湘西苗医刘氏小儿推拿流派“推五经”对缓解期哮喘患儿肠道菌群的影响  

Effect of Liu′s pediatric tuina school of Xiangxi Miao Medicine“Tui Wu Jing”on intestinal flora in children with asthma in remission stage

作　　者：谭欣欣 李萍 王梦玲 石磊 王鹏[3] 彭南彩 张嘉昕 李中正[1,4] Tan Xinxin;Li Ping;Wang Mengling;Shi Lei;Wang Peng;Peng Nancai;Zhang Jiaxin;Li Zhongzheng(School of Medicine of Jishou University,Jishou Hunan 416000;The First Affiliated Hospital of Jishou University,Jishou Hunan 416000;Hospital of Traditional Chinese Medicine Affiliated to Jishou University,Jishou Hunan 416000;The State Ethnic Committee’s Key Laboratory of Clinical Engineering Laboratory of Xiangxi Miao Pediatric Tuina,Jishou Hunan 416000)

机构地区：[1]吉首大学医学院,湖南吉首416000 [2]吉首大学第一附属医院,湖南吉首416000 [3]吉首大学附属中医院,湖南吉首416000 [4]湘西苗医小儿推拿医工交叉与转化国家民委重点实验室,湖南吉首416000

出　　处：《山西中医药大学学报》2024年第1期38-46,共9页Journal of Shanxi University of Chinese Medicine

基　　金：国家自然科学基金(82004496)。

摘　　要：目的:观察湘西苗医刘氏小儿推拿流派“推五经”治疗缓解期哮喘患儿的疗效及对肠道菌群的影响,并探讨其作用机制。方法:30例健康儿童作为健康组,不予任何干预。将60例缓解期哮喘患儿随机分为健康教育组和推拿组,每组30例。健康教育组采用常规干预和健康教育,推拿组在健康教育组的基础上加用小儿推拿“推五经”,每日1次,每周4次。两组均治疗3个月。比较健康教育组及推拿组治疗前后的中医主要证候积分,采用16SrRNA测序技术检测两组患儿治疗后及健康组的肠道菌群。结果:与本组治疗前比较,推拿组患儿喘憋、胸闷、咳嗽气急、哮鸣音等中医主要证候评分均减少,差异有统计学意义(P<0.05),健康教育组患儿喘憋、胸闷中医主要证候评分减少,差异有统计学意义(P<0.05)。与健康教育组比较,推拿组患儿治疗后喘憋、胸闷、咳嗽气急、哮鸣音等中医主要证候评分均减少更明显(P<0.05)。3组粪便样本肠道菌群物种组成比较,差异有统计学意义(P=0.001);健康教育组患儿肠道菌群丰富度、多样性、均匀度均低于健康组,差异有统计学意义(P<0.05)。治疗后,推拿组患儿红蝽菌纲、红蝽菌目、红蝽菌科、柯林斯菌属、粪球菌属、经黏液真杆菌属、SMB53、乳球菌属、02d06的丰度高于健康教育组,差异有统计学意义(LDA>2,P<0.05)。结论:湘西苗医刘氏小儿推拿流派“推五经”可有效改善缓解期哮喘患儿的中医主要证候,其机制可能与上调肠道有益菌的丰度,调整肠道微生态有关。上调哮喘患儿红蝽杆菌纲、红蝽菌目、粪球菌属的丰度,也为小儿推拿“推五经”可能改善哮喘患儿脑功能失调状态提供了参考依据。Objective:To observe the curative effect of Liu's pediatric tuina school of Xiangxi Miao Medicine“Tui Wu Jing”in the treatment of children with asthma in remission stage and its effect on intestinal flora,and to explore its mechanism.Methods:30 healthy children were selected as the healthy group without any intervention.A total of 60 children with asthma in remission stage were randomly divided into health education group and tuina group,30 cases in each group.The children in the health education group were given routine intervention and health education,and the children in the tuina group were given pediatric tuina“Tui Wu Jing”on the treatment basis of the health education group,once a day,4 times a week.Both groups were treated for 3 months.The main TCM syndrome scores of the health education group and the tuina group before and after treatment were compared.16S rRNA sequencing technology was used to detect the intestinal flora of the two groups after treatment and the healthy group.Results:Compared with those before treatment,the scores of main TCM syndromes such as asthmatic suffocating,chest tightness,cough,shortness of breath and wheezing in the tuina group decreased,and the differences were statistically significant(P<0.05).The scores of main TCM syndromes of asthmatic suffocating and chest tightness in the health education group decreased,and the difference was statistically significant(P<0.05).Compared with the health education group,the tuina group had significant reductions in the scores of main TCM syndromes such as asthmatic suffocating,chest tightness,cough,shortness of breath,and wheezing after treatment(P<0.05).There was a statistically significant difference in the composition of intestinal flora among the three groups(P=0.001).The richness,diversity and evenness of intestinal flora in the health education group were lower than those in the healthy group,and the difference was statistically significant(P<0.05).After treatment,the tuina group had significantly higher abundance of Coriobact

关 键 词：湘西苗医刘氏小儿推拿 哮喘 缓解期 肠道菌群 16SrRNA测序 

分 类 号：R725[医药卫生—儿科] R562[医药卫生—临床医学]