究知情同意书。
中国现代医生2019年8月第57卷第24期·妇幼医学·CHINA MODERN DOCTOR Vol.57No.24August 2019小儿腹泻在临床中较为常见,临床主要表现为呕吐、腹泻、发热等,如果没有及时治疗,会导致患儿电解质紊乱,严重情况还会危害患儿生命安全。
赖氨酸属于人体主要氨基酸,能够有效促进生长及智力发育,锌属于体内多种辅酶主要构成部分,能够有效促进患儿免疫细胞功能,加快胃肠黏膜修复,并且还能够促进患儿生长,对于促进腹泻之后患儿营养摄入及生长发育受限恢复非常重要。
因此,本文研究对赖氨葡锌在小儿腹泻治疗中的使用进行分析,现报道如下。
1资料与方法1.1一般资料选择我院在2018年1月~2019年3月接受治疗的60例小儿腹泻患儿,患儿均符合诸福棠实用儿科学,第7版小儿腹泻的诊断标准。
均有不同程度的大便次数增多和性状改变,可伴有发热、呕吐、腹痛等症状及不同程度水、电解质、酸碱平衡紊乱。
排除合并其他急慢性疾病者、免疫功能异常者及对本次研究药物过敏者[2]。
随机将其分为对照组30例和观察组30例。
对照组男16例,女14例,年龄6个月~5岁,平均(2.65±0.61)岁;腹泻次数每天3次以上;病程3~11d,平均(5.1±1.7)d。
观察组男19例,女11例,年龄5个月~4岁6个月,平均(2.60±0.63)岁,腹泻次数每天3次以上;病程3~10d,平均(5.3±1.4)d。
两组患儿一般资料比较差异无统计学意义(P >0.05),具有可比性。
赖氨葡锌治疗小儿腹泻的临床效果占文君江西省景德镇市妇幼保健院儿科,江西景德镇333000[摘要]目的分析赖氨葡锌对小儿腹泻治疗的效果。
方法选择2018年1月~2019年3月在我院接受治疗的60例小儿腹泻患儿,将其随机分为对照组和观察组,每组30例。
对照组采用综合治疗,观察组在综合治疗基础上使用赖氨葡锌治疗,比较两组患儿的治疗效果和腹泻、发热及呕吐的持续时间。
赖氨葡锌颗粒治疗我国小儿腹泻疗效的Meta 分析Meta analysis of compound Lysine Hydrochloride and Zinc Gluconate Granules in the treatment of infantile diarrhea in china付 竹①②，于 飞③，李在玲④，翁 鸿⑤，曾宪涛②⑤ FU Zhu, YU Fei, LI Zailing, WENG Hong, ZENG Xiantao摘要目的：采用Meta分析的方法对赖氨葡锌颗粒治疗小儿腹泻的疗效进行循证评价。
方法：检索PubMed、Embase、Cochrane Library、中国生物医学文献数据库、中国知网、万方数据库和重庆维普数据库，查找关于赖氨葡锌颗粒治疗小儿腹泻的随机对照试验，检索时限均为建库至2017年3月20日。
由两位作者独立进行文献筛选、资料提取及风险偏倚评价后，采用RevMan 5.3软件进行Meta分析。
结果：共纳入31项随机对照试验，共计3558例患儿。
Meta分析结果显示赖氨葡锌颗粒联合一般治疗组的总有效率（RR=1.22，95%CI：1.19～1.26，P＜0.00001）和显效率（RR=1.45，95%CI：1.36～1.55，P＜0.00001）均优于单用一般治疗组，且腹泻消失时间（MD=-1.94天，95%CI：-2.28～-1.59，P＜0.00001）和住院时间（MD=-2.47天，95%CI：-2.98～-1.96，P＜0.00001）均短于一般治疗组。
结论：当前证据表明，与单用一般治疗相比，加用赖氨葡锌颗粒可显著改善小儿急性、迁延性及慢性腹泻的症状，减少患儿住院时间。
关键词赖氨葡锌颗粒；小儿腹泻；Meta分析；随机对照试验；腹泻病Abstract Objective: To evaluate the efficacy of lysine hydrochloride and zinc gluconate granules for infant diarrhea using a meta-analysis. Methods: PubMed, Embase, Cochrane Library, CBM, CNKI, Wanfang Data and VIP databases were searched for identifying randomized controlled trials related to lysine hydrochloride and zinc gluconate granules in treatment of infant diarrhea up to March 20th, 2017. Two authors independently screened literature, extracted data and assessed the risk of bias of included trials. Then meta-analysis was performed using RevMan 5.3 software. Results: A total of 31 randomized controlled trials involving 3558 patients were included. The results of meta-analysis showed that the total effective rate (RR=1.22, 95%CI: 1.19～1.26, P＜0.00001) and significant efficiency (RR=1.45, 95%CI: 1.36～1.55, P＜0.00001) of lysine hydrochloride and zinc gluconate granules combined with routine treatment were both superior to the routine treatment alone. And the diarrhea disappeared time (MD=-1.94 day, 95%CI:-2.28～-1.59, P＜0.00001) and hospital stay (MD=-2.47 day, 95%CI: -2.98～-1.96, P＜0.00001) of lysine hydrochloride and zinc gluconate granules combined with routine treatment were shorter than the routine