健脾祛湿方敷脐联合脊柱推拿对小儿腹泻(脾虚湿盛证)肠黏膜屏障功能、肠道菌群和促炎因子的影响

Effects of Umbilical Application for Strengthening Spleen and Dispelling Dampness Decoction Combined with Spinal Massage on Intestinal Mucosal Barrier Function,Intestinal Flora and Pro-Inflammatory Factors in Children with Diarrhea(Spleen Deficiency and Dampness Syndrome)

目的:探讨健脾祛湿方敷脐联合脊柱推拿对小儿腹泻(脾虚湿盛证)肠黏膜屏障功能、肠道菌群和促炎因子的影响。方法:将2019年1月至2020年6月于解放军总医院第八医学中心住院治疗的小儿腹泻(脾虚湿盛证)患者106例纳为研究对象,分为对照组和中医联合组,分组方法采用随机数字表法。对照组患儿进行调整饮食方案、口服补液盐和脊柱推拿等基础对症治疗,中医联合组患儿在对照组的基础上进行健脾祛湿方敷脐治疗。两组患儿均连续治疗7 d。观察两组患儿的临床疗效,治疗前后中医症状积分、肠黏膜屏障功能、肠道菌群变化情况和促炎因子含量变化情况。结果:治疗后,两组患儿各项中医症状积分均降低,且中医联合组明显低于对照组,差异均有统计学意义(P<0.05)。中医联合组患儿的总有效率为94.34%(50/53),明显高于对照组(81.13%,43/53),差异有统计学意义(P<0.05)。治疗后,两组患儿血清D-乳酸和二胺氧化酶(DAO)含量均明显低于治疗前,肠道菌群中各菌群含量均明显高于治疗前,白细胞介素6(IL-6)、白细胞介素8(IL-8)和肿瘤坏死因子α(TNF-α)含量均明显低于治疗前;且中医联合组患儿血清D-乳酸和DAO含量明显低于对照组,各菌群含量明显高于对照组,IL-6、IL-8和TNF-α含量明显低于对照组,上述差异均有统计学意义(P<0.05)。结论:健脾祛湿方敷脐联合脊柱推拿对小儿腹泻的疗效较好,可有效增强患儿的肠黏膜屏障功能,调节肠道菌群平衡,抑制促炎因子分泌,促进患儿康复。

OBJECTIVE:To probe into the effects of umbilical application for strengthening spleen and dispelling dampness decoction combined with spinal massage on intestinal mucosal barrier function,intestinal flora and pro-inflammatory factors in children with diarrhea(spleen deficiency and dampness syndrome).METHODS:Totally 106 children with diarrhea(spleen deficiency and dampness syndrome)admitted into the Eighth Medical Center of PLA General Hospital from Jan.2019 to Jun.2020 were extracted to be divided into the control group and the traditional Chinese medicine combined group via the random number table.Children in the control group received basic symptomatic treatments such as dietary adjustment,oral rehydration salts and spinal massage,while the traditional Chinese medicine combined group was given umbilical application for strengthening spleen and dispelling dampness decoction on the basis of the control group.Both groups were treated for 7 d.Clinical efficacy,traditional Chinese medicine symptom score,intestinal mucosal barrier function,changes of intestinal flora and pro-inflammatory factors before and after treatment were observed in two groups.RESULTS:After treatment,the traditional Chinese medicine symptom scores of two groups were lower than those before treatment,and the traditional Chinese medicine combined group was significantly lower than the control group,with statistically significant difference(P<0.05).The total effective rate of traditional Chinese medicine combined group was 94.34%(50/53),significantly higher than 81.13%(43/53)of the control group,the difference was statistically significant(P<0.05).After treatment,the levels of serum D-lactic acid and DAO in two groups were lower than those before treatment,the intestinal flora was significantly higher than those before treatment,and the levels of IL-6,IL-8 and TNF-α were significantly lower than those before treatment;the levels of serum D-lactic acid and DAO in traditional Chinese medicine combined group were significantly lower than those in control group,and the intestinal flora was significantly higher than those in control group,while the levels of IL-6,IL-8 and TNF-α were significantly lower than those in control group,with statistically significant differences(P<0.05).CONCLUSIONS:The efficacy of umbilical application for strengthening spleen and dispelling dampness decoction combined with spinal massage on intestinal mucosal barrier function,intestinal flora and pro-inflammatory factors in children with diarrhea is significant,which can effectively enhance the intestinal mucosal barrier function of children,regulate the balance of intestinal flora,inhibit the secretion of pro-inflammatory factors and promote the recovery of children.