苍苓散对湿热型轮状病毒肠炎肠粘膜免疫及肠道菌群影响的研究
|
摘要
目的：
从总有效率、止泻时间及临床证候改善情况等角度着眼,客观规范地评价中药苍苓散治疗小儿湿热型轮状病毒肠炎的疗效,并观察苍苓散对肠道粘膜免疫及肠道菌群的影响,探讨其治疗轮状病毒肠炎的作用机制,为进一步开发疗效显著、安全可靠地复方新药提供理论和实验依据。
方法：
1.临床研究采用前瞻性的随机对照临床研究方法,研究的目标人群为6个月～2岁轮状病毒肠炎患儿,采用中心随机化分配系统分为中药苍苓散组和思密达组,分配比例1：1,治疗组口服中药苍苓散(药物由广州中医药大学第一附属医院中药房提供),每日一剂,3天为一疗程；对照组予以思密达口服,<1岁,1/3包,每天3次；6月～1岁,1/3包,每天3次；-2岁,1/2包,每天3次,3天为一疗程。观察两组患儿临床症状、总有效率等。
2.实验研究分别采用酶联免疫双抗体夹心法检测轮状病毒肠炎患儿治疗前后粪便中SIgA含量,以及采用实时荧光定量PCR (FQ-PCR)技术检测轮状病毒肠炎患儿治疗前后粪便双歧杆菌、乳酸杆菌及大肠杆菌含量。
结果：
1.治疗后苍苓散组的总有效率为96.16%,思密达组总有效率为79.17%,二者比较具有显著性差异(P<0.05),苍苓散组优于思密达组；
2.苍苓散组、思密达组止泻时间分别为2.53±1.35天、4.37±1.68天,两者的止泻时间比较有显著性差异(P<0.05),苍苓散组优于思密达组；
3.苍苓散组、思密达组腹胀消失时间分别为3.16±1.54天、5.42±1.93天。两者比较有显著性差异(P<0.05),苍苓散组优于思密达组；
4.苍苓散组、思密达组饮食恢复时间分别为3.47±1.52天、5.86±1.81天。两者比较有显著性差异(P<0.05),苍苓散组优于思密达组；
5.治疗后两组腹泻患儿粪便标本中的SIgA含量数值均较治疗前增加,与治疗前相比,有显著性差异(P 6.对双歧杆菌、乳酸杆菌、大肠杆菌分别分析,两组治疗前、后组间差异无统计学意义(P>0.05)；治疗前、后差值的组间差异无统计学意义(P>0.05)；治疗前、后组内差异均无统计学意义(P>0.05)。
7.对乳酸菌与大肠杆菌比值、双歧杆菌与大肠杆菌比值分别分析,两组治疗前、后组间差异无统计学意义(P>0.05)；治疗前、后差值的组间差异无统计学意义(P>0.05)；治疗前、后组内差异均无统计学意义(P<0.05)。
8SIgA分别与双歧杆菌、大肠杆菌、乳酸杆菌进行相关分析,治疗前后SIgA含量与双歧杆菌、大肠杆菌之间无显著相关关系(P>0.05),治疗前后SIgA含量与乳酸杆菌之间有显著相关关系(P<0.05)
结论
1.本次研究结果提示苍苓散治疗轮状病毒肠炎湿热证临床疗效可靠,苍苓散能迅速起到止泻,消除腹胀,改善患儿食欲,缩短病程,减少住院时间；
2.治疗三天,苍苓散可能具有促进轮状病毒感染急性期肠粘膜SIgA分泌作用；苍苓散早期治疗机制可能并非直接通过调节肠道菌群而起作用,可能存在其他作用靶点。也可能与标本采集时间节点的选取有关；
3.在轮状病毒肠炎中乳酸杆菌可能对SIgA的分泌具有刺激作用。
Objective
A randomized control clinical study of Chinese medicine in infantile rotavirus diarrhea treatment was conducted to evaluate objectively and standardized the effect of cang ling powder on infantile heat-dampness rotavirus diarrhea in terms of clinical syndrome appearance and so on.And observed the effect of Cang Ling powder on mucosal immunity and microecological regulation. to further analyzes the pathogenesis of HRV diarrhea and the possible targets of Cang Ling Powder, to provide scientific basis for the clinical treatment for Human rotavirus (HRV) diarrhea by traditional chinese medicine.
