中西医结合治疗小儿腹泻临床研究

Clinical Study of Combination of Traditional Chinese and Western Medicine in the Treatment of Infantile Diarrhea

目的:观察中西医结合治疗小儿腹泻的临床疗效及对血清中白细胞介素-23(interleukin-23,IL-23)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平的影响。方法:90例腹泻患儿随机分为对照组和观察组各45例。对照组给予蒙脱石散。观察组在对照组治疗基础上给予葛根芩连汤加减(1剂·d-1,常规水煮2次),并联合贴敷脐治疗。两组患者均连续治疗3 d。比较两组湿热证症状评分、腹泻次数及临床疗效。检测两组血清中IL-23和TNF-α水平。结果:治疗后,观察组湿热证症状评分、腹泻次数明显少于对照组(P<0.01)。观察组总有效率为97.78%,明显高于对照组总有效率82.22%(P<0.05)。治疗后,观察组血清中IL-23和TNF-α水平明显低于对照组(P<0.01)。结论:中西医结合治疗小儿腹泻,可明显改善中医临床症状,减少腹泻次数,提高临床疗效,降低血清中IL-23和TNF-α水平可能与其治疗效果相关。

Objective： To investigate efficacy of Gegen Qinlian Tang combined with navel-applied in treating infantile persistent diarrhea with damp heat syndrome,and the influence on the serum level of interleukin-23（ IL-23） and tumor necrosis factor-α（ TNF-α）. Methods： 90 cases of infantile persistent diarrhea with damp heat syndrome were randomly divided into the control group and the observation group with 45 cases in each group. Control group accepted montmorillonite powder. Observation group were treated with Gegen Qinlian Tang（ 1 dose a day and bid） combined with navel-applied. Course was for 3 days in both groups.Scores of symptoms of damp heat syndrome,diarrhea frequency,and efficacy were compared between two groups. Serum levels IL-23 and TNF-α were detected in both groups. Results： Scores of symptoms of damp heat syndrome and diarrhea frequency of observation group were less than those of control group（ P〈0. 01）. Total effective rate of the treatment was 97. 87%,which was obviously higher than control groups 82. 22%（ P〈0. 05）. After treatment,serum levels of IL-23 and TNF-α of observation group were remarkably lower than those of control group（ P〈0. 01）. Conclusion： Efficacy of Gegen Qinlian Tang combined with navel-applied in treating infantile persistent diarrhea with damp heat syndrome can improve symptoms of traditional Chinese medicine,decrease diarrhea frequency,increase efficacy,and inhibiting serum levels of IL-23 and TNF-α may be related to its effect.