Efficacy of Xingpi Yanger Granule combined with bifidobacterium quadruple viable tablets in the treatment of infantile diarrhea predominant irritable bowel syndrome
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摘要:
目的 探讨醒脾养儿颗粒联合双歧杆菌四联活菌片治疗小儿腹泻型肠易激综合征(IBS)的疗效。 方法 选取2018年10月—2020年10月南阳市中心医院收治的104例腹泻型IBS患儿。采用随机数表法将患儿分为对照组和观察组,每组52例。对照组采用双歧杆菌四联活菌片治疗,观察组采用醒脾养儿颗粒联合双歧杆菌四联活菌片治疗。比较2组总有效率及不良反应发生情况,对比2组治疗前后中医证候积分、T淋巴细胞亚群以及脑肠肽指标。 结果 观察组总有效率为90.38%(47/52),明显高于对照组的75.00%(39/52,χ2=4.299, P=0.038)。治疗后,观察组腹泻[(1.26±0.32)分vs. (1.87±0.39)分]、腹痛[(1.28±0.37)分vs. (1.94±0.43)分]、两胁胀满[(0.74±0.16)分vs. (1.07±0.24)分]、恶心[(0.54±0.13)分vs. (0.75±0.19)分]、纳少[(0.47±0.18)分vs. (0.82±0.27)分]证候积分均明显低于对照组(均P<0.05)。治疗后,观察组CD3+、CD4+、CD4+/CD8+水平高于对照组(均P<0.05);观察组CD8+水平低于对照组(t=4.418,P<0.05)。治疗后,观察组P物质、神经降压素、胃动素和胃泌素水平高于对照组(均P<0.05)。2组均未出现明显不良反应。 结论 醒脾养儿颗粒联合双歧杆菌四联活菌片治疗小儿腹泻型IBS疗效确切,能明显改善患儿临床症状、调节T淋巴细胞亚群和脑肠肽指标水平。 Abstract:Objective To investigate the efficacy of Xingpi Yanger Granule combined with bifidobacterium quadruple viable tablets in the treatment of infantile diarrhoea predominant irritable bowel syndrome (IBS). Methods A total of 104 children with diarrhoea-predominant IBS in Nanyang Central Hospital from October 2018 to October 2020 were selected and equally divided into control and observation groups by the random number table. The control group was treated with bifidobacterium quadruple viable tablets, and the observation group was treated with Xingpi Yanger Granule combined with bifidobacterium quadruple viable tablets. The total effective rate and adverse reactions were compared between the two groups. The traditional chinese medcine syndrome score, T lymphocyte subsets and brain gut peptide indexes of the two groups were compared before and after treatment. Results The total effective rate of the observation group was 90.38% (47/52), which was significantly higher than 75.00% (39/52) of the control group (χ2=4.299, P=0.038). After treatment, the syndrome scores of diarrhea [(1.26±0.32) points vs. (1.87±0.39) points], abdominal pain [(1.28±0.37) points vs. (1.94±0.43) points], fullness in both flanks [(0.74±0.16) points vs. (1.07±0.24) points], nausea [(0.54±0.13) points vs. (0.75±0.19) points], nausea [(0.47±0.18) points vs. (0.82±0.27) points] in the observation group were significantly lower than those of the control group (all P < 0.05). After treatment, the levels of CD3+, CD4+ and CD4+/CD8+ in the observation group were higher than those in the control group (all P < 0.05); the level of CD8+ in the observation group was lower than that in the control group (t=4.418, P < 0.05). After treatment, the levels of substance P, neurotensin, motilin and gastrin in the observation group were higher than those in the control group (all P < 0.05). No obvious adverse reaction was found in the two groups. Conclusion Xingpi Yanger Granule combined with bifidobacterium quadruple viable tablets effectively treat infantile-diarrhoea-predominant IBS, can significantly alleviate clinical symptoms and regulates T lymphocyte subsets and brain gut peptide levels. -
表 1 2组腹泻型IBS患儿总有效率比较[例(%)]
