四君子汤加味对小儿虚秘血液学及肠敏感度的影响

目的:观察四君子汤加减对小儿脾虚气弱型便秘的临床疗效,同时分析该法对部分血液学及肠敏感度的影响。方法:选取70例气虚型功能性便秘的患儿纳入研究,随机分为对照组及观察组,各35例。对照组患儿接受调节膳食结构、加强锻炼,每日温水冲服枯草杆菌、肠球菌二联活菌多维颗粒剂,观察组在对照组治疗基础上加用四君子汤加减,1剂/d,早晚温服。均以1周为1个疗程,共治疗2个疗程。治疗前后比较2组患儿中医证候积分、肛门直肠压力,眼心反射试验、卧立位试验以及结肠黏膜水通道蛋白8(Aquaporin 8,AQP8)表达。结果:2组患儿中医证候积分均较治疗前降低(P0.05),其中观察组患儿降低较对照组更明显(P0.05)。2组患儿治疗后眼心反射试验、卧立位试验阳性率均较治疗前下降(P0.05),其中观察组患儿下降的趋势更明显,与对照组比较差异有统计学意义(P0.05)。2组患儿治疗后肛门直肠压力均有所改善,其中观察组患儿改善更明显,与对照组比较差异有统计学意义(P0.05)。2组患儿治疗后AQP8水平有所下降,与对照组比较,观察组患儿治疗后AQP8水平更低(P0.05)。结论:四君子汤加减可有效治疗小儿脾虚气弱型便秘,其作用机制可能与降低机体AQP8表达有关。

Effects of Modified Sijunzi Decoction on Hematology Indexes and Intestinal Sensitivity of Pediatric Constipation of Deficiency Type

To observe the clinical curative effects of modified Sijunzi Decoction on pediatric constipation of spleen qi deficiency type, and to analyze the effects on parts of hematology indexes and intestinal sensitivity. Methods:A total of 70 cases of children with functional constipation of qi deficiency type who were admitted and treated in Shaanxi Provincial Hospital of TCM from January 2015 to January 2016, who were randomly divided into the control group and the observation group with 35 cases in each group. Patients in control group were adapted to regulate the dietary pattern, strengthen exercise, take Mami''ai (bacillus subtilis and enterococcus faecium with multivitamins granules) with warm water daily. The observation group combined with modified Sijunzi Decoction on the basis treatment of the control group, 1 dose/day, warm-taken in the morning and evening. Both of the two groups of patients were treated for two courses (1 week for a course of treatment). TCM syndrome integrals, the anorectal pressure, oculocardiac reflex test, recumbent-upright test and colonic mucosa Aquaporin 8 (AQP8) of patients of both groups were compared before and after treatment. Results:TCM syndrome integrals of the two groups reduced than before the treatment (P<0.05). The reduction of the observation group was more significantly than that of the control group (P<0.05). The oculocardiac reflex test, recumbent-upright test positive rate of the two groups declined after treatment (P<0.05), and the downward trend of the observation group was more significant, compared with the control group with statistically significant differences (P<0.05). The anorectal pressure of the two groups were improved after treatment, and the observation group improved more significantly. The differences were with statistically significant compared with control group (P<0.05). AQP8 levels of the two groups of the children decreased after treatment and patients in the observation group were lower compared with those in the control group after treatment (P<0.05). Conclusion:The modified Sijunzi Decoction can effectively cure pediatric constipation of spleen qi deficiency type and the mechanism may related to the reduction of AQP8 expression.