treatment alone. Conclusion: Current evidence suggested that, compared with routine treatment alone, zinc gluconate granules combined with routine treatment could significantly promote the efficacy of the symptoms of infant diarrhe a and reduce the hospital stay. Keywords Lysine hydrochloride and zinc gluconate granules; Infant diarrhea; Meta-analysis; Randomized controlled trial; diarrheaDOI：10.19450/ki.jcrh.2019.02.006通讯作者：曾宪涛，e-mail:zengxiantao1128@①十堰市太和医院(湖北医药学院附属医院)，湖北省十堰市茅箭区人民南路32号（442008）②十堰市太和医院循证医学中心(湖北医药学院附属医院)，湖北省十堰市茅箭区人民南路32号（442008）③武汉大学医院管理研究所，湖北省武汉市武昌区东湖路169号（430072）25④北京大学第三医院，北京市海淀区花园北路49号（100191）⑤武汉大学中南医院循证与转化医学中心，湖北省武汉市武昌区东湖路169号（430072）腹泻病是一组由多病原、多因素引起的消化道综合征，以粪便次数显著增加和粪便性状改变为主要临床表现。
双歧杆菌乳杆菌三联活菌片联合赖氨葡锌颗粒治疗小儿急性腹泻的临床效果及对复发率的影响目的探討双歧杆菌乳酸菌三联活菌片联合赖氨葡锌颗粒治疗小儿急性腹泻的临床疗效及对复发率的影响。
方法选取2015年9月～2017年1月我院收治的86例急性腹泻患儿作为研究对象，采用随机数字表法将其分为两组，每组各43例。
对照组患儿接受常规治疗（补水、纠正水电解质与酸中毒、给予双歧杆菌乳杆菌三联活菌片等），观察组患儿在对照组基础上使用赖氨葡锌颗粒。
观察两组患儿治疗后临床疗效、胃肠道屏障功能、复发率。
结果观察组患儿治疗后的总有效率（97.67%）明显高于对照组（81.40%），差异有统计学意义（P＜0.05）；治疗前，两组患儿二胺氧化酶（DAO）、D-乳酸、内毒素水平比较，差异无统计学意义（P>0.05）；治疗后，观察组患儿DAO、D-乳酸、内毒素水平明显低于对照组，差异有统计学意义（P＜0.05）；观察组患儿治疗后1个月无复发，治疗后2个月复发率为4.65%，治疗后3个月为13.95%，对照组患儿分别为9.30%、20.93%、32.56%，差异均有统计学意义（P＜0.05）。
结论双歧杆菌乳杆菌三联活菌片联合赖氨葡锌片治疗小儿急性腹泻效果显著，可有效提高肠道屏障功能，降低复发率，值得临床推广。
[Abstract]Objective To investigate the clinical effects of Live Combined Bifidobacterium and Lactobacillus Tablets combined with Compound Lysine Hydrochloride and Zinc Gluconate Granules in the treatment of children with acute diarrhea and its influence on recurrence rate.Methods 86 cases of children with acute diarrhea who accepted treatments in our hospital from September 2015 to January 2017 were selected as the research objects，and were divided into two groups by the random number table method，43 cases in each group.The control group were received routine treatment （water supplement，correction of water，electrolyte and acidosis，and were given the live Combined Bifidobacterium and Lactobacillus Tablets，etc.），while the observation group were treated with Compound Lysine Hydrochloride and Zinc Gluconate Granules on the basis of the control group.The clinical effects，gastrointestinal barrier function and recurrence rate after the treatment of two groups of patients were observed.Results The total effective rate after the treatment tin the observation group （97.67%）was higher than that in the control group （81.40%），and the difference was statistically significant （P＜0.05）.Before the treatment，there was no significant difference in the diamine oxidas（DAO）and D-lactic acid and endotoxin levels between the two groups（P>0.05）.After the treatment，the levels of DAO and D-lactic acid and endotoxin in the observation group were significantly lower than those in the control group，the difference was statistically significant （P＜0.05）.There