Methods
The clinical study was designed as a prospective, randomized, control trial in target population of6-month to2-year-old infants with HRV diarrhea, who were allocated into Cang Ling Powder group, and smectite group in proportion of1:1with randomizatal method. Clinical symptoms observation and detection of the change of SIgA and microecological regulation in stool between pre/post-treatment and follow-up.
Results
1. Clinical study of infantile heat-dampness HRV diarrhea
1.1Post-treatment total effective rates of Cang Ling Powder group was96.16%and Post-treatment total effective rates of Dioctahedral smectite group is79.17%, there were significant differences when compared the two treatments. Post-treatment total effective rates of Cang Ling Powder group was superior to Dioctahedral smectite group.
1.2The antidiarrheal time of Cang Ling Powder group and Dioctahedral smectite group was2.53±1.35days and4.37±1.68days respectively.there was significant difference between the antidiarrheal times of two treatments revealed by statistics analysis. The antidiarrheal time of Cang Ling Powder group was superior to Dioctahedral smectite group.
1.3The appetite recovery time of Cang Ling Powder group and Dioctahedral smectite group was3.47±1.52days and5.86±1.81days respectively. there was significant difference between the antidiarrheal times of two treatments revealed by statistics analysis. The appetite recovery time of Cang Ling Powder group was superior to Dioctahedral smectite group.
1.4The abdominal distension recovery time of Cang Ling Powder group and Dioctahedral smectite group was3.16±1.54days and5.42±1.93days respectively.there was significant difference between the antidiarrheal times of two treatments revealed by statistics analysis. The abdominal distension recovery time of Cang Ling Powder group was superior to Dioctahedral smectite group.
2. Experimental study of infantile heat-dampness HRV diarrhea
2.1Content of SIgA were detected in100infants with HRV diarrhea, and the results showed significant difference were revealed between the content of SIgA post-treatment stool specimens of infants in the two groups and that pre-treatment stool specimens; But there was no significant difference of the SIgA content about post-treatment stool specimens in two groups(cangling powder group and smectite group)(P>0.05);There were significant differere between the content of SIgA post-treatment stool specimens of infants in the two groups (cangling powder group and healthy group) specimens.
2.2To analyse the content of bifidobacteria, there was no difference in the two groups of both post-treatment stool specimens and pre-treatment stool specimens(P>0.05).
2.3To analyse the content of lactobacilli, there was no difference in the two groups of both post-treatment stool specimens and pre-treatment stool specimens(P>0.05).
2.4To analyse the content of escherichia coli, there was no difference in the two groups of both post-treatment stool specimens and pre-treatment stool specimens(P>0.05).
2.5To analyse the ratio of and escherichia coli, there was no difference in the two groups of both post-treatment stool specimens and pre-treatment stool specimens(P>0.05).
2.6To analyse the ratio of lactobacilli and escherichia coli, there was no difference in the two groups of both post-treatment stool specimens and pre-treatment stool specimens(P>0.05).
2.7To analyse the content of SIgA and bifidobacteria, there was no correlatons in the two groups of both post-treatment stool specimens and pre-treatment stool specimens(P>0.05).
2.8To analyse the content of SIgA and lactobacilli, there was significant correlatons in the two groups of both post-treatment stool specimens and pre-treatment stool specimens(P<0.05).
2.9To analyse the content of SIgA and escherichia coli, there was no correlatons in the two groups of both post-treatment stool specimens and pre-treatment stool specimens(P>0.05).
