摘要
目的:比较不同剂量赖氨葡锌联合消旋卡多曲治疗轮状病毒(RV)肠炎的临床疗效,及对血清炎症因子和心肌酶谱等的影响。方法:选择2021年1月至2024年10月于我院就诊的96例轮状病毒肠炎患儿,随机分为4组,各24例。一组予消旋卡多曲颗粒(四川百利药业)口服(对照组),其余3组(合称联合治疗组)在口服消旋卡多曲颗粒基础上,予不同剂量的赖氨葡锌颗粒(海南慧谷药业,每袋5 g)口服,分别命名为低剂量组、中剂量组和高剂量组。4组均连续治疗7 d。比较4组患儿治疗总体疗效,止泻、退热、止吐时间,血清白介素(IL)-6和肿瘤坏死因子-α(TNF-α)水平,以及血清肌酸激酶(CK)、肌酸激酶同工酶CK-MB、乳酸脱氢酶(LDH)及天门冬氨酸氨基转氨酶(AST)水平。结果:1)临床总体疗效:对照组、低剂量组、中剂量组、高剂量组治疗总有效率分别为70.83%(17/24),79.17%(19/24),95.83%(23/24)和91.67%(22/24)。联合治疗的3组治疗总有效率均明显高于对照组(P<0.05);中剂量组、高剂量组高于低剂量组(P<0.05),中剂量组与高剂量组比较差异无统计学意义(P>0.05)。2)止泻、退热及止吐时间:联合治疗的3组止泻、退热及止吐时间均明显短于对照组(P<0.05)。止泻、退热时间,中剂量组、高剂量组均短于低剂量组(P<0.05),中剂量组与高剂量组比较差异无统计学意义(P>0.05);止吐时间,中剂量组最低,高剂量和低剂量组长于中剂量组(P<0.05),高剂量组与低剂量组无明显差异(P>0.05)。3)炎症因子:4组治疗前血清IL-6和TNF-α水平比较差异无统计学意义(P>0.05),各组治疗后血清IL-6和TNF-α水平均降低(P<0.05),其中高剂量组最低。4)心肌损伤血液学指标:4组治疗前血清CK、CK-MB、LDH、AST水平比较差异均无统计学意义(P>0.05),各组治疗后血清CK、CK-MB、LDH、AST水平均降低(P<0.05),其中中剂量组和高剂量组最低,但两组间差异不明显(P>0.05)。结论:赖氨葡锌联合消旋卡多曲治疗RV肠炎疗效确切,中剂量和高剂量疗效更好,疗效相近,但高剂量有延长呕吐时间风险,建议临床中剂量用药,勿盲目补锌。
Objective To compare the clinical efficacy of different doses of lysine hydrochloride and zinc gluconate combined with racecadotril in the treatment of rotavirusenteritis(RVE),and its effects on serum inflammatory factors and myocardial enzyme spectrum.MethodsTotal 96 children with RVE who were treated in our hospital from January 2021 to October 2024 were randomly divided into four groups,with 24 cases in each group.One group was given racecadotril granules(Sichuan Baili Pharmaceutical)orally(the control group),and the other 3 groups(collectively referred to as the combined treatment group)were given different doses of lysine hydrochloride and zinc gluconate granules(Hainan Huigu Pharmaceutical,5g per bag)orally on the basis of oral racecadotril granules,and were named the low-dose group,the medium-dose group and the high-dose group.All four groups were treated continuously for 7 days.The overall therapeutic effect,the time of antidiarrheal,antipyretic and antiemetic,the serum levels of interleukin(IL)-6 and tumor necrosis factor-α(TNF-α),and the serum levels of creatine kinase(CK),creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH)and aspartate aminotransferase(AST)in the four groups of children were compared.Results1)Overall clinical efficacy:The total effective rates of the control group,the low-dose group,the medium-dose group and the high-dose group were 70.83%(17/24),79.17%(19/24),95.83%(23/24)and 91.67%(22/24),respectively.The total effective rates of the three combined treatment groups were significantly higher than that of the control group(P<0.05),which were higher in the medium-dose group and the high-dose group than in the low-dose group(P<o.05),and there was no statistically significant difference between the medium-dose group and the high-dose group(P>0.05).2)Time of antidiarrheal,antipyretic and antiemetic:The time of antidiarrheal,antipyretic and antiemetic in the three combined treatment group was significantly shorter than that of the control group(P<0.05).The time of antidiarrheal and antipyretic in the medium-dose group and the high-dose group was shorter than that in the low-dose group(P<0.05),and there was no statistically significant difference between the medium-dose group and the high-dose group(P>0.05).The time of antiemetic in the medium-dose group was the shortest,which was longer in the high-dose group and the low-dose group than in the medium-dose group(P<o.05),and there was no significant difference between the high-dose group and the low-dose group(P>0.05).3)Inflammatory factors:There was no statistically significant difference in the serum levels of IL-6 and TNF-αbefore treatment in the four groups(P>0.05),and the serum levels of IL-6 and TNF-αin each group decreased after treatment(P<0.05),which were the lowest in the high-dose group.4)Hematological indicators of myocardial damage:There was no statistically significant difference in the serum levels of CK,CK-MB,LDH and AST before treatment in the four groups(P>0.05),and the serum levels of CK,CK-MB,LDH and AST in each group decreased after treatment(P<0.05),which were the lowest in the medium-dose group and the high-dose group,but there was no significant difference between the two groups(P>0.05).Conclusion Lysine hydrochloride and zinc gluconate combined with racecadotril is effective in the treatment of RVE.The medium-dose and high-dose have better efficacy and are similar in efficacy,but the high-dose has the risk of prolonging the vomiting time.It is recommended to use the medium-dose in clinical practice and not to blindly supplement zinc.
作者
杨莉莉
杨扶阳
胡文淼
YANG Li-li;YANG Fu-yang;HU Wen-miao(Department of Pediatrics,Zhengzhou Third People's Hospital,Zhengzhou,Henan 450000)
出处
《中国肛肠病杂志》
2025年第5期31-35,共5页
Chinese Journal of Coloproctology
关键词
轮状病毒肠炎
赖氨葡锌
消旋卡多曲
剂量
疗效
Rotavirus enteritis
Lysine hydrochloride and zinc gluconate
Racecadotril
Dose
Efficacy
