探讨双歧杆菌活菌联合蒙脱石散对小儿腹泻的治疗效果。

选取2013年2月至2014年5月于湖北省鄂州市妇幼保健院儿科收治的72例年龄为6个月至2岁，平均为(1.2±0.4)岁的腹泻患儿为研究对象。其临床症状均包括大便次数增多、发热和脱水等。将其按照抽签法随机分成观察组(n＝36)与对照组(n＝36)。对照组给予蒙脱石散治疗，空腹口服，剂量标准如下：≤12个月患儿为1.0 g/次×3次/d，>12个月患儿为1.5 g/次×3次/d；观察组患儿在对照组基础上加用双歧杆菌活菌，1粒/次×3次/d。统计学分析两组疗效、症状改善时间、血清C反应蛋白(CRP)水平及不良反应发生率。本研究遵循的程序符合湖北省鄂州市妇幼保健院人体试验委员会制定的伦理学标准，得到该委员会批准，分组征得受试对象监护人的知情同意，并与其签署临床研究知情同意书。两组患儿性别、年龄、病程及腹泻严重程度等比较，差异均无统计学意义(P>0.05)。

观察组治疗总有效率为86.1%(31/36)，显著高于对照组的58.3%(21/36)，且差异有统计学意义(P<0.05)。经治疗，观察组症状改善时间，即腹泻停止时间、退热时间和大便恢复正常时间均显著短于对照组，差异均有统计学意义(P<0.05)；治疗后，两组患儿血清CRP水平均较治疗前显著降低，差异亦有统计学意义(P<0.05)；治疗后，观察组患儿血清CRP水平显著低于对照组。两组患儿治疗过程中均未出现严重不良反应。

双歧杆菌活菌联合蒙脱石散可有效治疗小儿腹泻，具有临床效果显著、临床症状恢复快、血清CRP水平降低迅速、不良反应少的优点，但是否值得临床推广，尚需多中心、大样本随机对照研究进一步证实。

To investigate clinical efficacy of viable bifidobacterium combined with montmorillonite powder on treatment of infantile diarrhea.

A total of 72 cases of children inpatients in Ezhou Maternal and Child Health Care Hospital from February 2013 to May 2014 with infantile diarrhea were enrolled in this study. They were randomly divided into observation group (n=36) and control group (n=36) by lot method. Children in control group were given montmorillonite powder, fasting oral, dose criteria: ages ≤12 months, 1.0 g ter in die, ages > 12 months, 1.5 g ter in die. Dose criteria of children in observation group was based on control group, and added viable bifidobacterium, 1 pillter ter in die. Clinical efficacies, serum C reacting protein (CRP) levels, clinical symptom improvement time, and adverse reactions rates between two groups were analyzed by statistics. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Ezhou Maternal and Child Health Care Hospital. Informed consent was obtained from the parents of each participating child. There were no significant differences between two groups among constituent ratio of gender, age, course and severity of infantile diarrhea (P>0.05).

The total effective rate of observation group was 86.1% (31/36), which was much higher than that in control group (58.3%, 21/36) , and there was significant difference between two groups (P<0.05). Clinical symptoms such as diarrhea stopping time, body temperature returned to normal, and recovery time in observation group were much shorter than those in control group, there were significant differences between two groups (P<0.05). At the end of treatment serum CRP levels in two groups were both reduced than those before treatment, serum CRP level in observation group was (7.9±2.1) mg/L, which was much lower than that in control group (13.5±3.2) mg/L, and there were significant differences between two groups (P<0.05). During the treatment, severe adverse reaction was not observed in two groups.

Viable bifidobacterium combined with montmorillonite powder can effectively treat infantile diarrhea, with advantages of significant clinical efficacy, quickly recovery of clinical symptoms, rapidly reduce of CRP level, and low adverse reactions worthy of promotion.