Conlusion
(1)The study reveal the Cang Ling powder had good effect on HRV diarrhea, it could relieve diarrhea, recover appetite and abdominal distension;So it could decline the course of diarrhea.
(2) Through three days, Cang Ling Powder could elevate the content of SIgA in heat-dampness HRV diarrhea infant, there was no significant difference in two groups;Cang Ling Powder had no effect on the bacterial flora content of heat-dampness HRV diarrhea infant, maybe in the forepart of HRV diarrhea, Cang Ling Powder worked throngh other track; or it was limited by the time of collecting stool specimens.
(3)Lactobacilli maybe can stimulate the secretion of SIgA
从总有效率、止泻时间及临床证候改善情况等角度着眼,客观规范地评价中药苍苓散治疗小儿湿热型轮状病毒肠炎的疗效,并观察苍苓散对肠道粘膜免疫及肠道菌群的影响,探讨其治疗轮状病毒肠炎的作用机制,为进一步开发疗效显著、安全可靠地复方新药提供理论和实验依据。
方法：
1.临床研究采用前瞻性的随机对照临床研究方法,研究的目标人群为6个月～2岁轮状病毒肠炎患儿,采用中心随机化分配系统分为中药苍苓散组和思密达组,分配比例1：1,治疗组口服中药苍苓散(药物由广州中医药大学第一附属医院中药房提供),每日一剂,3天为一疗程；对照组予以思密达口服,<1岁,1/3包,每天3次；6月～1岁,1/3包,每天3次；-2岁,1/2包,每天3次,3天为一疗程。观察两组患儿临床症状、总有效率等。
2.实验研究分别采用酶联免疫双抗体夹心法检测轮状病毒肠炎患儿治疗前后粪便中SIgA含量,以及采用实时荧光定量PCR (FQ-PCR)技术检测轮状病毒肠炎患儿治疗前后粪便双歧杆菌、乳酸杆菌及大肠杆菌含量。
结果：
1.治疗后苍苓散组的总有效率为96.16%,思密达组总有效率为79.17%,二者比较具有显著性差异(P<0.05),苍苓散组优于思密达组；
2.苍苓散组、思密达组止泻时间分别为2.53±1.35天、4.37±1.68天,两者的止泻时间比较有显著性差异(P<0.05),苍苓散组优于思密达组；
3.苍苓散组、思密达组腹胀消失时间分别为3.16±1.54天、5.42±1.93天。两者比较有显著性差异(P<0.05),苍苓散组优于思密达组；
4.苍苓散组、思密达组饮食恢复时间分别为3.47±1.52天、5.86±1.81天。两者比较有显著性差异(P<0.05),苍苓散组优于思密达组；
5.治疗后两组腹泻患儿粪便标本中的SIgA含量数值均较治疗前增加,与治疗前相比,有显著性差异(P
7.对乳酸菌与大肠杆菌比值、双歧杆菌与大肠杆菌比值分别分析,两组治疗前、后组间差异无统计学意义(P>0.05)；治疗前、后差值的组间差异无统计学意义(P>0.05)；治疗前、后组内差异均无统计学意义(P<0.05)。
8SIgA分别与双歧杆菌、大肠杆菌、乳酸杆菌进行相关分析,治疗前后SIgA含量与双歧杆菌、大肠杆菌之间无显著相关关系(P>0.05),治疗前后SIgA含量与乳酸杆菌之间有显著相关关系(P<0.05)
结论
1.本次研究结果提示苍苓散治疗轮状病毒肠炎湿热证临床疗效可靠,苍苓散能迅速起到止泻,消除腹胀,改善患儿食欲,缩短病程,减少住院时间；
2.治疗三天,苍苓散可能具有促进轮状病毒感染急性期肠粘膜SIgA分泌作用；苍苓散早期治疗机制可能并非直接通过调节肠道菌群而起作用,可能存在其他作用靶点。也可能与标本采集时间节点的选取有关；
3.在轮状病毒肠炎中乳酸杆菌可能对SIgA的分泌具有刺激作用。
Objective
A randomized control clinical study of Chinese medicine in infantile rotavirus diarrhea treatment was conducted to evaluate objectively and standardized the effect of cang ling powder on infantile heat-dampness rotavirus diarrhea in terms of clinical syndrome appearance and so on.And observed the effect of Cang Ling powder on mucosal immunity and microecological regulation. to further analyzes the pathogenesis of HRV diarrhea and the possible targets of Cang Ling Powder, to provide scientific basis for the clinical treatment for Human rotavirus (HRV) diarrhea by traditional chinese medicine.
