Effect of Saccharomyces boulardii sachets combined with montmorillonite powder in children with rotavirus enteritis and its influence on immune function and intestinal microecology

doi:10.3877/cma.j.issn.1673-5250.2021.06.016

Objective

To explore clinical effect of Saccharomyces boulardii sachets combined with montmorillonite powder in treatment of children with rotavirus enteritis (RVE) and its influence on immune function and intestinal microecology.

Methods

From May 2018 to May 2020, a total of 126 cases of RVE children were selected as research subjects. They were randomly divided into study group (n=63) and control group (n=63) according to random digital table method. Children in study group were treated with Saccharomyces boulardii sachets and montmorillonite powder, and children in control group were treated with Bifidobacterium and montmorillonite powder. The clinical effect and incidence of adverse reactions between two groups were compared by chi-square test. Duration of clinical symptoms, length of hospital stay, and levels of inflammatory factors [tumor necrosis factor (TNF)-α, interleukin (IL)-8], immune function indexes (CD4⁺ , CD8⁺ and CD4⁺ /CD8⁺ ), and amount of intestinal flora before and after treatment were compared between two groups by independent-samples t test and paired-samples t test. There were no statistically significant differences between two groups of children in clinical data, such as gender composition, age, weight, and incidence of mild and moderate dehydration, and serum levels of TNF-α and IL-8, levels of CD4⁺ , CD8⁺ , CD4⁺ /CD8⁺ , and amount of Bacteroides, Escherichia coli, Enterococcus, Lactobacillus and Bifidobacterium between two groups before treatment (P>0.05). This study was approved by the Ethics Committee of Hainan Women and Children Medical Center (approval No. Z20180111), and informed consent was signed with the guardians of children.

Results

①Total effective rate of study group was 96.8% (61/63), which was statistically higher than 87.3% (55/63) of control group, and the difference was statistically significant (χ²=3.910, P=0.048). ②Duration of diarrhea, vomiting, abdominal pain and length of hospital stay in study group were (32.4±5.5) h, (23.4±4.4) h, (25.6±3.9) h, and (46.3±6.7) h, respectively, which all were shorter than those in control group (54.4±7.3) h, (46.8±6.6) h, (49.9±5.9) h, (66.3±7.5) h, and all differences were statistically significant (t=7.498, 16.427, 11.944, all P<0.001). ③After treatment, serum TNF-α and IL-8 levels of two groups were significantly lower than those within each group before treatment, serum TNF-α and IL-8 levels in study group after treatment were significantly lower than those of control group after treatment, and all differences were statistically significant (P<0.001). ④After treatment, levels of CD4⁺ and CD4⁺ /CD8⁺ of two groups were significantly higher than those within each group before treatment, while levels of CD8⁺ were significantly lower than those within each group before treatment, and levels of CD4⁺ and CD4⁺ /CD8⁺ in study group after treatment were significantly higher than those of control group after treatment, while levels of CD8⁺ were significantly lower than those of control group after treatment, and all differences were statistically significant (P<0.05). ⑤After treatment, amount of Bacteroides, Lactobacillus and Bifidobacterium of two groups were significantly higher than those within each group before treatment, and amount of the above flora in study group after treatment were significantly higher than those of control group after treatment, while amount of Enterococcus and Escherichia coli of two groups were significantly lower than those within each group before treatment, and amount of Enterococcus and Escherichia coli in study group after treatment were significantly lower than those of control goup after treatment and all differences were statistically significant (P<0.05). ⑥Incidence of adverse reactions during treatment in study group was 4.8% (3/63), and the control group was 6.3% (4/63), there was no statistically significant difference between two groups (P>0.05).

Conclusions

Saccharomyces boulardii sachets combined with montmorillonite powder has a good clinical effect in treatment of children with RVE, which can improve the inflammatory reaction and immune function, regulate intestinal flora of children, and has high safety.

Key words: Rotavirus infections, Enteritis, Saccharomyces boulardii sachets, Montmorillonite powder, Immune function, Intestinal microecology, Child

表1 2组RVE患儿临床疗效比较[例数(%)]

组别	例数	显效	有效	总有效率
研究组	63	37(58.7)	24(38.1)	61(96.8)
对照组	63	27(42.9)	28(44.4)	55(87.3)
χ²值		3.180	0.524	3.910
P值		0.075	0.469	0.048

表1 2组RVE患儿临床疗效比较[例数(%)]

组别	例数	显效	有效	总有效率
研究组	63	37(58.7)	24(38.1)	61(96.8)
对照组	63	27(42.9)	28(44.4)	55(87.3)
χ²值		3.180	0.524	3.910
P值		0.075	0.469	0.048

表2 2组RVE患儿临床症状持续时间及住院时间比较(h，±s)

组别	例数	腹泻持续时间	呕吐持续时间	腹痛持续时间	住院时间
研究组	63	32.4±5.5	23.4±4.4	25.6±3.9	101.5±18.6
对照组	63	54.4±7.3	46.8±6.6	49.9±5.9	115.7±20.1
t值		19.061	23.483	27.312	4.116
P值		<0.001	<0.001	<0.001	<0.001

表2 2组RVE患儿临床症状持续时间及住院时间比较(h，±s)

组别	例数	腹泻持续时间	呕吐持续时间	腹痛持续时间	住院时间
研究组	63	32.4±5.5	23.4±4.4	25.6±3.9	101.5±18.6
对照组	63	54.4±7.3	46.8±6.6	49.9±5.9	115.7±20.1
t值		19.061	23.483	27.312	4.116
P值		<0.001	<0.001	<0.001	<0.001

