标题：新加胃苓汤联合肠道微生态调节剂治疗小儿迁延性腹泻的疗效及对患儿肠道微生态的影响

      作者：刘奇，郭宏丽    西安交通大学附属红会医院儿科，陕西 西安 710000

      卷次： 2020年31卷4期

      【摘要】 目的 观察新加胃苓汤联合肠道微生态调节剂治疗小儿迁延性腹泻的疗效，并探讨其对患儿肠道微生态的影响。方法 选取2018年3月至2019年3月在西安交通大学附属红会医院治疗的迁延性腹泻患儿112例，采用随机数表法分为对照组和观察组，每组56例。对照组给予整肠生胶囊治疗，观察组在对照组治疗基础上给予新加胃苓汤治疗，5 d为一个疗程，均治疗两个疗程。比较两组患儿的治疗效果、治疗前后的血浆D-乳酸、内毒素(ET)、二胺氧化酶(DAO)含量及尿乳果糖/甘露醇(L/M)值；同时比较两组患儿治疗前后粪便中的肠道常驻菌群数及症状积分；记录两组患儿治疗期间不良反应发生情况。结果 观察组患儿的治疗总有效率为96.43%，明显高于对照组的 83.93%，差异有统计学意义(P<0.05)；观察组患儿治疗后的症状积分为(0.92±0.15)分，明显低于对照组的(1.37±0.28)分，差异有统计学意义(P<0.05)；观察组患儿治疗后的血浆D-乳酸、ET、DAO含量及尿L/M值分别为(7.24±1.31) ng/mL、(0.29±0.03) Eu/mL、(5.16±0.89) U/mL、0.06±0.01，明显低于对照组的(8.95±1.58) ng/mL、(0.35±0.06) Eu/mL、(6.74±0.92) U/mL、0.08±0.01，差异均有统计学意义(P<0.05)；观察组患儿治疗后的肠杆菌群数少于对照组，肠球菌群数、乳杆菌群数、双歧杆菌群数多于对照组，差异均有统计学意义(P<0.05)；观察组患儿治疗期间不良反应发生率为1.79%，明显低于对照组的14.29%，差异有统计学意义(P<0.05)。结论 新加胃苓汤联合肠道微生态调节剂治疗小儿迁延性腹泻有效率高，其能缓解临床症状，改善胃肠功能，促进肠道微生态平衡，且不良反应少。
      【关键词】 新加胃苓汤；肠道微生态调节剂；小儿迁延性腹泻；疗效；肠道微生态
      【中图分类号】 R725.7 【文献标识码】 A 【文章编号】 1003—6350（2020）04—0459—04

Curative effect of Xinjia Weiling Decoction combined with intestinal microecological regulators on pediatricprotracted diarrhea and its influences on intestinal microecology.
LIU Qi, GUO Hong-li. Department of Pediatrics, theHonghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710000, Shaanxi, CHINA
【Abstract】 Objective To observe curative effect of Xinjia Weiling Decoction combined with intestinal micro-ecological regulators on pediatric protracted diarrhea and its influence on intestinal microecology. Methods A total of112 children with protracted diarrhea, who admitted to Honghui Hospital Affiliated to Xi'an Jiaotong University fromMarch 2018 to March 2019 were enrolled and divided into the control group and observation group according to randomnumber table method, with 56 children in each group. The control group was treated with Zheng Chang Sheng Capsules,and the observation group was treated with Xinjia Weiling Decoction on this basis the of treatment in the control group,with 5 d as a course of treatment. All the patients were treated for two courses. The curative effect, contents of plasmaD-lactic acid, endotoxin (ET) and diamine oxidase (DAO), and urine lactulose/mannitol (L/M), number of residential col-onies in feces and symptoms scores before and after treatment were compared between the two groups. The occurrenceof adverse reactions during treatment in both groups was recorded. Results The total response rate of treatment in theobservation group was significantly higher than that in the control group (96.43% vs 83.93%, P<0.05). After treatment,the symptom score of observation group was significantly lower than that of control group: (0.92±0.15) points vs (1.37±0.28) points, P<0.05); the contents of plasma D-lactic acid, ET and DAO, and urine L/M in the observation group were(7.24±1.31) ng/mL, (0.29±0.003) Eu/mL, (5.16±0.89) U/mL, 0.006±0.001, respectively, which were significantly lowerthan corresponding (8.95±1.58) ng/mL, (0.35±0.006) Eu/mL, (6.74±0.92U) U/mL, 0.08±0.01 in control group (all P<0.05); the number of Enterobacteriaceae in the observation group was significantly less than that in control group, whilethe number of Enterococcus, Lactobacillus and Bifidobacterium was more than those in control group (all P<0.05). Theincidence of adverse reactions during treatment in observation group was significantly lower than that in control group(1.79% vs 14.29%, P<0.05). Conclusion The efficiency of Xinjia Weiling Decoction combined with intestinal micro-ecological regulators is high in the treatment of pediatric protracted diarrhea, which can alleviate clinical symptoms, im-prove gastrointestinal function, promote intestinal microecological balance, with fewer adverse reactions.
      【Key words】 Xinjia Weiling Decoction; Intestinal microecological regulator; Pediatric protracted diarrhea; Cura-tive effect; Intestinal microecology