丁桂儿脐贴联合蒙脱石散治疗泄泻患儿的效果及对肠道菌群的影响

Curative effect of Dingguier Umbilical Paste combined with montmorillonite powder on diarrhea children and its influences on gastrointestinal floras

目的:探讨丁桂儿脐贴联合蒙脱石散治疗泄泻患儿的效果及对肠道菌群的影响。方法:将2018年6月-2020年6月收治的204例泄泻患儿随机分为研究组与对照组,各102例。对照组给予蒙脱石散治疗,研究组给予丁桂儿脐贴联合蒙脱石散治疗。观察比较两组患儿治疗后的临床疗效,记录两组患儿的大便性状改善时间及泄泻停止时间,比较两组患儿治疗前后的中医证候积分、肠道菌群(肠杆菌、双歧杆菌、乳酸杆菌)、二胺氧化酶(diamine oxidase,DAO)、D-乳酸、炎症因子(IL-6、IL-8、TNF-α)及免疫功能指标(IgG、IgM和IgA)的变化。比较两组患儿用药后的不良反应情况。结果:治疗后,研究组患儿的总有效率(92.16%)较对照组(82.35%)高,差异有统计学意义(P<0.05);研究组及对照组患儿的中位大便性状改善时间分别为44 h、48 h,差异有统计学意义(P<0.05),研究组及对照组患儿的中位腹泻停止时间分别为47 h、55 h,差异有统计学意义(P<0.05);研究组患儿的中医证候积分明显低于对照组,差异有统计学意义(P<0.05);研究组患儿的肠杆菌数量、D-乳酸、DAO、IL-6、IL-8以及TNF-α水平均明显低于对照组,均差异有统计学意义(均P<0.05),双歧杆菌、乳酸杆菌数量及血清IgG、IgM、IgA水平明显高于对照组,均差异有统计学意义(P<0.05);研究组和对照组患儿治疗期间的不良反应发生率分别为3.92%、7.84%,差异无统计学意义(P>0.05)。结论:泄泻患儿采用丁桂儿脐贴联合蒙脱石散治疗的疗效显著,能有效改善患儿的临床症状,增强肠道屏障功能,改善肠道菌群平衡,提高免疫力,降低机体炎症反应,且具有较高的安全性。

Objective:To explore the curative effect of Dingguier Umbilical Paste combined with montmorillonite powder on diarrhea children and its influences on gastrointestinal floras.Methods:A total of 204 children with diarrhea in the hospital were randomly divided into study group and control group between June 2018 and June 2020,102 cases in each group.The control group was given montmorilonite powder,while study group was given Dingguier Umbilical Paste and montmorillonite powder.The clinical curative effect after treatment was observed and compared between the two groups.The improvement time of stool property and disappearance time of diarrhea in both groups were recorded.The changes in scores of Traditional Chinese Medicine syndromes,intestinal floras(Enterobacter,Bifidobacterium,Lactobacillus),diamine oxidase(DAO),D-lactic acid,inflammatory factors(IL-6,IL-8,TNF-α)and immune function indexes(IgG,IgM,IgA)before and after treatment,and adverse reactions after medication were compared between the two groups.Results:After treatment,total response rate of treatment was higher in the study group than the control group(92.16%vs 82.35%,P<0.05).The differences in median improvement time of stool property between the study group and the control group were statistically significant(44 h vs 48 h,P<0.05),and differences in median disappearance time of diarrhea between the study group and the control group were statistically significant(47 h vs 55 h,P<0.05).The scores of Traditional Chinese Medicine syndromes in study group were significantly lower than those in the control group(P<0.05).The count of Enterobacteriaceae,and levels of D-lactic acid,DAO,IL-6,IL-8 and TNF-αin study group were significantly lower than those in the control group,while counts of Bifidobacterium and Lactobacllus,and levels of serum IgG,IgM and IgA were significantly higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions during treatment between the study group and the control group(3.92%vs 7.84%,P>0.05).Conclusion:Curative effect of Dingguier Umbilical Paste combined with montmorillonite powder is significant on diarrhea children,which can effectively improve clinical symptoms,enhance intestinal barrier function,improve the balance of intestinal floras,enhance immunity and reduce inflammatory response,with high medicationsafety.