孙谦+路娜娜+孙雯+孙越+李德军

[摘要] 目的 探究儿童抗生素相关性腹泻中药学干预的作用与价值。方法 方便选取2015年2月—2016年2月期间，该院接受治疗的80例儿童抗生素相关性腹泻患儿作为研究对象，根据不同的治疗方法将所有患儿分为对照组（n=40）和观察组（n=40），对照组患儿采用西医治疗，观察组患儿在对照组的基础上采用中药学干预，观察分析两组患儿的治疗效果，干预后的相关腹泻发生率，大便次数，大便次数恢复时间，大便性状恢复时间，腹泻总疗程，腹泻程度积分，药物起效时间和APACHEⅡ积分。结果 观察组患儿的治疗总有效率是95.00%明显高于对照组患儿的治疗总有效率是77.50%，观察组患儿干预后的相关腹泻发生率是7.50%（ 3/40），对照组患儿干预后的相关腹泻发生率是25.00%（10/40） （χ2=4.875 6，P<0.05）。两组患儿的治疗效果，干预后相关腹泻发生率，大便次数，大便次数恢复时间，大便性状恢复时间，腹泻总疗程，腹泻程度积分，药物起效时间和APACHEⅡ积分比较差异有统计学意义（P<0.05）。结论 在对照组的基础上采用中药学干预对儿童抗生素相关性腹泻患儿具有较大的意义，可有效提高患儿的治疗效果，降低患儿的相关腹泻发生率，减少患儿的大便次数，缩短患儿的大便次数恢复时间，大便性状恢复时间，腹泻总疗程和药物起效时间，降低患儿的腹泻程度積分和APACHEⅡ积分，为该病患儿的治疗提供较为科学的临床依据。

[关键词] 儿童抗生素相关性腹泻；中药学干预；临床作用；临床价值

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2017）03（b）-0001-03

[Abstract] Objective To study the effect and value of TCM intervention in the antibiotic associated diarrhea in children. Methods Convenient selection 80 cases of children with antibiotic associated diarrhea treated in our hospital from February 2015 to February 2016 were selected and divided into two groups with 40 cases in each according to the different treatment methods， the control group were treated with western medicine， while the observation group adopted the TCM intervention on the basis of the control group， and the treatment effect of the two groups was observed and analyzed and the incidence rate of associated diarrhea， frequency of defecation， recovery time of defecation time， recovery time of stool property， total treatment course of diarrhea， diarrhea degree integration， drug onset time and APACHEⅡ integration after intervention were observed. Results The total treatment effective rate in the observation group was obviously higher than that in the control group， （95.00% vs 77.50%）， after intervention， the incidence rate of associated diarrhea after intervention in the observation group and the control group was respectively 7.50%（3/40） and 25.00%（10/40） （χ2=4.875 6，P<0.05）， and the differences in the treatment effect， incidence rate of associated diarrhea after intervention， stool frequency， recovery time of stool time， recovery time of stool property， total treatment course of diarrhea， diarrhea degree integral， drug onset time and APACHEⅡ integral after intervention had statistical significance（P<0.05）. Conclusion The TCM intervention is of great significance to the children with antibiotic associated diarrhea on the basis of the control group， which can effectively improve the treatment effect， reduce the incidence rate of associated diarrhea， reduce the stool frequency， shorten the recovery time of stool frequency， recovery time of stool property， total treatment course of diarrhea and drug onset time and reduce the diarrhea degree integral and APACHEⅡ integral and provide the scientific clinical basis for the treatment of patients.

[Key words] Antibiotic associated diarrhea in children； TCM intervention； Clinical effect； Clinical value

抗生素相关性腹泻指的是采用广谱抗生素过程中引发腹泻，主要临床症状有肠道菌群失调症，是一种医源性感染的主要表现。目前，由于人群使用抗生素的种类、数量具有一定的差异，典型的抗生素相关性腹泻发生率大约是在3%～39%[1]。但是，目前随着抗生素的大量使用，再加上儿童的免疫功能、肠道菌群不成熟，感染抵抗能力较差，使得抗生素相关性腹泻在儿童中的发生率越来越高。抗生素相关性腹泻的发生对患儿的病情恢复会造成一定的影响，增加了患儿的住院时间，使得抗生素相关性腹泻的预防和治疗引起广大人群的关注[2]。……