was no recurrence in the observation group after the treatment for 1 months，recurrence rate after the treatment for 2 months was 4.65%，and 3 months was 13.95%，while the control group respectively were 9.30%，20.93%，32.56%，the differences were statistically significant （P＜0.05）.Conclusion The effect of Live Combined Bifidobacterium and Lactobacillus Tablets combinedwith Compound Lysine Hydrochloride and Zinc Gluconate Granules in the treatment of children with acute diarrhea are significant，which can effectively improve the intestinal barrier function and reduce the recurrence rate，thus it is worthy to be promoted in the clinical.[Key words]Zinc Gluconate Granules；Live Combined Bifidobacterium and Lactobacillus Tablets；Children with acute diarrhea；Recurrence小儿急性腹泻是临床常见的儿科疾病，是一组由多因素、多病因导致的，以大便性状改变、大便次数增多为特点的消化系统综合征，病毒感染是常见的致病因素[1]。
小儿秋季腹泻属于一种儿科消化道疾病，主要是由于感染轮状病毒引起，多发于秋冬季节且发病患儿年龄以3岁以下为主[1]。
主要临床症状表现为咳嗽、感冒并伴有发热现象，如果不及时治疗，会出现脱水、电解质紊乱、甚至抽搐，严重影响身体健康。
临床通常采用蒙脱石散+酪酸梭菌活菌进行治疗，但是效果不是较为明显，症状消退较慢[2，3]，需要进行持续研究。
本文对小儿秋季腹泻临床中采用赖氨葡锌联合酪酸梭菌活菌治疗的效果进行研究分析，为临床提供有力依据。
1资料与方法1.1一般资料：选取2017年11月—2019年11月本院收治的30例小儿秋季腹泻患者作为研究对象，根据电脑分配法随机分成两组，每组15例。
常规组男性10例，女性5例；年龄0.5~3岁，平均年龄（1.5±1.0）岁；病程1~7d，平均病程（3.2±0.5）d；平均体质量（12.1±0.5）kg。
实验组男性8例，女性7例；年龄0.5~3岁，平均年龄（1.6±0.7）岁；病程1~8d，平均病程（3.2±0.8）d；平均体质量（12.6±0.6）kg。
两组分组情况均经本院伦理委员会批准且基数资料组成比较，差异无统计学意义（P>0.05），具有可比性。
纳入标准：①经本院辅助检查被确诊为小儿秋季腹泻；②在发病1~3d内进行及时就医且经检查轮状病毒呈阳性；③无精神疾病，病史资料齐全；④排除具有语言障碍，无法进行正常沟通交流且存在其他严重心肺等并发症；⑤对于此次研究分析家属已经签字确认。
1.2治疗方法：常规组给予蒙脱石散（湖南中和制药有限公司，国药准字H20083621，规格：3g×6袋/盒）口服，将本品倒入50mL 温水，摇匀后服用，根据年龄服用，3次/d；即最大剂量不得超过3袋/d；酪酸梭菌活菌散（青岛东海药业有限公司，国药准字S2*******；规格：0.5g/袋）口服，服用方法与蒙脱石散一致，需要连续治疗7d。
doi：10.3969/j.issn.1009-4393.2021.02.001--论著--复方嗜酸乳杆菌联合赖氨葡锌颗粒治疗小儿腹泻的作用机制及临床疗效观察梁雁玲1，许瑾1，聂煜哲2（1.广东省韶关市第一人民医院儿科，广东韶关512000；2.粤北人民医院儿科，广东韶关512025）摘要：目的研究复方嗜酸乳杆菌联合赖氨葡锌颗粒治疗小儿腹泻的作用机制及临床疗效。
方法以随机数字表法将2018年9月至2019年9月本院收治的120例小儿腹泻患儿分为3组，每组40例。
3组均接受常规治疗，复方嗜酸乳杆菌组采取复方嗜酸乳杆菌治疗，赖氨葡锌颗粒组采取赖氨葡锌颗粒治疗，联合组采取复方嗜酸乳杆菌联合赖氨葡锌颗粒治疗，7d后比较3组临床疗效。
结果联合组总有效率为97.50%，高于复方嗜酸乳杆菌组的90.00%和赖氨葡锌颗粒组的87.50%，差异有统计学意义（P＜0.05），复方嗜酸乳杆菌组和赖氨葡锌颗粒组比较差异无统计学意义；3组不良反应发生率分别为10.00%、7.50%、7.50%，差异无统计学意义；联合组症状恢复时间短于嗜酸乳杆菌组和赖氨葡锌颗粒组，差异有统计学意义（P＜0.05），复方嗜酸乳杆菌组和赖氨葡锌颗粒组比较差异无统计学意义；治疗前，3组血锌、免疫功能、炎性细胞因子、肠道菌群、肠黏膜屏障功能比较差异无统计学意义，治疗后均较治疗前显著改善，差异有统计学意义（P＜0.05），联合组优于复方嗜酸乳杆菌组和赖氨葡锌颗粒组，差异有统计学意义（P＜0.05），复方嗜酸乳杆菌组和赖氨葡锌颗粒组比较差异无统计学意义。
结论复方嗜酸乳杆菌联合赖氨葡锌颗粒治疗小儿腹泻疗效显著，作用机制与抑制炎症反应、调节肠道菌群、改善肠黏膜屏障功能、提高机体免疫功能有关，值得临床推广应用。
关键词：小儿腹泻；复方嗜酸乳杆菌；赖氨葡锌颗粒；免疫功能Mechanism of action and clinical efficacy of compoundLactobacillus acidophilus combined with lysine zinc gluconate granules in treating children with diarrheaLIANG Yanling1,XU Jin1,NIE Yuzhe2(1.Department of Pediatrics,First People's Hospital of Shaoguan City,Guangdong Province,Shaoguan,Guangdong,512000,China;2.Department of Pediatrics,Yuebei People's Hospital,Shaoguan,Guangdong,512025,China) Abstract:Objective