【目的】 观察和评价酪酸梭菌活菌散与抗菌药联用治疗小儿肺炎预防小儿肺炎继发性腹泻的临床疗效。 【方法】 将305例肺炎患儿随机分为预防Ⅰ组(104例)、预防Ⅱ组(101例)和对照组(100例),三组均给予抗菌药及对症支持治疗。预防组在治疗的同时联用酪酸梭菌活菌散,0.5 g/次,3次/d,出现腹泻继续服用,其中预防Ⅰ组停用抗菌药后继续服用酪酸梭菌活菌散7 d,预防组Ⅱ组停用抗菌药后即停用酪酸梭菌活菌散;对照组不用酪酸梭菌活菌散预防,出现腹泻用酪酸梭菌活菌散治疗,0.5 g/次,3次/d。对三组继发腹泻的发生率、腹泻持续天数、肺炎治疗的总疗程进行统计分析。 【结果】 预防Ⅰ组继发腹泻发生率为4.8%,预防Ⅱ组继发腹泻发生率为10.9%,对照组继发腹泻发生率为32.0%,预防Ⅰ组、Ⅱ组和对照组相比差异均有统计学意义(P<0.05);预防Ⅰ组、预防Ⅱ组腹泻持续时间和治疗疗程显著短于对照组(P<0.01)。 【结论】 酪酸梭菌活菌散与抗菌药联用治疗肺炎,能显著降低小儿肺炎继发性腹泻的发生率,预防性应用具有积极的临床意义,且停用抗菌药后再用酪酸梭菌活菌散7 d,预防效果更好。

【Objective】 To observe and evaluate the efficacy of clostridium butyricum with antibacterial for preventing diarrhea for children with pneumonia. 【Methods】 The children with pneumonia were randomly divided into three groups. The subjects from control group (n=100) were routinely treated with antibacterial. For those who suffered from diarrhea in the control group, clostridium butyricum was administered at doses of 0.5 g tid. In addition to antibacterial therapy, the subjects from observation groupⅠ(n=104) and the observation groupⅡ(n=101) administered clostridium butyricum at doses of 0.5 g, tid. After ending the antibacterial therapy, the children from observation groupⅠadministered the probiotics for more 7days at the same dose. The beneficial effects were observed. 【Results】 The incidences of diarrhea were reduced in the observation groupⅠand Ⅱ comparing to the control group (4.8% or 10.9%vs 32.0%; P<0.05). Both the duration of diarrhea and the period of treatment in the observation groupⅠand Ⅱ were statistically shorter (P<0.01) than those of the control group. Adverse reaction was not found. 【Conclusions】 Administration of clostridium butyricum powder may have some positive effects on children with pneumonia, who are treating with antibacterial for preventing diarrhea. It may be a better way to administer the probiotics for more 7 days after ending antibacterial therapy.