Table 1. Comparison of total effective rate between the two groups of children with diarrheal IBS [cases (%)]
组别 例数 治愈 显效 有效 无效 总有效 对照组 52 5(9.62) 16(30.77) 18(34.61) 13(25.00) 39(75.00) 观察组 52 16(30.77) 21(40.38) 10(19.23) 5(9.62) 47(90.38) 注:2组总有效率比较,χ2=4.299,P=0.038。 表 2 2组腹泻型IBS患儿中医证候积分比较(x±s,分)
Table 2. Comparison of TCM syndrome scores between the two groups of children with diarrheal IBS (x±s, points)
组别 例数 时间 腹泻 腹痛 两胁胀满 恶心 纳少 对照组 52 治疗前 4.27±0.62 4.52±0.54 2.43±0.22 2.27±0.16 2.09±0.32 治疗后 1.87±0.39a 1.94±0.43a 1.07±0.24a 0.75±0.19a 0.82±0.27a 观察组 52 治疗前 4.33±0.58 4.47±0.48 2.41±0.24 2.28±0.15 2.14±0.35 治疗后 1.26±0.32ab 1.28±0.37ab 0.74±0.16ab 0.54±0.13ab 0.47±0.18ab 注:与同组治疗前比较,aP<0.05;与同期对照组比较,bP<0.05。 表 3 2组腹泻型IBS患儿T淋巴细胞亚群比较(x±s)
Table 3. Comparison of T lymphocyte subsets between the two groups of children with diarrhea IBS (x±s)
组别 例数 时间 CD3+(%) CD4+(%) CD8+(%) CD4+/CD8+ 对照组 52 治疗前 53.16±5.45 31.64±4.48 29.34±3.87 1.10±0.34 治疗后 57.27±5.34a 34.63±4.83a 27.33±3.18a 1.42±0.26a 观察组 52 治疗前 53.39±5.64 31.92±4.36 29.05±4.12 1.12±0.29 治疗后 61.57±5.89ab 39.62±4.62ab 24.54±3.26ab 1.71±0.18ab 注:与同组治疗前比较,aP<0.05;与同期对照组比较,bP<0.05。 表 4 2组腹泻型IBS患儿脑肠肽指标比较(x±s,ng/L)
Table 4. Comparison of brain and intestinal peptide indexes between the two groups of children with diarrhea IBS (x±s, ng/L)
组别 例数 时间 SP NT MTL GAS 对照组 52 治疗前 31.73±5.24 39.26±4.32 15.13±3.29 18.82±2.64 治疗后 38.52±6.54a 44.35±5.28a 22.64±3.92a 25.21±3.43a 观察组 52 治疗前 31.25±4.94 39.83±4.56 15.62±3.12 19.25±2.76 治疗后 44.16±6.82ab 49.27±5.94ab 29.17±4.35ab 30.62±4.02ab 注:与同组治疗前比较,aP<0.05;与同期对照组比较,bP<0.05。 -
[1] 李军祥, 陈誩, 唐旭东, 等. 肠易激综合征中西医结合诊疗共识意见(2017年)[J]. 中国中西医结合消化杂志, 2018, 26(3): 227-232. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXPW201803002.htmLI J X, CHEN J, TANG X D, et al. Consensus on Irritable Bowel Syndrome by Integrative Medicine(2017)[J]. Chinese Journal of Integrated Traditional and Western Medicine on Digestion, 2018, 26(3): 227-232. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXPW201803002.htm [2] 韩知忖, 任莉莉, 路飞, 等. 针刺联合中药治疗腹泻型肠易激综合征患者的效果观察[J]. 中华全科医学, 2019, 17(11): 1911-1913. doi: 10.16766/j.cnki.issn.1674-4152.001088HAN Z C, REN L L, LU F, et al. Analysis of the Acupuncture combined with Traditional Chinese Medicine in the treatment of diarrhea-predominant pattern irritable bowel syndrome patients[J]. Chinese Journal of General Practice, 2019, 17(11): 1911-1913. doi: 10.16766/j.cnki.issn.1674-4152.001088 [3] 杨芳, 严晶, 刘丽娜, 等. 肠易激综合征病因及发病机制研究的新进展[J]. 河北医科大学学报, 2020, 41(8): 987-992. doi: 10.3969/j.issn.1007-3205.2020.08.027YANG F, YAN J, LIU L N, et al. Recent advances in the etiology and pathogenesis of irritable bowel syndrome[J]. Journal of Hebei Medical University, 2020, 41(8): 987-992. doi: 10.3969/j.issn.1007-3205.2020.08.027 [4] 王喜红, 谢春娥, 薛晓轩, 等. 肠易激综合征的中西医治疗进展[J]. 西部中医药, 2020, 33(3): 156-159. https://www.cnki.com.cn/Article/CJFDTOTAL-GSZY202003044.htmWANG X H, XIE C E, XUE X X, et al. The Progress in the Treatment of Irritable Bowel Syndrome by Integrative Medicine[J]. Western Journal of Traditional Chinese Medicine, 2020, 33(3): 156-159. https://www.cnki.com.cn/Article/CJFDTOTAL-GSZY202003044.htm [5] 韩亚飞, 王允亮, 李军祥. 