Methods
The clinical study was designed as a prospective, randomized, control trial in target population of6-month to2-year-old infants with HRV diarrhea, who were allocated into Cang Ling Powder group, and smectite group in proportion of1:1with randomizatal method. Clinical symptoms observation and detection of the change of SIgA and microecological regulation in stool between pre/post-treatment and follow-up.
Results
1. Clinical study of infantile heat-dampness HRV diarrhea
1.1Post-treatment total effective rates of Cang Ling Powder group was96.16%and Post-treatment total effective rates of Dioctahedral smectite group is79.17%, there were significant differences when compared the two treatments. Post-treatment total effective rates of Cang Ling Powder group was superior to Dioctahedral smectite group.
1.2The antidiarrheal time of Cang Ling Powder group and Dioctahedral smectite group was2.53±1.35days and4.37±1.68days respectively.there was significant difference between the antidiarrheal times of two treatments revealed by statistics analysis. The antidiarrheal time of Cang Ling Powder group was superior to Dioctahedral smectite group.
1.3The appetite recovery time of Cang Ling Powder group and Dioctahedral smectite group was3.47±1.52days and5.86±1.81days respectively. there was significant difference between the antidiarrheal times of two treatments revealed by statistics analysis. The appetite recovery time of Cang Ling Powder group was superior to Dioctahedral smectite group.
1.4The abdominal distension recovery time of Cang Ling Powder group and Dioctahedral smectite group was3.16±1.54days and5.42±1.93days respectively.there was significant difference between the antidiarrheal times of two treatments revealed by statistics analysis. The abdominal distension recovery time of Cang Ling Powder group was superior to Dioctahedral smectite group.
2. Experimental study of infantile heat-dampness HRV diarrhea
2.1Content of SIgA were detected in100infants with HRV diarrhea, and the results showed significant difference were revealed between the content of SIgA post-treatment stool specimens of infants in the two groups and that pre-treatment stool specimens; But there was no significant difference of the SIgA content about post-treatment stool specimens in two groups(cangling powder group and smectite group)(P>0.05);There were significant differere between the content of SIgA post-treatment stool specimens of infants in the two groups (cangling powder group and healthy group) specimens.
2.2To analyse the content of bifidobacteria, there was no difference in the two groups of both post-treatment stool specimens and pre-treatment stool specimens(P>0.05).
2.3To analyse the content of lactobacilli, there was no difference in the two groups of both post-treatment stool specimens and pre-treatment stool specimens(P>0.05).
2.4To analyse the content of escherichia coli, there was no difference in the two groups of both post-treatment stool specimens and pre-treatment stool specimens(P>0.05).
2.5To analyse the ratio of and escherichia coli, there was no difference in the two groups of both post-treatment stool specimens and pre-treatment stool specimens(P>0.05).
2.6To analyse the ratio of lactobacilli and escherichia coli, there was no difference in the two groups of both post-treatment stool specimens and pre-treatment stool specimens(P>0.05).
2.7To analyse the content of SIgA and bifidobacteria, there was no correlatons in the two groups of both post-treatment stool specimens and pre-treatment stool specimens(P>0.05).
