儿宝颗粒对脾虚泻小儿免疫功能影响的观察
|
摘要
目的:观察儿宝颗粒对脾虚型腹泻患儿免疫蛋白,T细胞水平、粪便中分泌型免疫球蛋白A(SIg A)含量、肠道微生态指标的影响。方法:采用随机数字表法将180例脾虚泻患儿分成对照组和观察组各90例。对照组给予蒙脱石散内服进行治疗,观察组在对照组治疗的基础上加服儿宝颗粒,两组患儿均连续治疗10 d。进行治疗前后血清免疫球蛋白G(Ig G),Ig M和Ig A检测,外周血CD3~+,CD4~+,CD8~+及CD4~+/CD8~+检测,粪便中分泌型免疫球蛋白A(SIg A)和唾液淀粉酶活性值、尿D-木糖检测,进行治疗前后主要症状、体征评分,并进行药物安全性评价。结果:治疗后,观察组临床总有效率为95. 56%高于对照组的80%(χ~2=10. 149,P <0. 01);观察组Ig G,Ig M和Ig A均较治疗前有所升高(P <0. 05),治疗后观察组患儿Ig G,Ig M和Ig A均高于对照组(P <0. 05);治疗后观察组患儿CD3~+,CD4~+,及CD4~+/CD8~+均高于对照组(P <0. 05);观察组患儿粪便中SIg A含量较治疗前增加(P <0. 05),治疗后观察组粪便中SIg A含量高于对照组(P <0. 05);治疗后观察组患儿唾液淀粉酶活性值、尿D-木糖值均高于对照组(P <0. 05);治疗后观察组患儿主要症状评分均低于对照组(P <0. 05)。结论:在蒙脱石散治疗脾虚泻患儿基础上,儿宝颗粒可减轻脾虚型腹泻患儿的临床症状,提高治疗效果,并能改善患儿的免疫功能。
Objective: To observe the effect of Erbao grains on levels of immunoglobulin,T cells,secretory immunoglobulin A from feces,and intestinal microecology index of children with diarrhea due to spleen deficiency. Method: One hundred and eighty patients with diarrhea due to spleen deficiency were randomly divided into control group( 90 cases) and observation group( 90 cases) by random number table. Patients in control group got Montmorillonite powder. In addition to the therapy in control group,patients in observation were additionally given Erbao grains. And the course of treatment was 10 days. Before and after treatment,levels of serum immunoglobulin G( IgG), IgM, IgA, CD3~+, CD4~+, CD8~+, ratio CD4~+and CD8~+, secretory immunoglobulin A from feces( SIgA),activity of salivary amylase and urine D-xylose were detected,the main symptoms and signs were scored,and the safety was discussed. Result: After treatment,the clinical total effective rate in observation group was 95. 56%,which was higher than 80% in control group( χ~2= 10. 149,P < 0. 01).Compared with the data before the treatment,levels of Ig G,IgM,IgA and SIgA in observation group increased( P < 0. 05),which were higher than those in control group( P < 0. 05). After treatment,levels of CD3~+,CD4~+,CD4~+/CD8~+,activity of salivary amylase and urine D-xylose were higher than those in control group( P < 0. 05).Score of the main symptoms and signs were lower than those in control group( P < 0. 05). Conclusion: In addition to the therapy of Montmorillonite powder,Erbao grains can relieve the symptoms of children with diarrhea due to spleen deficiency,improve the efficacy,and ameliorate immunity of children.
Objective: To observe the effect of Erbao grains on levels of immunoglobulin,T cells,secretory immunoglobulin A from feces,and intestinal microecology index of children with diarrhea due to spleen deficiency. Method: One hundred and eighty patients with diarrhea due to spleen deficiency were randomly divided into control group( 90 cases) and observation group( 90 cases) by random number table. Patients in control group got Montmorillonite powder. In addition to the therapy in control group,patients in observation were additionally given Erbao grains. And the course of treatment was 10 days. Before and after treatment,levels of serum immunoglobulin G( IgG), IgM, IgA, CD3~+, CD4~+, CD8~+, ratio CD4~+and CD8~+, secretory immunoglobulin A from feces( SIgA),activity of salivary amylase and urine D-xylose were detected,the main symptoms and signs were scored,and the safety was discussed. Result: After treatment,the clinical total effective rate in observation group was 95. 56%,which was higher than 80% in control group( χ~2= 10. 149,P < 0. 01).Compared with the data before the treatment,levels of Ig G,IgM,IgA and SIgA in observation group increased( P < 0. 05),which were higher than those in control group( P < 0. 05). After treatment,levels of CD3~+,CD4~+,CD4~+/CD8~+,activity of salivary amylase and urine D-xylose were higher than those in control group( P < 0. 05).Score of the main symptoms and signs were lower than those in control group( P < 0. 05). Conclusion: In addition to the therapy of Montmorillonite powder,Erbao grains can relieve the symptoms of children with diarrhea due to spleen deficiency,improve the efficacy,and ameliorate immunity of children.
