连术颗粒治疗急性感染性腹泻(湿热下注证)对血浆内毒素的影响及疗效观察

Clinical observation of Lianzhu granule on the treatment of acute infectious diarrhea with downward flow of damp-heat type and its effects of plasma endotoxin

目的观察连术颗粒对急性感染性腹泻(湿热下注证)的疗效,及其抗内毒素的作用及机制。方法将60例急性感染性腹泻(湿热下注证)患者随机分为2组,每组各30例。治疗组予连术颗粒联合盐酸环丙沙星治疗,对照组予盐酸环丙沙星治疗,疗程为3 d。2组治疗前后分别取患者肘静脉血,检测血白细胞计数、中性粒细胞百分比,血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、可溶性白细胞分化抗原14(sCD14)、白细胞介素6(IL-6),血浆内毒素、一氧化氮(NO)、D-乳酸浓度;收集患者粪,进行粪常规镜检白细胞;统计临床疗效。结果 2组显效率及总有效率比较差异均有统计学意义(P<0.05),治疗组临床疗效优于对照组(P<0.05)。治疗后,2组血白细胞计数、中性粒细胞百分比及血清CRP水平,血浆内毒素、D-乳酸浓度,粪常规镜检白细胞数均较本组治疗前降低(P<0.05);治疗组血浆NO含量及血清TNF-α、sCD14、IL-6水平均较本组治疗前降低(P<0.05),且治疗组治疗后血清CRP、TNF-α、sCD14及IL-6水平,血浆内毒素、D-乳酸浓度、NO含量均低于对照组(P<0.05)。结论连术颗粒能有效治疗急性感染性腹泻,降低D-乳酸浓度,修复受损肠黏膜,减少内毒素吸收;降低NO、TNF-α、sCD14、IL-6水平,从而拮抗内毒素代谢。

Objective To observe the curative effects of Lianzhu granule on the treatment of acute infectious diarrhea with downward flow of damp-heat type and its effects and mechanism of resist endoxemia. Methods 60 patients with acute infectious diarrhea were randomly divided into two groups,30 cases in each group. Patients in treatment group were treated by Lianzhu granule combined with ciprofloxacin,and the control group received ciprofloxacin only,continuously treatment for 3 d. The blood was taken from cubital vein before and after treatment in two groups,to determine the white blood cell（WBC） count,neutrophilic granulocyte percentage, serum c-reactive protein（CRP）,tumor necrosis factor-α（TNF-α）,soluble cluster of differentiation antigen 14（sCD14）,interleukin 6（IL-6）,plasma endotoxin,NO and D-lactic acid concentration. Collected the feces samples from all patients,and the WBC was observed in microscopy,then the clinical effect was observed. Results There were statistical differences on obvious effective rate and total effective rate between two groups（P〈0.05）,the curative effect in treatment group was superior to that in control group（P〈0.05）. After treatment,the WBC count,neutrophilic granulocyte percentage,serum CRP,plasma endotoxin,D-lactic acid concentration and microscopic examination of WBC count were decreased in two groups（P〈0.05）. The levels of plasma NO,serum TNF-α,sCD14 and IL-6 after treatment were decreased in treatment group（P〈0.05）,and the levels of serum CRP,TNF-α,sCD14,IL-6,plasma endotoxin,D-lactic acid and NO after treatment were lower than those in control group（P〈0.05）. Conclusion Lianzhu granule has effective therapeutic effect on acute infectious diarrhea,can decrease D-lactic acid concentration,repair injury intestinal mucosa,reduce the absorption of endotoxin,and decrease NO,TNF-α,sCD14,IL-6,with effects of antagonistic endotoxin metabolism.