目的 探討小兒腸胃康顆粒聯(lián)合消旋卡多曲顆粒治療小兒病毒性腹瀉的臨床研究。方法 選取2019年1月-2019年12月阿壩藏族羌族自治州人民醫(yī)院治療的128例病毒性腹瀉的患兒作為研究對象，采用隨機數(shù)字法將患者分為對照組和觀察組，每組各64例。對照組口服消旋卡多曲顆粒，1.5 mg/（kg·次），3次/d。觀察組在對照組治療的基礎(chǔ)上開水沖服小兒腸胃康顆粒，5 g/次，3次/d。兩組患兒治療療程均為1周。觀察兩組患者的臨床療效和臨床癥狀改善情況，同時比較兩組治療前后的血清白細胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）和生長分化因子-15（GDF-15）水平及腸道菌群變化情況。結(jié)果 治療后，觀察組總有效率為93.8%，明顯高于對照組的81.2%，兩組總有效率比較差異具有統(tǒng)計學意義（P<0.05）。治療后，觀察組腹瀉改善時間、嘔吐改善時間、發(fā)熱改善時間及病毒轉(zhuǎn)陰時間均明顯低于對照組（P<0.05）。治療后，兩組IL-6、TNF-α及GDF-15水平均明顯降低（P<0.05）；治療后觀察組IL-6、TNF-α及GDF-15水平明顯低于對照組（P<0.05）。治療后，兩組雙歧桿菌、乳酸桿菌較治療前均明顯升高，而大腸桿菌較治療前明顯降低（P<0.05）；治療后，觀察組雙歧桿菌、乳酸桿菌明顯高于對照組，而大腸桿菌明顯低于對照組（P<0.05）。結(jié)論 小兒腸胃康顆粒聯(lián)合消旋卡多曲治療小兒病毒性腹瀉的療效顯著，可以快速改善患兒的臨床癥狀，縮短病毒轉(zhuǎn)陰時間，同時降低腸道炎癥反應，改善腸道菌群微生態(tài)平衡，具有一定的臨床推廣應用價值。

Objective To investigate the clinical study of Xiaoer Changweikang Granules combined with Racecadotril Granules in treatment of viral diarrhea in children. Methods A total of 128 children with viral diarrhea treated in the People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture from January 2019 to December 2019 were selected as the research objects, and the patients were divided into control group and observation group by random number method, with 64 patients in each group. Patients in the control group were po administered with Racecadotril Granules, 1.5 mg/kg, three times daily. Patients in the observation group were po administered with Xiaoer Changweikang Granules on the basis of control group, 5 g/time, and three times daily. The course of treatment was 1 week in two groups. After treatment, the clinical efficacy and improvement of clinical symptoms in two groups were observed, the serum levels of IL-6, TNF-α, and GDF-15, and intestinal flora in two groups before and after treatment were compared. Results After treatment, the total effective rate in the observation group was 93.8%, which was significantly higher than 81.2% in the control group, and the difference between the two groups was statistically significant (P<0.05). After treatment, the improvement time of diarrhea, vomiting, fever and virus turning negative in the observation group were significantly shorter than those in the control group (P<0.05). After treatment, the levels of IL-6, TNF-α, and GDF-15 in two groups were significantly decreased (P<0.05). And the levels of IL-6, TNF-α, and GDF-15 in the observation group were significantly lower than those in the control group (P<0.05). After treatment, bifidobacteria and lactobacillus in two groups were significantly increased, while escherichia coli was significantly decreased (P<0.05). After treatment, bifidobacteria and lactobacillus in the observation group were significantly higher than those in the control group, while escherichia coli was significantly lower than that in the control group (P<0.05). Conclusion Xiaoer Changweikang Granules combined with Racecadotril Granules in treatment of viral diarrhea in children has significant curative effect, which can quickly improve the clinical symptoms, shorten the time of virus turning negative, reduce intestinal inflammation, and improve the intestinal microecological balance, which has certain clinical popularization and application value.

R975

四川省衛(wèi)生和計劃生育委員會科研課題（2017PJ0082）