To study the mechanism of compound Lactobacillus acidophilus combined with lysine zinc gluconate granules in the treat-ment of infantile diarrhea and observe the clinical effect.Methods A random number table was used to divide120children with pediatric diarrhea admitted to our hospital from September2018to September2019into three groups,with40cases in each group.All three groups received conven-tional treatment,the compound Lactobacillus acidophilus group was treated with compound Lactobacillus acidophilus,the lysine zinc gluconate gran-ules group was treated with lysine zinc gluconate granules,and the combined group was treated with compound Lactobacillus acidophilus combined with lysine zinc gluconate granules.After7days,the clinical efficacy of the three groups was compared.Results The total effective rate of the com-bined group was97.50%,which was higher than90.00%of the compound Lactobacillus acidophilus group and87.50%of the lysine zinc gluconate granule group,the difference was statistically significant(P＜0.05),there was no significant difference between the compound Lactobacillus acidoph-ilus group and the lysine zinc gluconate granule group.The incidence of adverse reactions in the three groups were10.00%,7.50%,and7.50%,re-spectively,and the difference was not statistically significant.The symptom recovery time of the combined group was shorter than that of the Lacto-bacillus acidophilus group and the lysine zinc gluconate granule group,and the difference was statistically significant(P＜0.05),there was no signifi-cant difference between the compound Lactobacillus acidophilus group and the lysine zinc gluconate granule group.There was no statistically signifi-cant difference in blood zinc,immune function,inflammatory cytokines,intestinal flora,and intestinal mucosal barrier function among the three groups before treatment.After treatment,they were significantly improved compared with before treatment,and the difference was statistically signif-icant(P＜0.05),the combined group was better than the compound Lactobacillus acidophilus group and the lysine zinc gluconate granule group,the difference was statistically significant(P＜0.05),the compound Lactobacillus acidophilus group and the lysine zinc gluconate granule group have no significant difference.Conclusion The compound Lactobacillus acidophilus combined with lysine zinc gluconate granules has a definite effect in the treatment of pediatric diarrhea.The mechanism of action is related to inhibiting inflammation,regulating intestinal flora,improving intestinal mu-cosal barrier function,and improving immune function,it is worthy of clinical application.Key words:Pediatric diarrhea;Compound Lactobacillus acidophilus;Lysine zinc granules;Immune function小儿腹泻是小儿时期常见病症类型，近年来随着“二孩政策”的全面开放，该病症发病率呈明显上升态势[1]。
