运脾止泻方结合神阙灸治疗小儿泄泻临床效果观察

Observation on Clinical Effect of Yunpi Zhixie Prescription(运脾止泻方)Combined with Shenque(RN8)Moxibustion in Treatment of Diarrhea in Children

目的观察运脾止泻方结合神阙灸治疗小儿泄泻临床效果。方法本次合计纳入79例泄泻患儿(2020年7月—2022年10月)进行研究,以随机数字表法分成参照组与观察组,分别为39例、40例,参照组患儿采取基础治疗+蒙脱石散治疗,观察组患儿在参照组治疗基础上联合运脾止泻方及神阙灸治疗,数据观察:患儿临床疗效、止泻时间及腹痛消失时间、大便正常时间、大便质地及大便质量、大便性状评分、治疗前后患儿中医证候(大便稀薄、形体消瘦、面色萎黄、神疲倦怠等)积分变化、C反应蛋白(C-reactive protein,CRP)水平变化、治疗前后患儿肠道菌群(肠球菌、酵母真菌、乳杆菌)变化情况、用药不良反应情况以及患儿家属治疗满意率。结果参照组患儿治疗总有效率为82.05%(32/39),低于观察组患儿97.50%(39/40),P<0.05;与参照组患儿比较,观察组止泻时间及腹痛消失时间、大便正常时间均更短,大便质地及大便质量、大便性状评分均更佳,P均<0.05;两组患儿治疗前中医证候(大便稀薄及形体消瘦、面色萎黄、神疲倦怠等)积分及CRP水平比较,P>0.05,两组患儿治疗后中医证候(大便稀薄及形体消瘦、面色萎黄、神疲倦怠等)积分、CRP水平均改善,治疗后观察组患儿中医证候(大便稀薄及形体消瘦、面色萎黄、神疲倦怠等)积分、CRP水平优于参照组患儿,P<0.05;治疗前各组患儿肠道菌群(肠球菌、酵母真菌、乳杆菌)比较,P>0.05,治疗后各组患儿肠球菌与乳杆菌均显著上升,而酵母真菌均下降,观察组患儿治疗后肠球菌与乳杆菌数量多于参照组,酵母真菌比参照组少,P<0.05;观察组患儿无不良反应(0.00%),参照组出现1例呕吐(2.56%),可自行缓解,P>0.05;观察组患儿家属满意率(97.50%,39/40)显著高于参照组患儿家属满意率(82.05%,32/39),P<0.05。结论运脾止泻方结合神阙灸治疗小儿泄泻临床效果显著,可较好改善患儿肠道菌群情况,从而改善患儿的临床症状,提升治疗效果,治疗安全可靠,患儿家属较为认可,值得应用。

Objective To observe the clinical effect of Yunpi Zhixie Prescription(运脾止泻方)combined with Shenque(RN8)moxibustion on children with diarrhea.Methods A total of 79 children with diarrhea(from July 2020 to October 2022)were included in this study.The children were divided into the reference group and the observation group by random number table method,with 39 cases and 40 cases respectively.The reference group received basic treatment and montmorillonite powder and the observation group received Yunpi Zhixie Prescription(运脾止泻方)combined with Shenque(RN8)moxibustion on the basis of the reference group.The data observation included the clinical efficacy,the time for stopping diarrhea and disappearance of abdominal pain,the normal bowel movement time,stool texture and quality,stool trait score,the scores of traditional Chinese medicine symptoms(thin stool,thin body,pale complexion,fatigue,etc.)before and after treatment,the levels of C-reactive protein(CRP),the changes in gut microbiota(enterococcus,yeast fungi,lactobacilli)before and after treatment,the side effects of medication and satisfaction rate with treatment among family members of the patients.Results The total effective rate in the reference group was 82.05%(32/39),lower than that in the observation group[97.50%(39/40)](P<0.05).Compared with the control group,the observation group had shorter time for stopping diarrhea,disappearance of abdominal pain and normal bowel movements,and better stool texture,stool quality and stool character scores(all P<0.05).The scores of traditional Chinese medicine symptoms(thin stool,thin body,pale complexion,fatigue,etc.)and CRP levels in the two groups were not significant before treatment(P>0.05),and the scores of TCM syndrome(thin stool and thin body,pale complexion,lethargy,etc.)and CRP levels in the two groups were improved after treatment.After treatment,the scores of TCM symptoms and CRP levels in the observation group were better than those in the reference group(P<0.05).The intestinal flora(enterococcus,yeast fungi and lactobacillus)of children in two groups before treatment was not significant(P>0.05).After treatment,enterococcus and lactobacillus were significantly increased,while yeast fungi was decreased.The number of enterococcus and lactobacillus in the observation group was more than that in the reference group,and yeast fungi was less than that in the reference group(P<0.05).In the observation group,there was no adverse reaction(0.00%),and in the reference group,there was 1 case of vomiting(2.56%),which could be relieved by itself(P>0.05).The satisfaction rate of family members in the observation group(97.50%,39/40)was significantly higher than that in the reference group(82.05%,32/39)(P<0.05).Conclusion The clinical effect of Fengpi Zhixie Prescription combined with Shenque(RN8)moxibustion in the treatment of diarrhea in children is significant,which can effectively improve the intestinal flora of children,thereby improving the clinical symptoms and enhancing treatment effectiveness.The treatment is safe and reliable and is well recognized by the families of the children,making it worth applying.