Objective:Gastrointestinal heat retention syndrome(GHRS)is associated with lung-heat syndrome and is related to recurrent respiratory infection.Upper respiratory tract infection(URTI)lung heat syndrome is common in ch...Objective:Gastrointestinal heat retention syndrome(GHRS)is associated with lung-heat syndrome and is related to recurrent respiratory infection.Upper respiratory tract infection(URTI)lung heat syndrome is common in children.The study will explore the effect of GHRS on the structure and function of gut microbiota in children with URTI lung-heat syndrome.Methods:Participants were divided into both groups using the self-developed URTI scale and the“GHRS Diagnostic Scale$Pediatric Part”:GHRS-positive children(LS group)and GHRS-negative children(L group).General information,clinical symptoms,and stool were collected.We used 16S rRNA amplicon sequencing technology to determine the gene sequence of the V3eV4 region in feces and measure the gut microbiota of the both groups at the genus level.Results:A total of 23 children were included in the both groups.There were 12 cases in the LS group and 11 cases in the L group.There was no statistical difference between the both groups in age,gender,height,weight,and body mass index.The effective sequences shared by the both groups accounted for 85.66%of the total.In the gut microbiota,there was no difference in the a diversity and the b diversity between the both groups.Compared with the L group,the LS group had a significant increase in the relative abundance of the Ruminococcus gnavus group,Prevotella-9,Staphylococcus,and Actinomyces(P<.05).The functions of the both groups of microbiota primarily concentrate on metabolism,genetic information processing,and environmental information processing.The relative abundance of signaling molecules and interactions in the LS group were higher than that in the L group(P<.05).The redundancy analysis(RDA)showed that the URTI score had the greatest impact on the distribution of microbiota.Conclusion:GHRS may affect the development of URTI lung-heat syndrome by changing the relative abundances of gut microbiota.展开更多
【目的】评价加味普济消毒颗粒(由金银花、连翘、蒲公英、紫花地丁、荆芥、牛蒡子、皂角刺、赤芍、牡丹皮、芦根等组成)内服联合消肿散结膏(由黄芩、黄连、黄柏、皂角刺等组成)外敷治疗儿童急性扁桃体炎(acute tonsillitis in children,...【目的】评价加味普济消毒颗粒(由金银花、连翘、蒲公英、紫花地丁、荆芥、牛蒡子、皂角刺、赤芍、牡丹皮、芦根等组成)内服联合消肿散结膏(由黄芩、黄连、黄柏、皂角刺等组成)外敷治疗儿童急性扁桃体炎(acute tonsillitis in children,ATC)的临床疗效及对免疫功能与相关炎症指标的影响。【方法】将116例ATC肺胃郁热证患儿随机分为对照组和观察组,每组各58例。对照组给予头孢克肟分散片治疗,观察组给予加味普济消毒颗粒内服联合消肿散结膏外敷治疗,疗程为14 d并随访6个月。观察2组患儿治疗前后中医证候积分、外周血中白细胞计数(WBC)、T淋巴细胞亚群CD3^(+)、CD4^(+)、CD8^(+)和CD4^(+)/CD8^(+)水平及血清肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、C反应蛋白(CRP)水平的变化情况,比较2组患儿的临床疗效和各项临床症状消失时间,同时监测2组患儿的不良反应发生情况和扁桃体炎复发情况。【结果】(1)研究期间,对照组有8例患儿脱落,观察组无脱落病例,最终对照组50例、观察组58例患儿完成全部疗程的治疗。(2)治疗14 d后,观察组的总有效率为98.28%(57/58),对照组为90.00%(45/50);组间比较(秩和检验),观察组的临床疗效明显优于对照组(P<0.05)。(3)治疗后,观察组患儿的咽痛消失时间、脓点消失时间、退热时间及扁桃体恢复正常时间均较对照组明显缩短(P<0.05)。(4)治疗后,2组患儿的主症积分、次症积分和中医证候总积分均较治疗前明显降低(P<0.05),且观察组的降低幅度均明显优于对照组(P<0.05)。(5)治疗后,2组患儿的T淋巴细胞亚群CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平均较治疗前明显升高(P<0.05),CD8^(+)水平均较治疗前明显降低(P<0.05),且观察组对T淋巴细胞亚群CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平的升高幅度及对CD8^(+)水平的降低幅度均明显优于对照组(P<0.05)。(6)治疗后,2组患儿的WBC、TNF-α、IL-1β、IL-6及CRP水平均较治疗前明显降低(P<0.05),且观察组的降低幅度均明显优于对照组(P<0.05)。(7)治疗期间,2组患儿均未出现皮肤过敏及恶心、呕吐等胃肠道不良反应情况,具有较高的安全性。(8)随访6个月,观察组患儿的扁桃体炎复发率为5.17%(3/58),明显低于对照组的24.00%(12/50),组间比较,差异有统计学意义(χ2=8.330,P<0.05)。【结论】加味普济消毒颗粒内服联合消肿散结膏外敷治疗ATC肺胃郁热证患儿疗效显著,可明显缩短病程,改善临床症状,有效降低扁桃体炎复发率,其机制可能与增强机体免疫功能、抑制炎症反应有关。展开更多
基金This study was financially supported by the National Key R&D Program of China(2018YFC1704100 and 2018YFC1704101)Beijing Municipal Natural Science Foundation(7172131).
文摘Objective:Gastrointestinal heat retention syndrome(GHRS)is associated with lung-heat syndrome and is related to recurrent respiratory infection.Upper respiratory tract infection(URTI)lung heat syndrome is common in children.The study will explore the effect of GHRS on the structure and function of gut microbiota in children with URTI lung-heat syndrome.Methods:Participants were divided into both groups using the self-developed URTI scale and the“GHRS Diagnostic Scale$Pediatric Part”:GHRS-positive children(LS group)and GHRS-negative children(L group).General information,clinical symptoms,and stool were collected.We used 16S rRNA amplicon sequencing technology to determine the gene sequence of the V3eV4 region in feces and measure the gut microbiota of the both groups at the genus level.Results:A total of 23 children were included in the both groups.There were 12 cases in the LS group and 11 cases in the L group.There was no statistical difference between the both groups in age,gender,height,weight,and body mass index.The effective sequences shared by the both groups accounted for 85.66%of the total.In the gut microbiota,there was no difference in the a diversity and the b diversity between the both groups.Compared with the L group,the LS group had a significant increase in the relative abundance of the Ruminococcus gnavus group,Prevotella-9,Staphylococcus,and Actinomyces(P<.05).The functions of the both groups of microbiota primarily concentrate on metabolism,genetic information processing,and environmental information processing.The relative abundance of signaling molecules and interactions in the LS group were higher than that in the L group(P<.05).The redundancy analysis(RDA)showed that the URTI score had the greatest impact on the distribution of microbiota.Conclusion:GHRS may affect the development of URTI lung-heat syndrome by changing the relative abundances of gut microbiota.