2.8To analyse the content of SIgA and lactobacilli, there was significant correlatons in the two groups of both post-treatment stool specimens and pre-treatment stool specimens(P<0.05).
2.9To analyse the content of SIgA and escherichia coli, there was no correlatons in the two groups of both post-treatment stool specimens and pre-treatment stool specimens(P>0.05).
Conlusion
(1)The study reveal the Cang Ling powder had good effect on HRV diarrhea, it could relieve diarrhea, recover appetite and abdominal distension;So it could decline the course of diarrhea.
(2) Through three days, Cang Ling Powder could elevate the content of SIgA in heat-dampness HRV diarrhea infant, there was no significant difference in two groups;Cang Ling Powder had no effect on the bacterial flora content of heat-dampness HRV diarrhea infant, maybe in the forepart of HRV diarrhea, Cang Ling Powder worked throngh other track; or it was limited by the time of collecting stool specimens.
(3)Lactobacilli maybe can stimulate the secretion of SIgA
引文
[1]Parashar UD, Hummelman EG, Bresee JS, et al. Global illness and deaths caused by rotavirus disease in children [J]. Emerg infect Dis,2003,9 (5):565-572.
[2]Santosham M. Rotavirus vaccine--a powerful tool to combat deaths from diarrhea. N Engl J Med,2010,362 (4):358-360.
[3]Glass RI, Patel M, Parashar U. Lessons from the US rotavirus vaccination program. JAMA, 2011,306(15):1701-1702.
[4]陈忠龙.肠黏膜屏障与胃肠道疾病[J].海峡预防医学杂志,2007,13(2)：31-32.
[5]孙涛.唾液SIgA的结构及功能研究[J].北京口腔医学,2000,8(4)：200-203.
[6]Brandtazeg P. the secretory immunoglobulin system:regulation and biogicol significance, Focusing on human mammary gland. Adv Exp Med Bio,2002,503:1-16.
[7]Diebel LN, Liberati DM, Dulchavsky SA, et al. Surgery,2003; 134:574-581.
[8]王静安,王泽涵,王雪梅.王静安医学新书[M].成都：成都时代出版社,2007：120-121.
[9]史字广,单书健.当代名医临证精华小儿腹泻专辑[M].北京：中医古籍出版社,1988：57,109.
[10]季之颖,陈芳,杨燕.陈昭定教授治疗小儿久泻经验[J].中国中医急症,2005,14(2)：157.
[11]滕旭.王雪峰治疗小儿泄泻经验[J].辽宁中医杂志,2003,30(11)：925.
[12]马凤彬.何炎乐老中医治疗小儿腹泻经验[J].新中医,1997,29(8)：8-9
[13]罗云坚,儿科专病中医临床诊治[M].北京：人民卫生出版社,2000：219-220
[14]徐金星,马斯风.王烈教授治疗小儿轮状病毒感染性腹泻经验[J].中国中西医结合儿科学,2011,03(1)：19-20.
[15]郑宏,郑攀.郑启仲教授从燥论治秋季腹泻经验[J].中医研究,2010,23(10)：71-73.
[16]张艳.藿朴夏苓汤加减治疗小儿秋季腹泻疗效观察[J].中国中医急,2010,19(1)：33-34.
[17]伍向滨.葛根芩连汤加减治疗小儿轮状病毒肠炎[J].现代医院,2011,11(9)：43-44.
[18]加味葛根芩连汤治疗急性小儿湿热型秋季腹泻临床观察[J].现代中西医结合杂志,2006,15(16)：2185-2186.
[19]曾菊香.葛根芩连汤加味治疗婴幼儿腹泻60例[J].现代中西医结合杂志,2011,20(17)：2156-2157.
[20]葛洋新,谢本昌.参苓白术散治疗秋季腹泻的疗效[J].实用临床医学,2011,12(2)：76-77.
