加味四神汤联合腹部电针治疗重症患者抗生素相关性腹泻的疗效观察

Curative Effect of Modified Sishen Decoction Combined with Abdominal EA in Treatment of AAD in Critical Patients

目的:探讨加味四神汤联合腹部电针治疗重症患者抗生素相关性腹泻(脾肾阳虚证)的临床疗效。方法:将48例重症科病房收治的抗生素相关性腹泻(脾肾阳虚证)患者按随机数字表法分为治疗组和对照组,各24例。两组患者均给予内科基础治疗,对照组给予蒙脱石散联合双歧杆菌四联活菌片口服治疗,治疗组给予加味四神汤联合腹部电针,两组均治疗7 d。观察并比较两组治疗前后中医证候积分,肠道菌群(乳酸杆菌、双歧杆菌、肠球菌数量及球杆菌比值)和降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)水平,评估两组患者临床疗效及安全性。结果:治疗组临床总有效率83.33%(20/24)明显优于对照组66.67%(16/24)(P<0.05);两组患者治疗后中医证候积分、PCT、hs-CRP、IL-6水平明显降低(P<0.05),且治疗组显著低于对照组(P<0.05);治疗后两组乳酸杆菌和双歧杆菌数量升高,肠球菌数量、球/杆菌比值降低(P<0.05),且治疗组的变化幅度显著优于对照组(P<0.05)。结论:加味四神汤联合腹部电针治疗重症患者抗生素相关性腹泻有较好的临床疗效,能调节肠道菌群,降低炎性反应,改善临床症状,安全可靠,值得临床推广。

Objective:To explore the clinical efficacy of Modified Sishen Decoction combined with abdominal electro-acupuncture(EA)in treatment of antibiotic-associated diarrhea(ADD)of Yang-deficiency of Spleen and Kidney.Methods:48 critical patients with AAD of Yang-deficiency of Spleen and Kidney were randomly divided into the treatment group and the control group,with 24 patients in each group.Both groups were given basic medical treatment.In addition,the control group was given Montmorillonite Powder combined with Bifidobacterium Tetramethasone Viable Tablet,and the treatment group was treated with modified Sishen Decoction combined with abdominal EA.After 7 days of treatment,TCM symptom score,and the levels of intestinal flora(lactobacillus,bifidoba-cterium,enterococcus and coccidium ratio),procalcitonin(PCT),hS-CRP and interleukin-6(IL-6)were compared between the two groups.Clinical efficacy and therapy safety were also compared between the two groups.Results:The total effective rate was 83.33%(20/24)in the treatment group,which was significantly higher than 66.67%(16/24)in the control group(P<0.05).The score of TCM symptom and the levels of PCT,hs-CRP and IL-6 were significantly decreased after the treatment in the two groups(P<0.05);of which the treatment group was lower than the control group(P<0.05).The number of lactobacillus and bifidobacterium were increased,whereas the number of enterococcus and the ration of enterococcus and coccidium were decreased after the treatment in the two groups(P<0.05),and changes in the treatment group were more significant than those in the control group(P<0.05).Conclusion:Modified Sishen Decoction combined with abdominal EA has a good clinical efficacy in treatment of AAD,which can regulate intestinal flora and decrease inflammatory responses to improve clinical symptoms.It is safe and reliable and worthy of clinical promotion.