参苓白术散汤剂治疗小儿腹泻脾胃虚弱型68例临床观察

Clinical observation of the decoction of Shenling Baizhu Powder in treating 68 cases of infantile diarrhea due to weakness of spleen and stomach

目的观察参苓白术散汤剂治疗小儿腹泻脾胃虚弱型的临床疗效及对血浆中血管活性肽(VIP)、神经肽Y(NPY)及肠黏膜中5-羟色胺(5-HT)的影响。方法选取我院2014年4月至2015年3月收治的136例小儿腹泻脾胃虚弱型患儿作为研究对象,随机分为对照组与治疗组,各68例。对照组给予乳酸菌素片治疗,治疗组采用参苓白术散汤剂治疗。观察2组患儿的临床疗效、临床症状消失时间以及治疗前后VIP,NPY,5-HT水平的变化。结果治疗组总有效率为95.59%,对照组为83.82%,经统计学分析,差异有统计意义(P<0.05);治疗组大便次数恢复正常时间、性状变稠时间、腹泻停止时间分别为(2.01±0.88)d,(2.09±0.84)d,(2.57±0.99)d,均短于对照组的(4.64±0.77)d,(3.18±0.75)d,(4.78±0.69)d,差异均有统计意义(P<0.05);治疗后,治疗组VIP和5-HT水平下降幅度及NPY上升幅度均高于对照组,2组比较差异有统计意义(P<0.05)。结论参苓白术散汤剂治疗小儿腹泻效果显著,其作用机制可能与调节血浆VIP,NPY,5-HT水平有关。

Objective To observe the effect of Shenling Baizhu Powder in treating infantile diarrhea due to weakness of spleen and stomach and observe the influence on vasoactive peptide（ VIP）,neuropeptide Y（ NPY）and 5-hydroxytryptamine（ 5-HT）. Methods 136 cases of infantile diarrhea due to weakness of spleen and stomach（ admitted from April,2014 to March,2015） were randomly divided into control group and treatment group,68 cases in each group. The control group was given lactobacillin tablet,the treatment group was treated with the decoction of Shenling Baizhu Powder. Clinical effect and the time of transference cure were observed. The changes of VIP,NPY and 5-HT before and after treatment were compared. Results The total effective rate of treatment group was95. 59% and that of control group was 83. 82%,the difference was significant（ P 0. 05）. Time of remission and transference cure in treatment group was much less than that in control group,there was a significant difference（ P〈0. 05）. After treatment,the fall of VIP and 5-HT,the rise of NPY in treatment group changed more evidently than in control group,there was a significant difference（ P〈0. 05）. Conclusion The treatment is effective for children diarrhea,the mechanism of drug action may be related to the regulation of VIP,NPY and 5-HT.