[21]王惠.参苓白术散联合丁桂儿脐贴治疗小儿秋季腹泻50例[J].中医中药,2011,9(10)：69.
[22]陈军林.中西医结合治疗小儿难治性腹泻54例[J].中国中西医结合杂志,2000,20(1)：55-56.
[23]金爱军.七味白术散治疗婴幼儿秋季腹泻临床疗效观察[J].浙江中医药大学学报,2010,34(2)：871-872.
[24]施贻杰.辨证分型治疗小儿秋季腹泻76例疗效观察[J].河北中医,1997,19(4)：18
[25]王树山,杨松等.双苓止泻口服液治疗小儿轮状病毒性肠炎的临床研究[J].中国中酉医结合杂 志,1995,15(5)：284.
[26]江育仁.脾健不在补贵再运.上海中医药杂志[J],2002(1)：4-7.
[27]肖健.健脾祛湿汤治疗婴幼儿秋季腹泻80例临床疗效观察[J].四川中医,2012,30(1)：95-96.
[28]许华,曾繁冬等.苍苓散治疗婴幼儿轮状病毒肠炎临床研究[J].中药新药与临床药理,1997(3)：81-83.
[29]王丽,彭芝配,滕久祥等.秦香颗粒对人轮状病毒(HRV)感染乳鼠小肠黏膜淋巴细胞的影响[J].中国实验方剂学杂志,2011,17(2)：173-176.
[30]殷坚,彭芝配,滕久祥等.秦香颗粒对人轮状病毒感染乳鼠血清IFN-γ的影响[J].湖南中医药大学学报,2010,30(1)：25-27.
[31]彭芝配,王丽,章琼等.秦香颗粒对轮状病毒感染乳鼠粪便病毒抗原及小肠粘膜SIgA的影响[J].湖南中医药大学学报,2010,30(3)：17-19.
[32]李文英,傅万海,陈国新等.参芪扶正注射液对轮状病毒感染性肠炎小鼠血清IL-2、INF-γ的影响[J].海南医学,2010,21(14)：29-31.
[33]季红梅,许正香,王艳玲.自拟中药贴敷神阙穴佐治小儿轮状病毒性肠炎[J].中医中药,2011,35(12)：106-107
[34]卢乐声,孙亚锋.中药穴位贴敷辅助治疗轮状病毒肠炎88例[J].浙江中医杂志,2011,46(1)：34
[35]吴瑛,陈万强,金玉.轮泻停敷脐辅助治疗小儿轮状病毒肠炎的临床观察[J].中国中西医结合杂志,2011,30(12)：1275-1278.
[36]邢燕如,张瑾宜,孙亚锋.秋泻敷剂敷脐治疗婴幼儿轮状病毒性腹泻153例[J].浙江中医杂志,2011,45(12)：899
[37]杨晓仙.运脾调中推拿法治疗小儿轮状病毒肠炎临床观察[J].长春中医药大学学报,2011,27(5)：814-815.
[38]张子燕,沈红岩.运脾止泻推拿法治疗小儿轮状病毒肠炎临床观察[J].辽宁中医杂志,2011,38(5)：967-968.
[39]徐光宇,隆红艳.俞募穴推拿治疗婴幼儿轮状病毒肠炎50例[J].江西中医药,2011,42(6)：54-55.
[40]徐玲,李志山,陈光明等.推拿治疗小儿泄泻(湿热证)临床研究[J].长春中医药大学学报,2011,(5)：725-726.
[41]沈玉鹏.肠灵液灌肠治疗小儿病毒性腹泻100例疗效观察[J]甘肃中医,2004,17(2)：19-20.
[42]杨森,郭淑梅.中药灌肠治疗儿童秋季腹泻60例疗效观察[J]河北中医,2005,27(9)：663-664.
[43]安福宁,朱连科,何秀文.化湿解毒汤灌肠治疗轮状病毒性肠炎临床观察[J].中国中医急症,2010,19(12)：2037,2076.
