CAJ | 학술논문

目的评价布拉氏酵母菌散剂治疗对肺炎儿童抗生素相关性腹泻(antibiotic-associated diarrhea,AAD)的预防作用.方法采用双盲随机对照的方法将245例患有肺炎的住院儿童完全随机分成2组.预防组104例在抗生素治疗基础上加用布拉氏酵母菌散剂治疗；对照组141例,使用安慰剂及抗生素；出现腹泻后对照组加用布拉氏酵母菌散剂治疗,2组患儿均加用蒙脱石散口服和补液治疗.每日观察患儿排便次数及性状,统计2组患儿腹泻发生率、疗效、腹泻持续时间及肺炎总疗程.结果预防组共16例(15.38％),对照组共41例(29.08％)患儿发生AAD.2组患儿AAD发生率差异有统计学意义(P＜0.05)；与对照组相比,预防组发生AAD的风险下降了55.7％(RR =0.443,95％ CI0.233～0.845,P=0.012).预防组发生AAD的患儿腹泻持续时间及肺炎总疗程均较对照组短,差异有统计学意义(P分别为0.001、0.030).治疗期间未见药物不良反应.结论早期使用布拉氏酵母菌散剂可有效降低肺炎住院患儿发生AAD的风险,改善疗效,缩短住院时间,未发现不良反应.
목적 평개포랍씨효모균산제치료대폐염인동항생소상관성복사(antibiotic-associated diarrhea,AAD)적예방작용.방법 채용쌍맹수궤대조적방법장245례환유폐염적주원인동완전수궤분성2조.예방조104례재항생소치료기출상가용포랍씨효모균산제치료；대조조141례,사용안위제급항생소；출현복사후대조조가용포랍씨효모균산제치료,2조환인균가용몽탈석산구복화보액치료.매일관찰환인배편차수급성상,통계2조환인복사발생솔、료효、복사지속시간급폐염총료정.결과 예방조공16례(15.38％),대조조공41례(29.08％)환인발생AAD.2조환인AAD발생솔차이유통계학의의(P＜0.05)；여대조조상비,예방조발생AAD적풍험하강료55.7％(RR =0.443,95％ CI0.233～0.845,P=0.012).예방조발생AAD적환인복사지속시간급폐염총료정균교대조조단,차이유통계학의의(P분별위0.001、0.030).치료기간미견약물불량반응.결론 조기사용포랍씨효모균산제가유효강저폐염주원환인발생AAD적풍험,개선료효,축단주원시간,미발현불량반응.
Objective The aim of this randomized,double-blind,placebo-controlled trial was to evaluate the efficacy of the Saccharomyces boulardii (S.boulardii) power in preventing antibiotic-associated diarrhea (AAD) in hospitalized children with pneumonia.Methods Two hundred and forty-five hospitalized children with pneumonia were randomly divided into two groups,group 1 treated with antibiotics and S.boulardii power (n =104),and group 2 with antibiotics and placebo,along with S.boulardii power and zinc when suffered from diarrhea (n =141).All children received montmorillonite powder and fluid replacement therapy for diarrhea.The stool frequency and consistency were observed.Diarrhea incidence,diarrhea and pneumonia duration of treatment,and therapeutic effect were recorded.Results AAD is more prevalent in group 2 than in group 1 (P ＜0.05).A 55.7％ relative risk reduction in AAD was seen in group 1 compared with group 2 (RR =0.443,95％CI 0.233 ～ 0.845,P =0.012).Patients with preventive treatment of S.boulardii power in broup 1 had lower AAD incidence compared with those in group 2 (P ＜ 0.05).Both the diarrhea and pneumonia duration of treatment in group 1 were shorter than that in group 2(P =0.001 for diarrhea duration,P =0.030 for pneumonia duration,respectively).No drug related adverse reactions were found during the observation period.Conclusion Preventive use of S.boulardii power may effectively reduce the risk of AAD,improve therapeutic effect,and shorten hospital stays for hospitalized children with pneumonia.