表3 2组RVE患儿治疗前、后血清TNF-α、IL-8水平组内与组间比较(±s)

组别	例数	血清TNF-α(pg/mL)				血清IL-8(ng/L)
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
研究组	63	4.4±0.7	2.1±0.4	22.643	<0.001	160.9±30.0	64.5±17.4	22.063	<0.001
对照组	63	4.3±0.6	3.0±0.6	12.160	<0.001	159.0±32.9	98.7±23.4	11.855	<0.001
t值		0.806	9.906			0.338	9.309
P值		0.391	<0.001			0.735	<0.001

表3 2组RVE患儿治疗前、后血清TNF-α、IL-8水平组内与组间比较(±s)

组别	例数	血清TNF-α(pg/mL)				血清IL-8(ng/L)
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
研究组	63	4.4±0.7	2.1±0.4	22.643	<0.001	160.9±30.0	64.5±17.4	22.063	<0.001
对照组	63	4.3±0.6	3.0±0.6	12.160	<0.001	159.0±32.9	98.7±23.4	11.855	<0.001
t值		0.806	9.906			0.338	9.309
P值		0.391	<0.001			0.735	<0.001

表4 2组RVE患儿治疗前、后CD4⁺、CD8⁺、CD4⁺/CD8⁺水平组内与组间比较(±s)

组别	例数	CD4⁺(%)				CD8⁺(%)
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
研究组	63	39.8±7.2	48.3±8.1	6.183	<0.001	32.9±4.3	23.5±3.8	13.002	<0.001
对照组	63	40.3±7.6	42.4±7.0	4.363	<0.001	32.2±4.5	28.3±4.1	5.085	<0.001
t值		0.341	4.381			30.893	6.815
P值		0.734	<0.001			0.374	<0.001
组别	例数	CD4⁺/CD8⁺
组别	例数	治疗前	治疗后	t值	P值
研究组	63	1.22±0.26	2.03±0.32	15.593	<0.001
对照组	63	1.23±0.23	1.52±0.24	6.924	<0.001
t值		0.228	10.120
P值		0.820	<0.001

表4 2组RVE患儿治疗前、后CD4⁺、CD8⁺、CD4⁺/CD8⁺水平组内与组间比较(±s)

组别	例数	CD4⁺(%)				CD8⁺(%)
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
研究组	63	39.8±7.2	48.3±8.1	6.183	<0.001	32.9±4.3	23.5±3.8	13.002	<0.001
对照组	63	40.3±7.6	42.4±7.0	4.363	<0.001	32.2±4.5	28.3±4.1	5.085	<0.001
t值		0.341	4.381			30.893	6.815
P值		0.734	<0.001			0.374	<0.001
组别	例数	CD4⁺/CD8⁺
组别	例数	治疗前	治疗后	t值	P值
研究组	63	1.22±0.26	2.03±0.32	15.593	<0.001
对照组	63	1.23±0.23	1.52±0.24	6.924	<0.001
t值		0.228	10.120
P值		0.820	<0.001

表5 2组RVE患儿治疗前、后肠道菌群数量组内与组间比较[lg(CFU/g)，±s]

组别	例数	拟杆菌				大肠埃希菌
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
研究组	63	7.4±0.7	8.4±0.3	10.422	<0.001	8.4±1.5	6.7±1.4	6.576	<0.001
对照组	63	7.2±0.6	8.0±0.3	9.466	<0.001	8.3±1.5	8.2±1.6	0.351	0.726
t值		1.721	7.483			0.374	5.600
P值		0.088	<0.001			0.709	<0.001
组别	例数	肠球菌				乳酸杆菌
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
研究组	63	7.0±1.0	5.7±0.8	8.057	<0.001	7.5±1.6	10.2±1.3	10.395	<0.001
对照组	63	6.9±1.1	6.2±0.8	4.085	<0.001	7.4±1.6	8.4±1.6	3.508	<0.001
t值		0.534	3.508			0.351	6.930
P值		0.594	<0.001			0.726	<0.001
组别	例数	双歧杆菌
组别	例数	治疗前	治疗后	t值	P值
研究组	63	7.4±1.4	9.6±1.8	7.658	<0.001
对照组	63	7.4±1.4	8.3±1.6	3.360	0.001
t值		0	4.284
P值		1.000	<0.001

表5 2组RVE患儿治疗前、后肠道菌群数量组内与组间比较[lg(CFU/g)，±s]

组别	例数	拟杆菌				大肠埃希菌
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
研究组	63	7.4±0.7	8.4±0.3	10.422	<0.001	8.4±1.5	6.7±1.4	6.576	<0.001
对照组	63	7.2±0.6	8.0±0.3	9.466	<0.001	8.3±1.5	8.2±1.6	0.351	0.726
t值		1.721	7.483			0.374	5.600
P值		0.088	<0.001			0.709	<0.001
组别	例数	肠球菌				乳酸杆菌
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
研究组	63	7.0±1.0	5.7±0.8	8.057	<0.001	7.5±1.6	10.2±1.3	10.395	<0.001
对照组	63	6.9±1.1	6.2±0.8	4.085	<0.001	7.4±1.6	8.4±1.6	3.508	<0.001
t值		0.534	3.508			0.351	6.930
P值		0.594	<0.001			0.726	<0.001
组别	例数	双歧杆菌
组别	例数	治疗前	治疗后	t值	P值
研究组	63	7.4±1.4	9.6±1.8	7.658	<0.001
对照组	63	7.4±1.4	8.3±1.6	3.360	0.001
t值		0	4.284
P值		1.000	<0.001

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