消旋山莨菪碱在急性肠胃炎患儿中的应用及对痉挛型腹痛的防治效果

doi:10.3760/cma.j.issn.1007-1245.2023.24.021

摘要/Abstract

摘要：

目的　观察消旋山莨菪碱（654-2）结合常规疗法治疗小儿急性肠胃炎的效果及对痉挛型腹痛的防治效果。方法　选取2021年1月至2022年12月南阳医学高等专科学校第一附属医院收治的128例急性肠胃炎患儿进行随机对照试验，采用随机数字表法将入组患儿分为常规组和联合组，各64例。常规组男34例，女30例，年龄3～14（8.52±1.16）岁，实施常规治疗；联合组男32例，女32例，年龄5～12（8.61±1.25）岁，采用654-2配合治疗。比较两组患儿治疗后的症状缓解情况，治疗前后的胃肠平滑肌功能、疼痛改善情况及不良反应情况。统计学方法采用χ²检验、t检验。结果　经不同方式治疗后，联合组患儿腹痛缓解时间、腹泻缓解时间、止吐时间、退热时间均低于常规组［（15.22±4.41）h比（18.66±4.14）h、（7.25±2.41）h比（8.61±2.25）h、（4.61±1.25）h比（5.33±2.11）h、（6.62±2.31）h比（7.76±1.25）h］，差异均有统计学意义（t=4.550、3.300、2.349、3.472，均P<0.05）。治疗后，联合组的胶质细胞原性神经营养因子（GDNF）高于常规组，脑源性神经营养因子（BDNF）、CC趋化因子3（CCR3）均低于常规组［（50.65±10.23）ng/L比（44.61±10.12）ng/L、（6.62±2.41）g/L比（7.93±2.75）g/L、（13.39±3.26）kDa比（15.77±3.41）kDa］，差异均有统计学意义（t=3.358、2.866、4.036，均P<0.05）。在不同治疗方案下，联合组治疗24 h、48 h、72 h后的视觉模拟疼痛（VAS）评分均低于常规组［（4.45±1.23）分比（5.66±2.17）分、（3.21±0.76）分比（4.26±1.35）分、（2.62±0.38）分比（3.41±0.47）分］，差异均有统计学意义（t=3.881、5.422、10.457，均P<0.05）。联合组治疗后的药物不良反应发生率与常规组比较［7.81%（5/64）比6.25%（4/64）］，差异无统计学意义（χ²=0.186，P>0.05）。结论　654-2结合常规疗法能有效缩短急性肠胃炎患儿症状缓解时间，对改善患儿肠道平滑肌功能、抑制痉挛型腹痛均有积极作用，联合应用此药未明显增加患儿的药物不良反应发生风险，安全性较高。

关键词:

急性肠胃炎, 山莨菪碱-2, 肠道平滑肌, 痉挛型腹痛, 用药安全性, 小儿

Abstract:

Objective　To observe the effect of raceanisodamine (654-2) combined with conventional therapy for children with acute gastroenteritis and its prevention and treatment of abdominal spastic pain. Methods　One hundred and twenty-eight children with acute gastroenteritis treated at First Hospital, Nanyang Medical College from January 2021 to December 2022 were selected for the randomized controlled trial. The enrolled children were divided into a conventional group and a combination group by the random number table method, with 64 cases in each group. There were 34 boys and 30 girls in the conventional group; they were 3-14 (8.52±1.16) years old. There were 32 boys and 32 girls in the combination group; they were 5-12 (8.61±1.25) years old. The conventional group took routine treatment, while the combination group took routine treatment and 654-2. The symptom relief after the treatment, the gastrointestinal smooth muscle function and pain improvement before and after the treatment, and the incidences of adverse reactions were compared between the two groups. χ² and t tests were applied. Results　After different treatments, the diarrhea relief time, abdominal pain relief time, antiemetic time, and fever relief time of the combination group were lower than those of the conventional group [(15.22±4.41) h vs. (18.66±4.14) h, (7.25±2.41) h vs. (8.61±2.25) h, (4.61±1.25) h vs. (5.33±2.11) h, and (6.62±2.31) h vs. (7.76±1.25) h], with statistical differences (t=4.550, 3.300, 2.349, and 3.472; all P<0.05). After the treatment, the levels of glial cell derived Neurotrophin (GDNF), brain-derived neurotrophic factor (BDNF), and CC chemokine 3 (CCR3) in the combination group were better higher than those in the conventional group [(50.65±10.23) ng/L vs. (44.61±10.12) ng/L, (6.62±2.41) g/L vs. (7.93±2.75) g/L, and (13.39±3.26) kDa vs. (15.77±3.41) kDa], with statistical differences (t=3.358, 2.866, all 4.036; all P<0.05). The scores of Visual Analogue Scale (VAS) 24, 48, and 72 h after the treatment in the combination group were lower than those in the control group [(4.45±1.23) vs. (5.66±2.17), (3.21±0.76) vs. (4.26±1.35), and (2.62±0.38) vs. (3.41±0.47)], with statistical differences (t=3.881, 5.422, and 10.457; all P<0.05). After the treatment, there was no statistical difference in the incidence of adverse reactions between the combination group and the conventional group [7.81% (5/64) vs. 6.25% (4/64); χ²=0.186; P>0.05]. Conclusion　654-2 combined with routine treatment for children with acute gastroenteritis can effectively promote their recovery of symptoms, improve their intestinal smooth muscle function, and inhibit their abdominal spastic pain, and does not significantly increase the risk of adverse drug reactions, with relatively high safety.

Key words:

Acute gastroenteritis, Anisocholine-2, Intestinal smooth muscle, Abdominal spastic pain, Medication safety, Children

程诚蒲海波.

消旋山莨菪碱在急性肠胃炎患儿中的应用及对痉挛型腹痛的防治效果 [J]. 国际医药卫生导报, 2023, 29(24): 3629-3633.

Cheng Cheng, Pu Haibo.

Raceanisodamine for children with acute gastroenteritis and its prevention of abdominal spastic pain [J]. International Medicine and Health Guidance News, 2023, 29(24): 3629-3633.

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