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口服黑接骨木、锌、热处理嗜酸乳杆菌(HA122)、阿拉伯半乳聚糖、维生素 D、维生素 E 和维生素 C 对儿童分泌性中耳炎的影响:一项随机对照试验。

The effects of oral supplements with Sambucus nigra, Zinc, Tyndallized Lactobacillus acidophilus (HA122), Arabinogalactans, vitamin D, vitamin E and vitamin C in otitis media with effusion in children: a randomized controlled trial.

机构信息

Otology and Cochlear Implant Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy.

出版信息

Eur Rev Med Pharmacol Sci. 2019 Jul;23(14):6360-6370. doi: 10.26355/eurrev_201907_18460.

Abstract

OBJECTIVE

To evaluate the ability of oral supplements with immune-stimulating molecules (Sambucus nigra, Zinc, Tyndallized Lactobacillus acidophilus (HA122), Arabinogalactans, vitamin D, vitamin E and vitamin C) to reduce the inflammation of the upper airway tract and improve the outcome of otitis media with effusion (OME) in children.

PATIENTS AND METHODS

Randomized controlled trial. One-hundred ninety-eight children (CI 95%: 12-96 months) were divided into four groups. Group 1 (48 subjects) received 10 ml of oral supplements (OS) with immune-stimulating molecules for three months (20 days consecutively, then 10 days of suspension - the therapeutic scheme was repeated three times); Group 2 (54 children) underwent treatment with 10 ml of OS for 90 consecutive days; Group 3 (48 subjects) received 15 ml of OS for 45 consecutive days; a control group (48 children) underwent the standard treatment for rhinitis and OME. Outcome measures included otoscopy, tympanometry, fibroendoscopy, and the pure tone audiometry (PTA) at T0 (before treatment), T1 (45 days after treatment), and T2 (90 days after treatment).

RESULTS

All children treated with OS showed a reduction of Upper Airway Infection (UAI) episodes and OME compared to the control group independent of the administration method and posology. The three groups treated with OS showed statistically significant differences between T0 and T2 for otoscopy, tympanometry, fibroendoscopy, and PTA. In Group 2, the otoscopy and the tympanometry scores improved at T1. Group 2 and 3 had better PTA results than Group 1.

CONCLUSIONS

OS with immune-stimulating molecules should be considered as a supporting therapy in children affected by recurrent episodes of UAI associated with OME due to their capacity to improve the immune response and reduce the inflammatory phenomena. OS can improve the fibroendoscopic findings by restoring middle ear ventilation, in addition to their ability to reduce inflammation in the middle ear.

摘要

目的

评估口服免疫刺激分子补充剂(黑接骨木、锌、经 Tyndall 处理的嗜酸乳杆菌(HA122)、阿拉伯半乳聚糖、维生素 D、维生素 E 和维生素 C)减少上呼吸道炎症并改善儿童分泌性中耳炎(OME)结局的能力。

患者和方法

这是一项随机对照试验。198 名儿童(置信区间 95%:12-96 个月)被分为四组。第 1 组(48 名受试者)接受为期 3 个月的免疫刺激分子口服补充剂(OS)治疗(连续 20 天,然后暂停 10 天-治疗方案重复 3 次);第 2 组(54 名儿童)接受 10ml OS 连续 90 天治疗;第 3 组(48 名受试者)接受 15ml OS 连续 45 天治疗;对照组(48 名儿童)接受常规治疗鼻炎和 OME。观察指标包括耳镜、鼓室图、纤维内镜和纯音听阈(PTA),分别在 T0(治疗前)、T1(治疗后 45 天)和 T2(治疗后 90 天)进行。

结果

与对照组相比,所有接受 OS 治疗的儿童的上呼吸道感染(UAI)发作和 OME 均减少,而与给药方法和剂量无关。三组 OS 治疗组在 T0 和 T2 时的耳镜、鼓室图、纤维内镜和 PTA 均有统计学差异。第 2 组在 T1 时耳镜和鼓室图评分改善。第 2 组和第 3 组的 PTA 结果优于第 1 组。

结论

免疫刺激分子 OS 应被视为复发性 UAI 伴 OME 儿童的辅助治疗方法,因为其具有改善免疫反应和减轻炎症反应的能力。OS 通过恢复中耳通气来改善纤维内镜检查结果,此外还能减轻中耳炎症。

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