引文
[1]张扬,全淑燕,曾力楠,等.全球现有儿童腹泻临床实践指南的循证评价[J].中国药房,2018,29(8):1110-1117.
[2]胡思源,李晓璇.中药治疗小儿腹泻病临床试验设计与评价概要[J].天津中医药,2018,35(8):564-568.
[3]中华医学会儿科学分会消化学组,《中华儿科杂志》编辑委员会.中国儿童急性感染性腹泻病临床实践指南[J].中华儿科杂志,2016,54(7):483-488.
[4]程爱,周盈.小儿腹泻病的中医治疗概况[J].中医儿科杂志,2016,12(2):69-73.
[5]张丽学.宝儿康散治疗脾虚湿困型小儿腹泻的临床疗效观察[J].中国中药杂志,2015,40(8):1605-1609.
[6]杨志华,杨文华.金双歧、蒙脱石散联合儿宝颗粒治疗婴幼儿腹泻疗效观察[J].中医儿科杂志,2012,8(4):27-28.
[7]高华.儿宝颗粒治疗小儿消化不良的疗效探讨[J].中国优生优育,2013,19(9):719.
[8]赵智强,汪元平,项小人,等.儿宝颗粒对小儿厌食症模型大鼠胃、空肠段黏膜形态及VIP、SS表达的影响[J].山东中医药大学学报,2010,9(2):176-177.
[9]王慧.双歧杆菌活菌联合蒙脱石散治疗小儿腹泻的效果及对其免疫功能的影响[J].河南医学研究,2017,26(18):3422-3423.
[10]胡亚美,江载芳.诸福棠实用儿科学(上下)[M].7版.北京:人民卫生出版社,2012:21-22.
[11]江育仁,张奇文.实用中医儿科学[M]. 2版.上海:上海科技出版社,2005:33-34.
[12] Levy K,Woster A P,Goldstein R S,et al. Untangling the impacts of climate change on waterborne diseases:a systematic review of relationships between diarrheal diseases and temperature, rainfall, flooding, and drought[J]. Environ Sci Technol,2016,50(10):4905-4922.
[13]赖冬梅.中西医结合治疗小儿脾胃虚弱迁延性及慢性腹泻临床观察[J].医药前沿,2015,19(16):231-232.
[14]鲁俊平,秦艳虹,师会娟.秦艳虹教授治疗小儿脾虚泻研究[J].中国中西医结合儿科学,2016,8(5):545-547.
[15]王芳.中医外治法综合治疗小儿泄泻40例临床观察[J].中国民间疗法,2016,24(4):36.
[16]汤景平,顾承萍,黄烈平.参苓白术散汤剂治疗小儿腹泻脾胃虚弱型68例临床观察[J].中医儿科杂志,2016,12(3):55-58.
[17]徐珊,汪受传.汪受传温运脾阳法治疗小儿脾虚泻的学术观点与临床经验[J].中华中医药杂志,2016,14(8):3150-3152.
[18]李丽霞,宋铁玎.宋铁玎从脾虚夹积论治小儿泄泻[J].实用中医内科杂志,2016,30(6):6-7.
[19]徐景利,李志城,梁峥嵘,等.喜炎平联合蒙脱石散治疗小儿腹泻疗效及安全性的Meta分析[J].中国实验方剂学杂志,2016,22(3):211-216.
[20]马雁军,王珍.儿宝颗粒治疗小儿脾虚泄泻纳呆202例临床观察[J].山西医药杂志,2008,37(16):691-692.
[21]曹水霞,王艳召,舒广惠.布拉氏酵母菌治疗小儿腹泻对细胞免疫功能的影响分析[J].当代医学,2017,23(17):96-98.
[22]卢灵莉,张伟锋,陈华林.小儿腹泻与T淋巴细胞亚群、血清维生素D3水平的关系[J].临床医学工程,2016,23(3):331-332.
