枯草杆菌二联活菌制剂鼻饲给药治疗昏迷患者抗生素相关性腹泻的疗效观察

目的：研究枯草杆菌二联活菌制剂经鼻饲给药治疗昏迷患者抗生素相关性腹泻的临床疗效。方法：收集以2011 年1 月至2014 年1 月本院确诊的76 例患抗生素相关性腹泻的昏迷患者作为研究对象，按随机数字表法分为对照组(38 例)和试验组(38例)，对照组在基础治疗的基础上给予鼻饲蒙脱石散收敛止泻治疗，而试验组在对照组的基础上，同时给予枯草杆菌二联活菌胶囊（美常安）鼻饲给药治疗。对比治疗前后两组患者的症状改善情况以及粪便实验室检查指标，记录两组不良反应。结果：除治疗过程中死亡4 例、意识转清停止鼻饲8 例外，试验组33 例，对照组31 例完成试验。试验组治疗有效率明显高于对照组的(X2=2.627，P <0.05)。给药第6d 试验组的白细胞转阴率为81.8%，明显高于对照组的30%(P<0.05)，给药第6 d 及治疗后试验组的肠道菌群纠正率分别为84.2%、94.7%，明显高于对照组的41.2%、64.7%，差异均有统计学意义(P<0.05)。对照组患者不良反应的发生率明显高于试验组（P<0.05）。结论：枯草杆菌二联活菌制剂鼻饲给药可显著改善昏迷患者抗生素相关性腹泻的症状，使肠道菌群更快得以纠正、缓解使肠道炎症，且安全性高，值得临床推广使用。

Feeding Joint Sublilis Bacillus Probiotic Through Nose for Coma Patientswith Antibiotic Associated Diarrhoea

Objective:To explore the clinical efficacy of feeding joint sublilis Bacillus probiotic through nose in the treatment ofcoma patients with antibiotic associated diarrhoea.Methods:A total of 76 coma patients with antibiotic associated diarrhoea, who werediagnosed in Zhongshan Affiliated Hospital of Dalian University from January 2011 to January 2014, were chosen as subjects andrandomly divided into control group (n=38) and experimental group (n=38). The control group was treated with basic therapy andmontmorillonite powder astringent fed through nose, while the experimental group was added joint Sublilis Bacillus probiotic(Mei ChangAn) fed through nose on the basis of control group''s therapy. The improvement of symptoms and the laboratory examination indexes ofthe stool in the two groups before and after treatment were compared; the adverse reactions of the two groups were recorded.Results:33patients in the experimental group and 31 patients in the control group completed the trial except 4 cases of death and 8 cases of stoppingfeeding through nose due to the recovery of consciousness during the treatment process. The treatment effective rate of experimentalgroup was significantly higher than that of control group(P<0.05). The white blood cell turning negative rate ( 81.8%) in the experimentalgroup was significantly higher than that (30%) in the control group 6d after treatment (P<0.05). The correct rate of intestinal bacteria inthe experimental group 6d after treatment and after treatment were 84.2% and 94.7% respectively, which were significantly higher thanthose(41.2%and 64.7%) in the control group, the differences were statistically significant(P<0.05). The incidence of adverse reactions inthe control group was significantly higher than that in the experimental group (P<0.05).Conclusion:Feeding Joint Sublilis Bacillusprobiotic through nose can significantly improve the symptoms of coma patients with antibiotic associated diarrhea, quickly correct theintestinal bacteria group, alleviate intestinal inflammation, with high safety, which is worthy of clinical promotion.