参苓白术散对小儿脾虚泄泻消化吸收与肠道局部免疫功能的影响

目的:观察参苓白术散加减对脾虚型泄泻患儿的临床疗效,同时评价其对消化吸收与肠道局部免疫功能的影响。方法:选取2017年1~9月新疆医科大学附属中医医院收治的脾虚型泄泻患儿50例纳入研究,按照随机数字表法随机法分为对照组和观察组,每组25例,对照组予蒙脱石散及补液盐对症处理,观察组在上述治疗方案基础上加用参苓白术散加减,1剂/日,200 m L煎煮早晚分服温服,2组均连续治疗10 d,比较2组治疗前后中医证候积分、临床疗效以及免疫水平变化。结果:1)治疗前2组中医证候积分相仿(P 0. 05),治疗后分值2组均有所下降,其中观察组下降幅度更大,与对照组比较,差异有统计学意义(P 0. 05); 2)治疗后观察组临床总有效率为92%,对照组80%,差异有统计学意义(P 0. 05),观察组效果明显更优; 3)观察组淋巴转化率高于对照组,差异有统计学意义(P 0. 05);(4) 2组CD4~+、CD4~+/CD8~+比值、Ig G、Ig M均高于治疗前(P 0. 05),CD8~+、Ig A的含量低于治疗前(P 0. 05),其中观察组由于对照组。结论:参苓白术散可有效改善脾虚型泄泻临床症状,可能与其具有改善免疫功能有关。

Effects of Shenling Baizhu Powder on Digestion and Absorption and Intestinal Immune Function in Children with Diarrhea due to Spleen Deficiency Syndrome

To observe the clinical effects of Shenling Baizhu Powder on children with diarrhea due to spleen deficiency syndrome,and to evaluate its effects on digestion and absorption and intestinal immune function.Methods:A total of 50 children with diarrhea due to spleen deficiency syndrome in Affiliated Chinese Medicine Hospital of Xinjiang Medical University from January 2017 to September 2017 were enrolled in the study.According to the random number table method,they were randomly divided into the control group and the observation group.The control group was treated with montmorillonite powder and rehydration salt.The observation group was treated with Shenling Baizhu Powder on the basis of the above-mentioned treatment scheme with one dose per day,and 200 mL decoction was taken in the morning and evening.Two groups were treated for 10 days,and TCM syndrome scores,clinical efficacy,and immune level changes were compared before and after treatment in the two groups.Results:1) Before treatment,the scores of TCM syndromes in the two groups were similar (P>0.05).After treatment,the scores of both groups decreased.The decrease of the observation group was more significant (P<0.05).2) After treatment,the total effective rate was 92% in the observation group and 80% in the control group.The difference was statistically significant (P<0.05).3) The rate of lymph conversion in the observation group was higher than that in the control group (P<0.05).4) The ratio of CD4+,CD4+/CD8+,IgG and IgM in both groups were significantly higher than those before treatment (P<0.05).Concentrations of CD8+ and IgA were lower than those before treatment (P<0.05),and the concentrations in the observation group were higher than those of the control group.Conclusion:Shenling Baizhu Powder can effectively improve the clinical symptoms of diarrhea due to spleen deficiency,which may relate to its effects of improving immune function.