[44]吴建荣,王荣茂.针灸加思密达治疗婴幼儿秋季腹泻54例[J].江苏中医药,2006,27(3)：49.
[45]于竹力.针灸治疗小儿腹泻32例[J].针灸临床杂志,2006,2(10)：19-20.
[46]程红云,周春清,王霖.隔药灸治疗小儿轮状病毒腹泻疗效观察[J].光明中医,2011,26(12)：2480-2481.
[47]Kapikian AZ, Hoshino Y, Chanock RM. Roraviruses [A]//KnipeDM,Howley PM. Fields Virology[M]. Fourth ed. Philadelphia:lppincott williams & willians,2001:1787-1833.
[48]常如需,潘瑞芳,朱冰,等.广州地区婴幼儿腹泻轮状病毒感染及型别的研究[J].中华儿科杂志,2002,40(7)：405-407.
[49]曾玫,陈洁,龚四堂等.我国五所城市儿童医院诺如病毒和轮状病毒腹泻的流行病学监测[J].中华儿科杂志,2010,48(8)：564-570.
[50]童美琴,陈黎勤,尚世强,等.2001—2003年杭州地区婴幼儿腹泻VP7型别分型[J].中华儿科杂志,2005,43(8)：595-598.
[51]尹应先,肖密丝,欧志英等.2005-2007年广州地区腹泻儿童感染轮状病毒情况分析[J].热带医学杂志,2009,9(7)：757-759.
[52]谢华萍,耿进妹,伍业健,等.2009年广州地区轮状病毒分子流行病学研究[J].预防医学情报志,2011,27(10)：773-776.
[53]Sandhu BK. European Society of Paediatric Gastroen-terology, Hepatology, and Nutrition Working Group on Acute Diarrhoea. Rationale for early feeding in childhood gastroenteritis[J]. J Pediatr Gastroenterol Nutr,2001,33(Suppl 2):S13-S16.
[54]Duggan C, Nurko S. "Feeding the gut":the scientific basis for continued enteral nutrition during acute diarrhea[J]. J Pediatr,1997,131(6):801-808
[55]顾蓁,沈华琴.喂养方式对婴幼儿轮状病毒腹泻的影响[J].临床儿科杂志,2010,28(1)：57-60.
[56]Wobudeya E, Bachou H, Karamagi CK, et al. Breastfeeding and the risk of rotavirus diarrhea in hospitalized infants in Uganda:a matched case control study [J]. BMC Pediatr. 2011 (17):11-17.
[57]中华医学会儿科学会分会消化学组.儿童腹泻病诊断治疗原则的专家共识.中华儿科杂志,2009,47(8)：634-636
[58]Hahn, S, Kim Y, Garner P. Reduced osmolatity oral fehydration solution for treating dehydration due to diarrhea in children:systematic review[J]. BMJ,2001,323(7304): 81-85.
[59]Szajewska H, Dziechciarz P, Mrukowicz J. Meta-analysis. Smectite in the treatment of acute infectious diarrhea in children[J].Aliment Pharmacol Ther,2006,23(2):217-227.
[60]Chernenko VV, Kharchenko NV. Cytoprotective properties of smecta on the intestinal mucosa of the alimentary canal [J].Lik Sprava.,2001, (5-6):164-166.
[61]张振,王晓梅,汤建桥等.鼠李糖乳杆菌对感染人轮状病毒乳鼠空肠黏膜上皮细胞的保护作用[J].华中科技大学学报(医学版),2012,41(1)：67-71.
[62]石海矾,陈益平,徐志伟等.嗜酸乳杆菌对人轮状病毒感染乳鼠小肠黏膜白细胞黏附分子-1、 γ-干扰素表达的影响[J].实用医学杂志,2010,26(8)：1314-1317.
