小儿推拿疗法在小儿脾虚质中的应用及其对肠道菌群的调节作用的60例临床观察

Application of pediatric massage therapy in children with spleen deficiency and its regulatory effects on intestinal flora in 60 cases

目的:观察小儿推拿疗法在小儿脾虚质中的应用及其对肠道菌群的调节作用。方法:选择2021年12月-2023年3月就诊的脾虚质患儿60例,随机分为观察组和对照组,每组30例进行比较。对照组指导患儿生活作息、饮食起居等生活习惯,随访2个月,进行证候积分评价,留取便样进行肠道菌群分析,期间患儿出现各类疾病采取对症治疗。观察组在对照组的基础上使用小儿推拿方法进行治疗。观察两组患儿治疗前后便样中肠道菌群、证候积分、疗效;进行肠道菌群16SrDNA扩增子实验并分析。结果:两组治疗后均有较好疗效,证候积分均有改善(P<0.05);观察组肠道菌群中有益菌罗氏菌水平显著提升(P<0.05),有害菌埃希氏杆菌显著减少(P<0.05);治疗后,对照组与观察组罗氏菌与埃希氏杆菌比较差异均具有统计学意义治疗后;观察组疗效更佳。两组治疗后有效率比较差异无统计学意义(P>0.05)。两组治疗前后属水平微生物菌群多样性LEfSe LDA比较显示,对照组治疗后粪杆菌属、罗氏菌属显著升高(P<0.05);与治疗前比较,治疗后埃希氏杆菌的差异无统计学意义(PP>0.05),未被标记。两组治疗前后属水平关键物种差异性比较显示,治疗前,两组的粪杆菌属、埃希氏杆菌属、罗氏菌属的差异均无统计学意义(P>0.05)。治疗后,对照组的粪杆菌属、罗氏菌属显著提升(P<0.05),埃希氏杆菌的差异无统计学意义(P>0.05)。观察组治疗前后粪杆菌属、罗氏菌属显著升高(P<0.05),埃希氏杆菌属显著降低(P<0.05)。治疗后两组粪杆菌属比较差异无统计学意义(P>0.05),观察组罗氏菌属显著升高(P<0.05),埃希氏杆菌属显著降低(P<0.05)。两组治疗前后Alpha多样性显示,对照组治疗前后Coverage指数的差异有统计学意义(P<0.05)。观察组治疗前后Shannon指数、Simpson指数、Coverage指数比较的差异均具有统计学意义(P<0.05)。结论:推拿可以调节肠道菌群状态,提高罗氏菌、粪杆菌等有益菌丰度,通过肠-脑轴的双向调节作用影响人体功能,提高免疫力,因此推测这可能是推拿调理儿童体质的作用机制之一。

Objective:To observe the application of pediatric massage therapy in children with spleen deficiency constitution and its regulatory effect on intestinal flora.Methods:A total of 60 children with spleen deficiency who were treated from December 2021 to March 2023 were randomly divided into the observation group and the control group,with 30 cases in each group for comparison.The control group was instructed on lifestyle habits such as daily routines,diet,and living habits,followed up for 2 months,and underwent syndrome score evaluation.Stool samples were taken for intestinal flora analysis,and symptomatic treatment was given to children with various diseases during the period.The observation group received pediatric massage therapy on the basis of the control group.The intestinal flora in stool samples,syndrome score,and efficacy of treatment before and after treatment were observed in both groups of children;16SrDNA amplification sub-experiments were conducted and analyzed for intestinal flora.Results:Both groups showed good therapeutic effects after treatment,with improvements in syndrome scores(P<0.05).In the observation group,the level of beneficial bacteria Rothia in the gut microbiota significantly increased(P<0.05),while harmful bacteria Escherichia significantly decreased(P<0.05).After treatment,there were statistically significant differences in Rothia and Escherichia levels between the control group and the observation group;the observation group showed better therapeutic effects.There was no statistically significant difference in the effective rate between the two groups after treatment(P>0.05).A comparison of LEfSe LDA of genus-level microbial community diversity before and after treatment in the two groups revealed that the genera of Alculigenes foecalis genus and Rothia significantly genus increased in the control group after treatment(P<0.05).Compared with before treatment,there was no statistically significant difference in Escherichia after treatment(P>0.05),and it was not marked.A comparison of the differences in key genera levels between the two groups before and after treatment revealed that there were no statistically significant differences in the genus of Alculigenes foecalis,Escherichia,and Rothia between the two groups before treatment(P>0.05).After treatment,the levels of Alculigenes foecalis genus and Rothia genus in the control group significantly increased(P<0.05),while there was no statistically significant difference in Escherichia(P>0.05).In the observation group,the levels of Alculigenes foecalis genus and Rothia genus significantly increased(P<0.05)before and after treatment,while the level of Escherichia significantly decreased(P<0.05).After treatment,there was no statistically significant difference in the Alculigenes foecalis genus between the two groups(P>0.05).However,the observation group showed a significant increase in the genus of Rothia(P<0.05)and a significant decrease in the genus of Escherichia(P<0.05).The Alpha diversity before and after treatment in both groups showed that there was a statistically significant difference in the Coverage index in the control group before and after treatment(P<0.05).The differences in Shannon index,Simpson index,and Coverage index before and after treatment in the observation group were statistically significant(P<0.05).Conclusion:Massage can regulate the gut microbiota status,increase the abundance of beneficial bacteria such as Alculigenes foecalis and Rothia,and affect human functions through the bidirectional regulation of the gut-brain axis,thereby enhancing immunity.Therefore,it is speculated that this may be one of the mechanisms of massage in regulating children's physical constitution.