Efficacy and Rationale of Differentiated Racecadotril Doses Combined with Bifidobacterium Triple Viable in Managing Pediatric Persistent Diarrhea: A Comprehensive Analysis

Objective: Pediatric persistent diarrhea poses a severe burden on children's health. This study investigates the efficacy and fundamental mechanisms of varying doses of racecadotril in combination with bifidobacterium triple viable for treating this condition in children. Methods: Employing a randomized controlled trial design, participants diagnosed with pediatric persistent diarrhea were randomly allocated to a high-dose group (observation) and a low-dose group (control), both treated with racecadotril combined with bifidobacterium triple viable. During treatment, clinical parameters were meticulously recorded and analyzed. ELISA techniques were utilized to quantify alterations in immune, inflammatory, and oxidative stress markers in serum. Quantitative culture methods for gut microbiota were employed to assess changes in intestinal flora composition before and after treatment. Results: Compared to the low-dose group, the high-dose treatment group demonstrated significantly shorter durations for fever resolution, vomiting cessation, diarrhea control, and dehydration correction. Furthermore, the overall treatment efficacy was higher in the high-dose group without notable increases in adverse reactions. The high-dose group showed elevated IgG and IgA levels, reduced inflammatory markers (hs-CRP, IL-6, TNF-α), and increased anti-inflammatory factor IL-10. Additionally, oxidative stress marker MDA decreased while SOD activity enhanced. Gut microbiota analysis revealed substantial improvement in the high-dose group, with an increase in beneficial bacteria and a decrease in harmful bacteria. Conclusion: The high-dose group of racecadotril combined with bifidobacterium triple viable demonstrated superior efficacy in improving clinical and laboratory manifestations in pediatric persistent diarrhea compared to the low-dose group.