| The first part Clinical ResearchObjective:The clinical efficacy of different probiotic combinations on children with acute diarrhea was evaluated by comparing Clostridium butyricum powder and Saccharomyces boulardii in different combinations for the treatment of acute diarrhea in children,and observing the changes of diarrhea duration,stool frequency,stool properties and concomitant symptoms of children after treatment.Methods:Children with acute non-invasive diarrhea who visited the pediatric outpatient department of Henan Provincial People’s Hospital from July 2021 to December 2022 were included as the study samples.They were randomly divided into probiotic group A and probiotic group B using a random number table.All the children received regular treatment with Smectite after diagnosis,on the basis of which probiotic group A was given Clostridium butyricum powder and Saccharomyces boulardii at the same time,and probiotic group B was given Clostridium butyricum powder first,followed by Saccharomyces boulardii after an interval of 2 hours.Both groups were given medication for 3 days and followed up by telephone for 5days.The duration of diarrhea,daily frequency of stool and stool characteristics of the children in the two groups were observed and recorded.Finally,the total effective rate of the two groups was compared,and the adverse reactions and medication compliance were observed.Results:After different treatment regimens were given,the clinical symptoms and signs of children in probiotic A and B groups showed significant improvement.(1)Evaluation of treatment effect:The total effective rate of probiotics group A was 82.61%,and that of probiotics group B was 80.95%.There was no significant difference in the total effective rate between the two groups(P>0.05).(2)The duration of diarrhea in the two groups after treatment: the mean duration of diarrhea in the probiotic group A was shorter than that in the probiotic group B,but there was no statistical significance(P>0.05).(3)The number and characteristics of stool per day between the two groups after treatment: During the whole intervention and follow-up period,there were no significant differences in the average number and characteristics of stool per day in the two groups(P>0.05);However,there were significant differences between the two groups in the frequency and characteristics of stool at different time points of treatment(P<0.05),that is,with the number of stool in the two groups were significantly reduced,and the characteristics of stool were significantly improved.(4)Adverse reactions and compliance of the children in the two groups during treatment:No adverse reactions were observed in the diarrhea children in the probiotic group A and the probiotic group B during the trial,and the compliance of the children in the probiotic group B was worse than that in the probiotic group A.Conclusions:Probiotics group A and B showed significant efficacy in the treatment of acute non-invasive diarrhea in children,but the clinical efficacy of the two groups was similar with no significant difference.The second part Experimental StudyObjective:By establishing the rat model of acute diarrhea and detecting the relevant indexes after probiotic intervention,the clinical efficacy comparison and potential mechanism of Clostridium butyricum powder and Saccharomyces boulardii in acute diarrhea rats were discussed,that is,simultaneous use or separate use,to provide theoretical basis for clinical research.Methods:Forty healthy female SD rats,SPF grade,5 weeks of age,weighed(145.03±0.54)g.After 5 days of cage adaptive feeding,the patients were randomly divided into normal group,model group,probiotic group A and probiotic group B using a random number table,with 10 birds in each group.The model group and probiotics group A and B were all sulphated by free Dextran sulphate sodium solution of 5% for 7 days to establish rat models of acute diarrhoea.Probiotics group A was simultaneously treated by gavage of Clostridium butyricum powder and Saccharomyces boulardii.Probiotics group B was first given Clostridium butyricum powder,and then given Saccharomyces boulardii again at an interval of 2hours.Model group was given the same amount of 0.9% sodium chloride solution intragastric administration.The general condition,weight change,fecal characteristics and fecal level of rats in the four groups were recorded.Enzyme linked immunosorbent assay was used to determine serum levels of cytokines(C-reactive protein,procalcitonin,interleukin-6 and tumor necrosis factor-α)and liver function(aspartate aminotransferase,alanine aminotransferase,albumin and total protein)in each group.The colonic length and histological changes of rats in each group were observed and compared,and the clinical efficacy and potential mechanism of different administration modes of Clostridium butyricum powder and Saccharomyces boulardii in the treatment of acute diarrhea were compared.Results:The experimental results showed that in the rat model of acute diarrhea induced by DSS,the body weight of rats in the model group decreased significantly and diarrhea occurred.The expression levels of proinflammatory factors in serum of rats were detected,and the results showed that the levels of C-reactive protein,procalcitonin,interleukin-6 and tumor necrosis factor-α were significantly increased(P<0.001).The serum levels of aspartate aminotransferase,alanine aminotransferase and albumin were also significantly increased(P<0.001).Macroscopically and photoscopically,the colon length of rats in the model group was significantly shortened,and local damage occurred in the colon tissue,accompanied by inflammatory cell infiltration.After gavage with Clostridium butyricum powder and Saccharomyces boulardii,the diarrhea induced by DSS was significantly improved,the trend of weight loss was alleviated,and the phenomenon of colon shortening was inhibited(P<0.001).The therapeutic effect of probiotics group A was similar to that of probiotics group B.The combination of Clostridium butyricum powder and Saccharomyces boulardii could significantly reduce the concentrations of pro-inflammatory factors(C-reactive protein,procalcitonin,interleukin-6 and tumor necrosis factor-α)in serum of rats(P<0.01).At the same time,the liver function(aspartate aminotransferase,alanine aminotransferase and albumin)of rats in the probiotic A and B groups were also significantly improved after probiotic intervention(P<0.05).The colonic histology showed that Clostridium butyricum powder and Saccharomyces boulardii could improve the degree of inflammation and lesion range of colon in rats.Conclusions:Clostridium butyricum powder in combination with Saccharomyces boulardii had a protective effect on DSS-induced acute diarrhea,and the mechanism of protective effect of probiotics may be related to control of inflammatory response and improvement of liver function. |
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