基于脑-肠轴研究葛根止泻汤联合针灸对腹泻患儿的临床研究  

Clinical Study on Gegen Zhixie Decoction Combined with Acupuncture in the Treatment of Pediatric Diarrhea Based on the Brain-Gut Axis

作　　者：李红梅 历松 王艳玲 LI Hongmei;LI Song;WANG Yanling(Department of Pediatrics,Qinhuangdao Chinese Medicine Hospital,Qinhuangdao 066003,China)

机构地区：[1]秦皇岛市中医医院儿科,河北秦皇岛066003

出　　处：《中医药学报》2025年第4期97-101,共5页Acta Chinese Medicine and Pharmacology

基　　金：河北省中医药管理局科研计划项目(2022536)。

摘　　要：目的:基于脑-肠轴研究葛根止泻汤联合针灸对腹泻患儿肠黏膜屏障、肠道菌群及脑肠肽SP、促肾上腺皮质激素释放激素(CRH)、促肾上腺皮质激素(ACTH)的影响。方法:选择2022年1月—2023年1月于秦皇岛市中医医院治疗的80例泄泻患儿,采用随机数字表法分为基础组和中医联合组,每组40例,基础组给予常规西医治疗,中医联合组在基础组治疗基础上给予患儿葛根止泻汤及针灸治疗,治疗后比较两组临床疗效,观察两组治疗前后中医证候评分,检测肠道微生态肠球菌、葡萄球菌、乳酸菌数量,测定D-乳酸、P物质(SP)、二胺氧化酶、5-羟色胺(5-HT)、脂多糖、ACTH、神经肽Y(NPY)、CRH水平。结果:中医联合组总有效率为95.00%(38/40),基础组总有效率为75.00%(30/40),中医联合组患儿总有效率高于基础组(P<0.01);中医联合组中医证候评分较基础组低(P<0.01);中医联合组肠球菌、葡萄球菌表达量较基础组低(P<0.01),中医联合组乳酸菌表达量较基础组高(P<0.01);中医联合组D-乳酸、脂多糖、二胺氧化酶表达量低于基础组(P<0.01);中医联合组5-HT、SP表达量低于基础组(P<0.01),中医联合组NPY表达量高于基础组(P<0.01);中医联合组ACTH、CRH水平低于基础组(P<0.01)。结论:葛根止泻汤联合针灸治疗腹泻患儿,可保护肠黏膜屏障,调节肠道菌群,改善脑-肠轴、下丘脑-垂体-肾上腺轴平衡,缓解病情,提升临床疗效。Objective:To study the effects of Gegen Zhixie Decoction combined with acupuncture on intestinal mucosal barrier,gut microbiota,and brain-gut peptides including substance P(SP),corticotropin-releasing hormone(CRH),and adrenocorticotropic hormone(ACTH)in children with diarrhea based on the brain-gut axis.Methods:A total of 80 pediatric patients with diarrhea treated at Qinhuangdao Chinese Medicine Hospital from January 2022 to January 2023 were randomly divided into a basic treatment group(n=40)and a TCM combined treatment group(n=40).The basic group received conventional Western medical treatment,while the TCM combined group was additionally treated with Gegen Zhixie Decoction and acupuncture.After treatment,clinical efficacy was compared between the two groups.Pre-and post-treatment TCM syndrome scores were observed,and intestinal microecology markers,including Enterococcus,Staphylococcus,and Lactobacillus populations,were assessed.Levels of D-lactic acid,substance P(SP),diamine oxidase(DAO),5-hydroxytryptamine(5-HT),lipopolysaccharides(LPS),ACTH,neuropeptide Y(NPY),and CRH were also measured.Results:The total effective rate in the TCM combined group was 95.00%(38/40),significantly higher than that in the basic group(75.00%,30/40)(P<0.01).TCM syndrome scores in the TCM combined group were significantly lower than those in the basic group(P<0.01).Enterococcus and Staphylococcus populations were lower in the TCM combined group(P<0.01),while Lactobacillus populations were higher(P<0.01).Levels of D-lactic acid,LPS,and DAO were lower in the TCM combined group compared to the basic group(P<0.01).SP and 5-HT levels were lower(P<0.01),whereas NPY levels were higher in the TCM combined group(P<0.01).ACTH and CRH levels were also lower in the TCM combined group(P<0.01).Conclusion:Gegen Zhixie Decoction combined with acupuncture can protect the intestinal mucosal barrier,regulate gut microbiota,improve the balance of the brain-gut axis and hypothalamic-pituitary-adrenal axis,alleviate symptoms,and enhance clinical efficac

关 键 词：葛根止泻汤 针灸 腹泻患儿 肠黏膜屏障 脑-肠轴 

分 类 号：R285.6[医药卫生—中药学]