温阳调肠止泻方对重症监护室抗生素相关性腹泻患者肠道菌群及免疫功能的影响

Effect of Wenyang Tiaochang Zhixie Prescription(温阳调肠止泻方)on Intestinal Flora and Immune Function in Patients with Antibiotic-Associated Diarrhea in ICU

目的探讨温阳调肠止泻方对ICU抗生素相关性腹泻患者肠道菌群及免疫功能的影响。方法选择医院2020年1月—2022年12月收治的ICU抗生素相关性腹泻患者120例作为研究对象,采用随机数字表通过简单随机的方法将其分为研究组与对照组每组60例,给予对照组口服双歧杆菌四联活菌片治疗,研究组在对照组的基础上,给予温阳调肠止泻方口服治疗,两组均治疗14 d。比较两组患者中医证候疗效、治疗前后中医症状积分、肠道菌群(双歧杆菌、肠杆菌、乳杆菌、肠球菌)变化情况以及免疫功能指标[免疫球蛋白A(Immunoglobulin A,IgA)、免疫球蛋白M(Immunoglobulin M,IgM)、T细胞亚群(CD^(+)_(3)、CD^(+)_(4)、CD^(+)_(8))]变化情况以及不良反应发生情况。结果两组治疗后中医证候积分均较本组治疗前明显降低,研究组明显低于对照组(P<0.05),研究组与对照组总有效率分别为86.67%和71.67%(P<0.05),研究组双歧杆菌、乳杆菌及肠杆菌水平高于对照组(P<0.05),两组治疗后肠球菌水平比较差异无统计学意义(P>0.05),治疗后两组IgA、IgM、CD^(+)_(3)、CD^(+)_(4)水平均较本组治疗前明显升高,其中研究组高于对照组(P<0.05),两组CD+8水平均较本组治疗前降低,研究组低于对照组(P<0.05),两组治疗期间均未见明显不良反应。结论温阳调肠止泻方治疗ICU抗生素相关性腹泻疗效显著,能有效降低患者中医证候积分,对改善肠道菌群和提高患者免疫功能具有显著效果,适合推广应用。

Objective To investigate the effects of Wenyang Tiaochang Zhixie Prescription(温阳调肠止泻方)on intestinal flora and immune function in patients with antibiotic-associated diarrhea in intensive care unit(ICU).Methods A total of 120 patients with antibiotic-associated diarrhea in ICU admitted to the hospital from January 2020 to December 2022 were selected as the research objects.By simple random number table,they were divided into study group and control group with 60 cases in each group.The control group was given oral Bifidobacterium Quadruplex Viable Tablets.Both groups were given oral treatment with Wenyang Tiaochang Zhixie Prescription for 14 days.The TCM syndrome efficacy,TCM symptom scores before and after treatment,changes of intestinal flora(Bifidobacterium,Enterobacterium,Lactobacillus,Enterococcus),changes of immune function indexes[immunoglobulin(IgA,IgM),T cell subsets(CD^(+)_(3),CD^(+)_(4),CD^(+)_(8))]and the occurrence of adverse reactions were compared between the two groups.Results After treatment,TCM syndrome scores in both groups were significantly lower than those before treatment,and the scores of the study group were significantly lower than those of the control group(P<0.05).The total effective rate of the study group and the control group was 86.67%and 71.67%(P<0.05),respectively.The levels of Bifidobacterium,Lactobacillus and Enterobacter in the study group were higher than those in the control group(P<0.05).There was no signifi-cant difference in Enterococcus level between the two groups after treatment(P>0.05).The levels of immunoglobulin A(IgA),immunoglobulin M(IgM),CD^(+)_(3)and CD^(+)_(4)in the two groups after treatment were significantly higher than those before treatment,and the level of CD+8 in the study group was higher than that in the control group(P<0.05),and the level of CD^(+)_(8) in both groups was lower than that before treatment.The level of the study group was lower than that of the control group(P<0.05),and no ob-vious adverse reactions were observed in both groups during treatment.Conclusion Wenyang Tiaochang Zhixie Prescription has significant efficacy in the treatment of antibiotic-associated diarrhea in ICU,effectively reduces the TCM syndrome scores of pa-tients,and has significant effect on improving intestinal flora and immune function of patients,so it is suitable for popularization and application.