暖脐散神阙贴敷对脾虚型泄泻患儿肠道微生态及胃肠功能的影响

Effects of Application of Nuanqi Powder at Shenque(CV 8)on the Intestinal Microecology and Gastrointestinal Function in Children with Diarrhea due to Spleen Deficiency

目的 探讨暖脐散神阙贴敷治疗小儿脾虚型泄泻临床价值。方法 选取2020年2月—2022年2月期间河南中医药大学第一附属医院收治的脾虚型泄泻患儿86例,采用随机数字表法分为对照组与试验组,每组各43例。对照组给予常规治疗,试验组在对照组基础上联合暖脐散神阙贴敷,治疗7 d。观察比较两组患儿症状缓解情况、疾病疗效、治疗安全性及治疗前后肠道微生态变化、胃肠功能指标[胃泌素(Gastrin, GAS)、5-羟色胺(5-hydroxytryptamine, 5-HT)、血管活性肠肽(Vasoactive intestinal peptide, VIP)]水平及不良反应情况。结果 治疗后试验组腹痛缓解、腹泻停止、呕吐停止与大便正常时间短于对照组,差异有统计学意义(P<0.05)。治疗后试验组疾病疗效总有效率95.35%(41/43)高于对照组81.40%(35/43),差异有统计学意义(P<0.05)。治疗后两组患儿双歧杆菌、乳杆菌、拟杆菌含量较治疗前增高,粪球菌、大肠杆菌、葡萄球菌、韦荣球菌含量较治疗前降低,差异有统计学意义(P<0.05),且试验组患儿双歧杆菌、乳杆菌、拟杆菌含量高于对照组,粪球菌、大肠杆菌、葡萄球菌、韦荣球菌含量低于对照组,差异有统计学意义(P<0.05)。治疗后两组患儿GAS水平较治疗前增高,5-HT、VIP水平较治疗前降低,差异有统计学意义(P<0.05);且试验组患儿GAS水平高于对照组,5-HT、VIP水平低于对照组,差异有统计学意义(P<0.05)。两组患儿均未发生严重不良反应。结论 暖脐散神阙贴敷治疗小儿脾虚型泄泻效果显著,有利于缓解泄泻相关症状,改善患儿肠道微生态环境与胃肠功能,且安全性较高。

Objective To explore the clinical value of the application of Nuanqi Powder at Shenque(CV 8)in the treatment of diarrhea due to spleen deficiency in children.Methods A total of 86 children with diarrhea(syndrome of spleen deficiency)treated in the First Affiliated Hospital of Henan University of Chinese Medicine from February 2020 to February 2022 were selected and assigned into control and observation groups(n=43)according to the random number ta-ble method.The control group received routine treatment,and the observation group additionally received application of Nu-anqi Powder at Shenque(CV 8).The treatment lasted for 7 days.The time to symptom relief,efficacy,and safety(adverse reactions)were compared between the two groups.The intestinal flora changes and gastrointestinal function indicators[gas-trin(GAS),5-hydroxytryptamine(5-HT),and vasoactive intestinal peptide(VIP)]were determined before and after treatment.Results The time to the relief of abdominal pain,diarrhea,vomiting and the recovery of normal stool in the ob-servation group was shorter than that in the control group(P<0.05).The observation group had higher total effective rate than the control group[95.35%(41/43)vs.81.40%(35/43),P<0.05].The treatment in both groups increased the counts of Bifidobacterium,Lactobacillus,and Bacteroides and decreased the counts of Coprococcus,Escherichia coli,Staph-ylococcus,and Veillonella(P<0.05),and the changes in the observation group were more significant than those in the control group(P<0.05).The treatment in both groups elevated the GAS level and lowered the 5-HT and VIP levels(P<0.05).Moreover,the observation group had higher GAS level and lower 5-HT and VIP levels than the control group(P<0.05).Neither group showed severe adverse reactions.Conclusion The application of Nuanqi Powder at Shenque(CV 8)relieved the diarrhea-related symptoms,restored the intestinal microenvironment,and improved the gastrointesti-nal function in the children with diarrhea due to spleen deficiency and demonstrated high safety.