槐杞黄颗粒联合聚乙二醇4000散治疗儿童便秘疗效及对患儿肠道菌群、免疫功能的影响

目的 研究槐杞黄颗粒联合聚乙二醇4 000散治疗儿童便秘疗效及对患儿肠道菌群、免疫功能的影响。方法 选择2016年4月-2019年2月邢台市人民医院收治的便秘患儿96例，采用随机数表法分为对照组和观察组，每组各48例。对照组患儿分两次温水冲服聚乙二醇4000散，1.5 g/（kg·d），并根据患儿粪便嵌塞情况逐渐减量。观察组患儿在对照组的基础上温水冲服槐杞黄颗粒，10 g/次，2次/d。2周为1个疗程，两组患儿均治疗2个疗程。观察两组患者的临床疗效，比较两组患儿治疗前后免疫功能、肠道菌群水平、临床症状评分、中医证候总分、生存质量评分（HRQOL）及不良反应发生情况。结果 治疗后，对照组总有效率为79.17%，低于试验组总有效率93.75%，差异有统计学意义（P<0.05）。治疗后，两组CD3⁺、CD4⁺、CD4⁺/CD8⁺水平升高，CD8⁺水平降低（P<0.05），其中观察组CD3⁺、CD4⁺、CD4⁺/CD8⁺水平高于对照组，CD8⁺水平低于对照组，差异有统计学意义（P<0.05）。治疗后，两组肠道内双歧杆菌、乳酸杆菌水平升高，葡萄球菌、大肠杆菌水平降低（P<0.05）；其中观察组双歧杆菌、乳酸杆菌水平高于对照组，葡萄球菌、大肠杆菌水平低于对照组，差异有统计学意义（P<0.05）。治疗后，两组排便次数、排便难度、排便时间和大便性状等评分均降低（P<0.05）；其中观察组排便次数、排便难度、排便时间和大便性状评分低于对照组，差异有统计学意义（P<0.05）。治疗后，两组中医症候总分明显减少，HRQOL评分升高（P<0.05），其中观察组中医症候总分低于对照组，HRQOL评分高于对照组，差异有统计学意义（P<0.05）。两组不良反应发生率无明显差异。结论 槐杞黄颗粒联合聚乙二醇4000散治疗便秘患儿，能够显著改善患儿便秘症状和生存质量，提高免疫功能，调节肠道内菌群水平，效果显著。

Effect of Huaiqihuang Granules combined with Macrogol 4000 Powder on constipation, intestinal flora, and immune function in children

Objective To study the therapeutic effect of Huaiqihuang Granules combined with Macrogol 4 000 Powder on constipation, intestinal flora, and immune function in children. Methods A total of 96 children with constipation admitted to Xingtai People''s Hospital fromApril 2016 to February 2019 were randomly divided into control group and observation group, and each group had 48 cases. In the control group, children were po administered with Macrogol 4000 Powder in warm water for twice, 1.5 g/(kg·d), and the amount was gradually reduced according to the fecal impaction of the children. In the observation group, the children were po administered with Huaiqihuang Granules with warm water on the basis of the control group, 10 g/time, and twice daily. 2 weeks for a course of treatment, children were treated for two courses of treatment. The clinical efficacy in two groups was observed, and the immune function, intestinal flora level, clinical symptom score, total TCM syndrome score, HRQOL score, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the total effective rate in the control group was 79.17%, which was lower than 93.75% in the observation group, the difference was statistically significant (P<0.05). After treatment, the levels of CD3⁺, CD4⁺, CD4⁺/CD8⁺ in two groups were increased, and the levels of CD8⁺ were decreased (P<0.05). And the levels of CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in the observation group were significantly higher than those in the control group (P<0.05), the level of CD8⁺ was lower than those in the control group, the difference was statistically significant (P<0.05). After treatment, the levels of bifidobacteria and lactobacillus in the intestines of two groups were increased, while the levels of staphylococcus and escherichia coli were decreased (P<0.05). And the levels of bifidobacteria and lactobacillus in the observation group were higher than those in the control group, the levels of staphylococcus and escherichia coli were lower than those in the control group, with statistically significant differences (P<0.05). After treatment, the score of defecation frequency, defecation difficulty, defecation time, and defecation character in two groups were all decreased (P<0.05). And the defecation frequency, defecation difficulty, defecation time and stool character score in the observation group were lower than those in the control group, with statistically significant differences (P<0.05). After treatment, the total score of TCM syndromes in two groups were significantly decreased, and the HRQOL score were increased (P<0.05). And the total score of TCM syndromes in the observation group was lower than that in the control group, while the HRQOL score was higher than that in the control group, with statistically significant differences (P<0.05). There was no significant difference in the incidence of adverse reactions between two groups. Conclusion Huaiqihuang Granules combined with Macrogol 4000 Powder can significantly improve the constipation symptoms and quality of life of children with constipation, improve the immune function, and regulate the level of intestinal flora, the effect is significant.