姜芡止泻汤治疗抗生素相关性腹泻脾肾阳虚证疗效及对肠道菌群结构的影响

目的 观察姜芡止泻汤治疗抗生素相关性腹泻(AAD)脾肾阳虚证的疗效及对肠道菌群结构的影响.方法 采用随机数字表法将120例患者分为治疗组及对照组各60例.治疗组予姜芡止泻汤,每日1剂,每日2次,口服或鼻饲;对照组予甲硝唑片+双歧杆菌三联活菌,每日3次,口服或鼻饲.2组均连续治疗7 d.观察2组临床疗效、中医症状评分、西...

Efficacy of Jiangqian Zhixie Decoction on Antibiotic-related Diarrhea with Spleen-kidney Yang Deficiency Syndrome and Its Effects on Intestinal Microflora Structure

Objective To observe the clinical efficacy of Jiangqian Zhixie Decoction in treating antibiotic associated diarrhea(AAD)with spleen-kidney yang deficiency syndrome and its effects on intestinal flora structure.Methods Totally 120 patients were divided into treatment group and control group(60 cases in each group)according to random number table method.The treatment group was treated with Jiangqian Zhixie Decoction,one dosage per day,twice a day,orally or nasal feeding;and the control group was treated with metronidazole tablets+bifidobacterium triplex viable bacteria,three times a day,orally or nasal feeding.Treatment for both groups lasted for 7 d.The clinical efficacy,TCM symptom score and Western medicine symptom score were observed.Five cases in the treatment group were selected for high-throughput gene sequencing to evaluate the status of the intestinal flora.Results The control group lost 2 cases.The total effective rate was 70.00%(42/60)in the treatment group and 46.55%(27/58)in the control group,with statistical significance(P<0.05).TCM symptom scores(stool diarrhea,bloating and abdominal pain,bowel irritation,fullness of the abdomen,loss of appetite,chills and cold limbs,waist and knee pain)and Western medicine symptom scores(number of diarrhea,stool characteristics)decreased better than the control group(P<0.05).The analysis of intestinal floraαdiversity showed that the average Shannon index of AAD patients was 5.71.It was speculated that the species diversity of intestinal flora was much lower than that of normal individuals.The OTUs level analysis and principal component analysis of the samples showed that the intestinal microecological structure of the patients changed after treatment.At phylum level,Firmicutes phyla decreased,and Proteobacteria and Bacteroidetes increased.At the genus level,the decreased abundance included Enterococcus,Clostridium,Faecalis,Enterobacteriaceae,etc.,and the increased abundance included Lacetospirillaceae,Rumenococcus,Oscillospirillum,etc.,with no statistical significance(P>0.05).Conclusion Jiangqian Zhixie Decoction has a good clinical effect in the treatment of AAD with spleen-kidney yang deficiency syndrome,which can significantly improve the clinical symptoms of patients,inhibit the abnormal reproduction of pathogenic bacteria,support the growth of probiotics,thereby adjust the structure of intestinal flora and promote the recovery of gastrointestinal function.