阿莫西林克拉维酸钾联合水杨酸乙醇耳浴对化脓性中耳炎的疗效及免疫功能的影响

Therapeutic efficacy of amoxicillin and clavulanate potassium combined with ear irrigation with salicylic acid in ethanol for suppurative otitis media and its effects on immune function

摘要:

目的 探讨阿莫西林克拉维酸钾联合水杨酸乙醇耳浴对化脓性中耳炎的疗效及免疫功能的影响。方法 选取2019年5月—2022年6月贵州省人民医院收治的86例化脓性中耳炎患者。随机数表法分为对照组、研究组，每组43例。对照组给予水杨酸乙醇耳浴治疗，研究组在对照组基础上给予阿莫西林克拉维酸钾，两组均持续治疗2周后观察疗效。对比两组听力功能、致病菌清除率及临床疗效；比较两组的外周血炎症因子、免疫功能情况；记录治疗期间药物不良反应发生情况。结果 研究组治疗前后的气导阈值、骨导阈值的差值均高于对照组（P <0.05）。研究组致病菌率清除率、总有效率均高于对照组（P <0.05）。研究组治疗前后IL-4、TGF-β、IL-17和Th1/Th2、Th17/Treg、CD4⁺/CD8⁺的差值均高于对照组（P <0.05）。两组患者治疗期间未出现不良反应，心电图及肝肾功能亦无异常。结论 阿莫西林克拉维酸钾联合水杨酸乙醇耳浴治疗化脓性中耳炎可提高患者听力功能，清除致病菌，增强治疗疗效，进一步抑制炎症因子合成，改善患者免疫功能，安全可靠。

Abstract:

Objective To investigate the therapeutic efficacy of amoxicillin and clavulanate potassium combined with ear irrigation with salicylic acid in ethanol for suppurative otitis media and its effects on the immune function.Methods Eighty-six patients with suppurative otitis media admitted to our hospital from May 2019 to June 2022 were selected. They were divided into the control group and the study group by random number table method, with 43 cases in each group. The control group received ear irrigation with salicylic acid in ethanol, and the study group was additionally treated with amoxicillin and clavulanate potassium. The therapeutic efficacy was observed after 2 weeks of continuous treatment in both groups. The hearing function, the clearance rate of pathogenic bacteria and clinical efficacy were compared between the two groups. The inflammatory factors in peripheral blood and immune function of the two groups were also compared. The incidence of adverse drug reactions during treatment was analyzed.Results The differences of air conduction threshold and bone conduction threshold before and after treatment in the study group were higher than those in the control group (P < 0.05). The clearance rate of pathogenic bacteria and the overall effective rate in the study group were higher than those in the control group (P < 0.05). The differences of serum levels of interleukin-4 (IL-4), transforming growth factor-β (TGF-β) and IL-17 as well as the ratios of Th1/Th2, Th17/Treg and CD4⁺/CD8⁺ cells before and after treatment in the study group were higher than those in the control group (P < 0.05). There was no adverse reaction in the two groups during treatment, with the electrocardiogram and the liver and renal function being normal.Conclusions Amoxicillin and clavulanate potassium combined with ear irrigation with salicylic acid in ethanol for treating suppurative otitis media can improve the hearing function of patients and remove pathogenic bacteria, thereby enhancing the therapeutic efficacy. It further inhibits the production of inflammatory factors and enhance the immune function of patients as a safe and reliable therapeutic regimen.