穴位贴敷治疗对急性腹泻小儿肠道菌群的影响

Effect of acupoint application on intestinal flora in the treatment of acute diarrhea in infants and young children

目的研究穴位贴敷治疗对急性腹泻小儿肠道菌群的影响。方法选择2018年8月至2019年12月在我院就诊治疗的急性腹泻小儿194例,随机分为对照组98例和观察组96例。对照组予口服蒙脱石散、建议口服补充液体及对症处理,必要时予静脉补液;观察组在对照组治疗基础上加中药穴位贴敷,中药选取:肉桂、干姜、苍术、吴茱萸、木香、石榴皮,磨粉混匀制成小药饼备用,贴敷选取穴位:神阙、天枢、中脘、脾俞,每日1次,每次2 h,两组治疗疗程均为3 d。治疗期间每日记录患儿腹泻相关症状表现,以评估治疗效果;在两组研究对象开始治疗前及治疗3 d后分别采集新鲜粪便标本,其乳酸杆菌、双歧杆菌、肠杆菌及肠球菌含量应用细菌的16S rRNA荧光PCR方法检测,并计算B/E(双歧杆菌/肠杆菌)比值。结果观察组治愈率高于对照组,两组总体疗效比较差异有统计学意义(P<0.05)。治疗后观察组乳酸杆菌、双歧杆菌含量及B/E值均高于对照组,肠杆菌含量低于对照组,差异有统计学意义(P<0.05)。两组肠球菌含量比较差异无统计学意义(P>0.05)。结论穴位贴敷治疗可通过对肠道菌群定植的内环境产生影响,提高小儿肠道的内源性乳酸杆菌、双歧杆菌等专性厌氧菌含量,提高肠道定植抗力,从而发挥到调节肠道菌群平衡的作用。

Objective To observe the effect of acupoint application on intestinal flora in the treatment of acute diarrhea in infants and young children.Methods Totally 194 children with acute diarrhea treated in our hospital from Aug.2018 to Dec.2019 were included in the study,and they were divided into observation group(96)and control group(98)by random number table method.The control group took montmorillonite orally,and it was suggested that liquid be taken orally and systematic treatment be performed,and intravenous fluid was given if necessary.Based on this,the observation group was also given acupoint application of Chinese medicines,and the medicines included:cinnamon,dried ginger,Rhizoma atractylodis,Fructus evodiae,Radix aucklandiae and pomegranate bark.These medicines were ground into powder and made into little medicinal pies for use.The acupoints were as follows:Shenque,Tianshu,Zhongwan and Piyu.The application was performed once a day,two hours each time.The course of treatment was 3 days for both groups.During the treatment,the symptoms related to diarrhea were recorded each day to evaluate the symptoms related to diarrhea were recorded each day to evaluate the therapeutic effect.The fresh feces specimen was collected respectively before treatment and 3 days after treatment in both groups.The 165 rRNA fluorescence PCR was used to detect the content of lactobacilli,bifidobacteria,enterobacteria and enterococcus,and the value of bifidobacteria/enterobacteria(B/E value)was calculated.Results The cure rate of the observation group was higher than that of the control group,and there was statistical difference in the overall therapeutic effect(P<0.05).After treatment,the content of lactobacilli and bifidobacteria and B/E value were higher in observation group than in control group,while the content of enterobacteria was lower(P<0.05).There was no statistical difference in the content of enterococcus between the two groups(P<0.05).Conclusion Acupoint application therapy can improve the content of endogenous lactobacilli,bifidobacteria and other specific anaerobic bacteria in children's intestinal tract,and improve the resistance of intestinal tract colonization,and play a role in regulating the balance of intestinal flora by affecting the internal environment of intestinal flora colonization.