芩连止泻汤加减联合布拉氏酵母菌散治疗小儿慢性腹泻疗效及对肠道微生态的影响

Effect of Qinlian Zhixie Decoction combined with Saccharomyces boulardii powder on chronic diarrhea in children and its influence on intestinal microecology

目的观察芩连止泻汤加减联合布拉氏酵母菌散治疗小儿慢性腹泻的疗效及对患儿肠道微生态的影响。方法将2018年6月—2019年6月沧州市中心医院儿科门诊收治的140例慢性腹泻患儿使用抽签方式分为对照组69例和研究组71例。对照组在常规治疗基础上给予布拉氏酵母菌散治疗,研究组在对照组治疗基础上应用芩连止泻汤加减治疗。观察2组治疗10 d、30 d后腹痛、大便改善情况评估临床疗效,观察2组治疗前及治疗10 d、30 d后免疫功能、肠道菌群数量变化,统计治疗期间不良反应发生率。结果治疗10 d后,研究组大便次数正常率、大便性状正常率、粪便常规正常率均显著高于对照组(P均<0.05);治疗30 d后,研究组粪便常规正常率显著高于对照组(P<0.05)。研究组治疗总有效率为98.6%(70/71),对照组为89.9%(62/69),2组比较差异有统计学意义意义(P<0.05)。治疗10d、30 d后研究组血清IgA、IgG水平,CD4^+占比、CD4^+/CD8^+均显著高于对照组(P均<0.05),CD8^+占比均显著低于对照组(P均<0.05),肠杆菌、肠球菌数量均显著少于对照组(P均<0.05),双歧杆菌、拟杆菌数量均显著多于对照组(P均<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论芩连止泻汤加减联合布拉氏酵母菌散可有效改善慢性腹泻患儿症状及免疫功能,有助于调节肠道微生态,安全可靠。

Objective It is to observe the curative effect of Qinlian Zhixie Decoction combined with Saccharomyces boulardii powder on chronic diarrhea in children and its effect on intestinal microecology.Methods 140 children with chronic diarrhea admitted to the Pediatric Clinic of Cangzhou Central Hospital from June 2018 to June 2019 were divided into the control group with 69 cases and study group with 71 cases by drawing lots.The control group was treated with Saccharomyces boulardii powder on the basis of conventional treatment,and the study group was treated with Qinlian Zhixie Decoction on the basis of the treatment of the control group.The improvement of abdominal pain,stool after 10 days and 30 days of treatment was observed in the two groups,and the clinical efficacy was evaluated.The changes of immune function and intestinal flora in the two groups were observed before treatment and after 10 days,30 days of treatment,the incidence of adverse reactions during treatment was calculated.Results After 10 days of treatment,the normal rate of stool frequency,the normal rate of stool characteristics,and the normal rate of stool routine examination in the study group were significantly higher than those in the control group(P<0.05);after 30 days of treatment,the normal rate of stool routine examination in the study group was significantly higher than that in the control group(P<0.05).The total effective rate of treatment in the study group was 98.6%(70/71),and the rate in the control group was 89.9%(62/69),the difference between the two groups was statistically significant(P<0.05).After 10 days and 30 day of treatment,the levels of serum IgA and IgG,the proportion of CD4^+and CD4^+/CD8^+in the study group were significantly higher than those in the control group(all P<0.05),and the proportion of CD8^+was significantly lower than that in the control group(P<0.05),the quatity of Enterobacter and Enterococcus was significantly less and the quatity of Bifidobacterium and Bacteroides was significantly higher than those of the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Qinlian Zhixie Decoction combined with Saccharomyces boulardii powder can effectively improve the symptoms and immune function of children with chronic diarrhea,it is helpful for regulating the intestinal microecology,and is safe and reliable.