[23]王建雄.太子参苓汤治疗小儿腹泻78例[J].湘南学院学报:医学版,2004,21(4):63-64.
[24]张晓丹,许嗣立,贾波,等.白术茯苓与白术茯苓汤对脾气虚腹泻大鼠模型胃肠形态及水液代谢的影响[J].四川中医,2014,12(3):61-64.
[2]胡思源,李晓璇.中药治疗小儿腹泻病临床试验设计与评价概要[J].天津中医药,2018,35(8):564-568.
[3]中华医学会儿科学分会消化学组,《中华儿科杂志》编辑委员会.中国儿童急性感染性腹泻病临床实践指南[J].中华儿科杂志,2016,54(7):483-488.
[4]程爱,周盈.小儿腹泻病的中医治疗概况[J].中医儿科杂志,2016,12(2):69-73.
[5]张丽学.宝儿康散治疗脾虚湿困型小儿腹泻的临床疗效观察[J].中国中药杂志,2015,40(8):1605-1609.
[6]杨志华,杨文华.金双歧、蒙脱石散联合儿宝颗粒治疗婴幼儿腹泻疗效观察[J].中医儿科杂志,2012,8(4):27-28.
[7]高华.儿宝颗粒治疗小儿消化不良的疗效探讨[J].中国优生优育,2013,19(9):719.
[8]赵智强,汪元平,项小人,等.儿宝颗粒对小儿厌食症模型大鼠胃、空肠段黏膜形态及VIP、SS表达的影响[J].山东中医药大学学报,2010,9(2):176-177.
[9]王慧.双歧杆菌活菌联合蒙脱石散治疗小儿腹泻的效果及对其免疫功能的影响[J].河南医学研究,2017,26(18):3422-3423.
[10]胡亚美,江载芳.诸福棠实用儿科学(上下)[M].7版.北京:人民卫生出版社,2012:21-22.
[11]江育仁,张奇文.实用中医儿科学[M]. 2版.上海:上海科技出版社,2005:33-34.
[12] Levy K,Woster A P,Goldstein R S,et al. Untangling the impacts of climate change on waterborne diseases:a systematic review of relationships between diarrheal diseases and temperature, rainfall, flooding, and drought[J]. Environ Sci Technol,2016,50(10):4905-4922.
[13]赖冬梅.中西医结合治疗小儿脾胃虚弱迁延性及慢性腹泻临床观察[J].医药前沿,2015,19(16):231-232.
[14]鲁俊平,秦艳虹,师会娟.秦艳虹教授治疗小儿脾虚泻研究[J].中国中西医结合儿科学,2016,8(5):545-547.
[15]王芳.中医外治法综合治疗小儿泄泻40例临床观察[J].中国民间疗法,2016,24(4):36.
[16]汤景平,顾承萍,黄烈平.参苓白术散汤剂治疗小儿腹泻脾胃虚弱型68例临床观察[J].中医儿科杂志,2016,12(3):55-58.
[17]徐珊,汪受传.汪受传温运脾阳法治疗小儿脾虚泻的学术观点与临床经验[J].中华中医药杂志,2016,14(8):3150-3152.
[18]李丽霞,宋铁玎.宋铁玎从脾虚夹积论治小儿泄泻[J].实用中医内科杂志,2016,30(6):6-7.
[19]徐景利,李志城,梁峥嵘,等.喜炎平联合蒙脱石散治疗小儿腹泻疗效及安全性的Meta分析[J].中国实验方剂学杂志,2016,22(3):211-216.
[20]马雁军,王珍.儿宝颗粒治疗小儿脾虚泄泻纳呆202例临床观察[J].山西医药杂志,2008,37(16):691-692.
[21]曹水霞,王艳召,舒广惠.布拉氏酵母菌治疗小儿腹泻对细胞免疫功能的影响分析[J].当代医学,2017,23(17):96-98.
[22]卢灵莉,张伟锋,陈华林.小儿腹泻与T淋巴细胞亚群、血清维生素D3水平的关系[J].临床医学工程,2016,23(3):331-332.
[23]王建雄.太子参苓汤治疗小儿腹泻78例[J].湘南学院学报:医学版,2004,21(4):63-64.
[24]张晓丹,许嗣立,贾波,等.白术茯苓与白术茯苓汤对脾气虚腹泻大鼠模型胃肠形态及水液代谢的影响[J].四川中医,2014,12(3):61-64.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |