酪酸梭菌活菌散联合四磨汤对厌食症患儿神经肽Y和胃动素水平的影响及疗效观察

Influence and curative effect of Live Clostridium butyricum Powder combined with Simo Decoction on neuropeptide Y and motilin levels of children with apositia

目的探讨酪酸梭菌活菌散联合四磨汤对厌食症患儿神经肽Y（NPY）和胃动素（MTL）水平的影响及疗效观察。方法选取儿童厌食症患者82例,随机分为观察组和对照组各41例。两组纠正以往不良饮食习惯及予以健胃消食药等常规治疗。观察组加用酪酸梭菌活菌散联合四磨汤治疗,连用6周。其中酪酸梭菌活菌散1.0g/次,2次/d,温开水冲服;四磨汤口服液10mL/次,2-3次/d。对照组患儿加用单用四磨汤治疗,其用法及疗程与观察组相同。分析与检测两组患儿治疗前及治疗6周后血清NPY及MTL指标变化,并评估其临床疗效及随访半年内的复发情况。结果治疗6周后,两组血清NPY和MTL水平较前明显上升（P〈0.05或P〈0.01）,且观察组上升值明显大于对照组（P〈0.05）;同时观察组临床总有效率（95.12%）明显高于对照组（78.05%）（χ^2=5.14,P〈0.05）。对治疗有效者随访半年,观察组39例中复发8例,对照组32例中复发14例。观察组复发率（20.51%）明显低于对照组（43.75%）（χ^2=4.44,P〈0.05）。结论酪酸梭菌活菌散联合四磨汤治疗儿童厌食症的近期疗效显著,增强患儿食欲,提高患儿体重,且其中远期疗效亦较佳,可减少其复发率,作用机制与其能提高血清NPY和MTL指标水平密切相关。

Objective To discuss the influence and efficacy of live Clostridium butyricum Powder combined with Simo Decoction on the levels of neuropeptide Y（NPY）and motilin（MTL）of children with apositia.Methods 82 children with apositia were selected and divided into observation group or control group at random,with 41 cases in each group.Both groups were given routine treatment such as correction of unhealthy eating habit and administration of digestive/stomachic drugs etc.The observation group was additionally given live Clostridium butyricum Powder combined with Simo Decoction for 6weeks,while the control group was additionally given Simo Decoction alone.The changes of serum NPY and MTL levels of children before and 6weeks after treatment were observed and detected,and the clinical efficacy and reccurrence rate at sixmonth follow-up were compared between the two groups.Results The serum NPY and MTL levels of children in both groups increased obviously after treatment（P〈0.05 or P〈0.01）,with the observation group superior to the control group（P〈0.05）.The total clinical efficiency rate in observation group（95.12%）was much higher than that in control group（78.05%）（χ^2=5.14,P〈0.05）.The recurrence rate of observation group at six-month follow-up was 20.51%,significantly lower than that in control group（43.75%）（χ^2=4.44,P〈0.05）.Conclusion Live Clostridium butyricum Powder combined with Simo Decoction has significant short-term and favorable long-term curative effect on children with apositia;the mechanism of action is closely associated with its effect of raising serum NPY and MTL levels.