腹泻型肠易激综合征发病机制及中药干预研究进展[J]. 辽宁中医药大学学报, 2018, 20(1): 114-117. https://www.cnki.com.cn/Article/CJFDTOTAL-LZXB201801036.htmHAN Y F, WANG Y L, LI J X. Pathogenesis of diarrhea-predominant irritable bowel syndrome and its research progress of intervention with Chinese Medicine[J]. Journal of Liaoning University of Traditional Chinese Medicine, 2018, 20(1): 114-117. https://www.cnki.com.cn/Article/CJFDTOTAL-LZXB201801036.htm [6] 李文玲, 杨洁, 李红云, 等. 醒脾养儿颗粒联合西药对小儿消化不良性腹泻免疫功能的影响及临床疗效分析[J]. 世界中医药, 2019, 14(2): 466-468, 472. doi: 10.3969/j.issn.1673-7202.2019.02.045LI W L, YANG J, LI H Y. Clinical Effects of Xingpi Yanger Granule Combined with Western Medicine on Infantile Dyspepsia Diarrhea and Its Effect on Immune Function[J]. World Chinese Medicine, 2019, 14(2): 466-468, 472. doi: 10.3969/j.issn.1673-7202.2019.02.045 [7] 孙菁, 袁耀宗. 肠易激综合征: 罗马Ⅲ标准与我国共识意见解读[J]. 医学与哲学, 2008, 29(12): 12-14. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZL200806004.htmSUN J, YUAN Y Z. Consensus of Criteria of IBS: Comparison of Changsha Consensus and Rome Ⅲ Criteria[J]. Medicine and Philosophy, 2008, 29(12): 12-14. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZL200806004.htm [8] 中华中医药学会脾胃病分会. 肠易激综合征中医诊疗专家共识意见(2017)[J]. 中医杂志, 2017, 58(18): 1614-1620. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ201718024.htmBranch of Spleen and Stomach Diseases, Chinese Association of Traditional Chinese Medicine. Expert Consensus on TCM Diagnosis and Treatment of Irritable bowel Syndrome (2017)[J]. Journal of Traditional Chinese Medicine, 2017, 58(18): 1614-1620. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ201718024.htm [9] 郑筱萸. 中药新药临床研究指导原则[M]. 北京: 中国医药科技出版社, 2002: 139-143.ZHENG X Y. Guidelines for clinical research of new TCM drugs[M]. Beijing: China Medical Science and Technology Press, 2002: 139-143. [10] 朱佳杰, 刘珊, 赵鹏程, 等. 肠易激综合征的流行病学研究进展[J]. 国际消化病杂志, 2017, 37(5): 271-273. https://www.cnki.com.cn/Article/CJFDTOTAL-GWXH201705001.htmZHU J J, LIU S, ZHAO P C, et al. Advances in the epidemiology of irritable bowel syndrome[J]. International Journal of Digestive Diseases, 2017, 37(5): 271-273. https://www.cnki.com.cn/Article/CJFDTOTAL-GWXH201705001.htm [11] 贺星, 刘卫, 唐郡, 等. 腹泻型肠易激综合征动物模型建立及评价[J]. 胃肠病学和肝病学杂志, 2020, 29(12): 1386-1390. https://www.cnki.com.cn/Article/CJFDTOTAL-WCBX202012017.htmHE X, LIU W, TANG J, et al. Establishment and evaluation of an animal model of diarrhea-predominant irritable bowel syndrome[J]. Chinese Journal of Gastroenterology and Hepatology, 2020, 29(12): 1386-1390. https://www.cnki.com.cn/Article/CJFDTOTAL-WCBX202012017.htm [12] 曹瑜. 肠易激综合征腹泻型的证候学研究进展[J]. 中西医结合心血管病电子杂志, 2017, 5(3): 17-18. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXJH201703013.htmCAO Y. Research progress in syndrome of irritable bowel syndrome with diarrhea[J]. Cardiovascular Diseases Electronic Journal of Integrated Traditional Chinese and Western Medicine, 2017, 5(3): 17-18. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXJH201703013.htm [13] 胡玥, 吕宾. 肠易激综合征的治疗进展[J]. 