温脾止泻散敷脐联合捏脊疗法对儿童脾虚湿盛型腹泻患儿肠黏膜屏障功能、肠道菌群及细胞免疫水平影响  

Effect of Wenpi Zhixie Powder on Intestinal Mucosal Barrier Function,Intestinal Microflora and Cellular Immune Level in Children with Syndrome Due to Spleen Deficiency and Dampness

作　　者：苏家辉[1] 刘翠瑛[1] SU Jiahui;LIU Cuiying(Foshan Traditional Chinese Medicine Hospital,Foshan 528000,Guangdong,China)

机构地区：[1]佛山市中医院,广东佛山528000

出　　处：《辽宁中医药大学学报》2020年第6期136-139,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：广东省医学重点科技攻关计划(2017-YS001332-17)。

摘　　要：目的探讨温脾止泻散敷脐联合捏脊疗法对儿童脾虚湿盛型腹泻患儿肠黏膜屏障功能、肠道菌群及细胞免疫水平的影响。方法选择医院儿科门诊2017年2月—2018年4月收治的110例符合临床试验标准的患儿作为研究对象,采用随机数字表法进行分组,随机分为中医组和对照组,每组各55例。对照组给予双歧杆菌四联活菌片治疗,中医组在对照组基础上给予温脾止泻散敷脐联合捏脊疗法,比较治疗前后肠黏膜屏障功能、肠道菌群及细胞免疫水平,并评价临床疗效。结果肠道菌群比较:治疗后两组双歧杆菌、乳酸肝菌均有明显提高(P<0.05),葡萄球菌、大肠杆菌均有明显降低(P<0.05),且中医组双歧杆菌、乳酸肝菌显著高于对照组(P<0.05),葡萄球菌、大肠杆菌显著低于对照组(P<0.05);细胞免疫水平比较:治疗后两组CD3^+、CD4^+、CD4^+/CD8^+、自然杀伤细胞(natural killer cell,NK)明显升高(P<0.05),CD8+明显降低(P<0.05),且中医组CD3^+、CD4^+、CD4^+/CD8^+、NK高于对照组(P<0.05),CD8^+低于对照组(P<0.05);肠黏膜屏障功能比较:治疗后两组内毒素、乳果糖/甘露醇(lactulose/mannitol,L/M)、二胺氧化酶(Diamine oxidase,DAO)、D-乳酸均明显降低(P<0.05),且中医组显著低于对照组(P<0.05)。治疗后两组中医证候积分明显降低(P<0.05),且中医组显著低于对照组(P<0.05)。中医组总有效率90.91%显著高于对照组76.36%(P<0.05),治疗过程中两组均未发生明显不良反应。结论温脾止泻散敷脐联合捏脊疗法治疗儿童腹泻效果显著,能显著缓解症状,促进肠黏膜屏障功能恢复,改善肠道菌群紊乱,提高患儿免疫功能。Objective To investigate the effects of Wenpi Zhixie Powder on intestinal mucosal barrier function,intestinal flora and cellular immunity in children with spleen deficiency and dampness syndrome diarrhea. Methods 110 children who met the clinical trial criteria from February 2017 to April 2018 in the pediatric clinic of our hospital were selected as the research objects and divided into two groups by random number table method. They were randomly divided into two groups:the traditional Chinese medicine group and the control group,with 55 cases in each group. The control group was treated with Bifidobacterium tetralogy live bacteria tablets,while the Chinese medicine group was treated with Wenpi Zhixie Powder combined with umbilical cord massage on the basis of the control group. The intestinal mucosal barrier function,intestinal flora and cellular immunity levels were compared before and after treatment,and the clinical efficacy was evaluated. Results Compared with the control group,the intestinal flora of the two groups increased significantly after treatment(P<0.05),Staphylococcus and Escherichia coli decreased significantly(P<0.05),and the levels of Bifidobacterium and Lactobacillus in the TCM group were significantly higher than those in the control group(P<0.05),while the levels of Staphylococcus and Escherichia coli were significantly lower than those in the control group(P<0.05). Comparisons of cellular immunity:After treatment,CD3^+,CD4^+,CD4^+/CD8^+,NK in the two groups increased significantly(P<0.05),CD8+ decreased significantly(P<0.05),and CD3^+、CD4^+、CD4^+/CD8^+ NK in the TCM group were higher than those in the control group(P<0.05),while CD8^+ was lower than that in the control group(P<0.05).Comparison of intestinal mucosal barrier function:After treatment,endotoxin,L/M,DAO and D-lactic acid in the two groups were significantly decreased(P<0.05),and the TCM group was significantly lower than the control group(P<0.05). After treatment,the scores of TCM symptoms in the two groups decreased signific

关 键 词：腹泻 儿童 温脾止泻散 捏脊疗法 肠黏膜屏障功能 肠道菌群 细胞免疫 

分 类 号：R512.5[医药卫生—内科学]