中国实用内科杂志, 2020, 40(2): 105-110. https://www.cnki.com.cn/Article/CJFDTOTAL-SYNK202002007.htmHU Y, LYU B. Progress in the treatment of irritable bowel syndrome[J]. Chinese Journal of Practical Internal Medicine, 2020, 40(2): 105-110. https://www.cnki.com.cn/Article/CJFDTOTAL-SYNK202002007.htm [14] 丁佳媛, 刘绍能. 腹泻型肠易激综合征的中医诊治概况[J]. 环球中医药, 2018, 11(12): 2042-2047. https://www.cnki.com.cn/Article/CJFDTOTAL-HQZY201812057.htmDING J Y, LIU S N. Overview of TCM diagnosis and treatment of diarrheal irritable bowelsyndrome[J]. Global Traditional Chinese Medicine, 2018, 11(12): 2042-2047. https://www.cnki.com.cn/Article/CJFDTOTAL-HQZY201812057.htm [15] 吕虹艳, 朱建丽, 袁慧强. 葡萄糖酸锌联合双歧杆菌四联活菌治疗小儿秋季腹泻的临床效果观察[J]. 中国基层医药, 2018, 25(12): 1573-1577. https://www.cnki.com.cn/Article/CJFDTOTAL-WMIA201924113.htmLYU H Y, ZHU J L, YUAN H Q. Clinical effect of zinc gluconate combined with tetralogy of viable bifidobacterium tablets in the treatment of infantile autumn diarrhea[J]. Chinese Journal of Primary Medicine and Pharmacy, 2018, 25(12): 1573-1577. https://www.cnki.com.cn/Article/CJFDTOTAL-WMIA201924113.htm [16] 纪菲菲, 张益光, 李昌崇. 双歧杆菌四联活菌片联合蒙脱石散治疗腹泻型肠易激综合征疗效观察[J]. 中国微生态学杂志, 2017, 29(12): 1434-1436. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWS201712018.htmJI F F, ZHANG Y G, LI C C. The effect of Bifidobacterium Tetravaccine tablets combined with Montmorillonite powder for treatment of diarrhea type irritable bowel syndrome[J]. Chinese Journal of Microecology, 2017, 29(12): 1434-1436. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWS201712018.htm [17] 王晓丽. 酪酸梭菌活菌散联合醒脾养儿颗粒治疗小儿消化不良性腹泻的疗效及安全性分析[J]. 临床医药文献电子杂志, 2018, 5(55): 149. https://www.cnki.com.cn/Article/CJFDTOTAL-LCWX201855132.htmWANG X L. Efficacy and safety of Clostridium butyricum powder combined with XingpiYang'er granule for the treatment of lienteric diarrhea in children[J]. Journal of Clinical Medical Literature (Electronic Edition), 2018, 5(55): 149. https://www.cnki.com.cn/Article/CJFDTOTAL-LCWX201855132.htm [18] 江苏敏, 赵艳钧, 李媛媛, 等. 基于脑肠轴论治肠易激综合征的中西医临床研究进展[J]. 世界中医药, 2020, 15(21): 3351-3354, 3358. https://www.cnki.com.cn/Article/CJFDTOTAL-SJZA202021032.htmJIANG S M, ZHAO Y J, LI Y Y, et al. Clinical research on progress of irritable bowel syndrome based on brain-gut axis[J]. World Chinese Medicine, 2020, 15(21): 3351-3354, 3358. https://www.cnki.com.cn/Article/CJFDTOTAL-SJZA202021032.htm [19] 王凯, 刘利萍, 席作武. 探讨芍药汤联合痛泻要方对溃疡性结肠炎患者炎症细胞因子及免疫功能的研究[J]. 中国免疫学杂志, 2019, 35(5): 560-563. https://www.cnki.com.cn/Article/CJFDTOTAL-ZMXZ201905009.htmWANG K, LIU L P, XI Z W. Effect of Shaoyao decoction combined with Tongxieyao recipe on inflammatory cytokines and immune function in patients with ulcerative colitis[J]. Chinese Journal of Immunology, 2019, 35(5): 560-563. https://www.cnki.com.cn/Article/CJFDTOTAL-ZMXZ201905009.htm [20] 刘娅薇, 惠华英, 谭周进. 脑肠轴传输中的胃肠肽类激素[J]. 世界华人消化杂志, 2019, 27(16): 1007-1012. https://www.cnki.com.cn/Article/CJFDTOTAL-XXHB201916008.htmLIU Y W, HUI H Y, TAN Z J. Gastrointestinal peptide hormones associated with brain-intestinal axis[J]. World Chinese Journal of Digestology, 2019, 27(16): 1007-1012. https://www.cnki.com.cn/Article/CJFDTOTAL-XXHB201916008.htm
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