[63]World Health Organization, United Nations Children's Fund. WHO/UNICEF Joint Statement:Clinical Management of Acute Diarrhoea[R]. The United Nations Children's Fund/World Health Organization,2004.
[64]Sachdev I-IP, Mittal NK, Mittal SK, et al. A controlled trial on utility of oral zinc supplementation in acute dehydrating diarrhea in infants[J]. J Pediatr Gastroenterol Nutr,1988,7(6):877-881.
[65]王丽娟,袁嘉丽.中医药调节黏膜免疫防治感染的研究与展望[J].现代中西医结合杂志,2010,19(34)：4504-4505,4510
[66]Brandtzage P, Fastad IN,Haraldsen G.Regional specialization in the mucosal immune system:primed cells do not always home along the same track[J]. Immunal Today,1999,20:267-277
[67]高杰英：粘膜上皮细胞与粘膜免疫：上皮细胞生物学——初探[M]：北京：军事医学科学院出版社,2000：213-216
[68].朱高发.神经-内分泌-免疫网络研究进展[J].中国实验临床免疫学杂志,1989,1(6)：421.
[69]付凯飞,彭瑞云.肠免疫组织对肠上皮细胞生长的影响[J].国外医学(免疫学分册),2005,28(6)：328-331.
[70]. Gill SR, Pop M, Deboy RT, Eckburg PB, Turnbaugh PJ, Samuel BS, et al. Metagenomic analysis of the human distal gut microbiome[J]. Science 2006;312:1355-1359.
[71]. Mestecky J, Lamm ME, McGhee JR, Bienenstock J, Mayer L, Strober W:Mucosal Immunology San Diego, CA:Academic Press,3 2005.
[72]杜瑞亭,托娅,张和平等.干酪乳杆菌Zhang对小鼠肠道免疫功能的影响[J].营养学报,2009,31(4)：396-399.
[73]王友湘,陈庆森.瑞士乳杆菌菌体的分离以及对小鼠肠道粘膜SIgA影响的研究[J].食品研究与开发,2008,29(5)：50-53.
[74]杨慧.芽孢杆菌制剂对小鼠小肠粘膜结构及粘膜免疫的影响研究[D].四川农业大学,2007.
[75]王忠堂,姚咏明,肖光夏等.补充双歧杆菌可促进烫伤大鼠肠道SIgA合成与分泌[J].感染、炎症、修复,2002,3(4)：232-235,封三.
[76]袁亚杰,杨毅,王卫平等.维生素A缺乏对肠粘膜树突状细胞的影响[J].营养学报,2011,33(4)：358-361,366.
[77]贺南方,姚洪森,张健等.维生素A与儿童呼吸道免疫功能[.门.河北医药,2005,27(2)：142.
[78]艾国平,粟永萍,刘晓宏等.重组人白细胞介素-4对儿类损伤时受损小肠粘膜免疫功能的促恢复作用[J].第三军医大学学报,1999,21(1)：1-4.
[79]钟波,徐辉,粟永萍等.重组人白细胞介素-11对放射后小鼠肠道枯膜免疫系统的保护作用的实验研究[J].第三军医大学学报,2005,27(12)：1256-1258.
[80]罗治彬,吴嘉惠,史景泉等.高锌对大鼠肠粘膜免疫的影响[J].中国药理学与毒理学杂志,2000,14(1)：36-39.
[81]Rey J, Garin N, Spertini F, et al. J Immumol,2004,172:3026-3033
[82]冯小燕,陈贻骥.维生素A在分泌型免疫球蛋白A生成中的作用[J].儿科药学杂志,2009,15(4)：56-59.
[83]Nikawa T, Odahara K, Koizumi H, et al. Vitamin A prevents the decline in immunoglobulin A and Th2 cytokine levels in small intsetinal mucosa of protein-malnourished mice[J]. J Nutr,1999,129(5):934-941.
[84]Mora J R, von Andrian U H. Role of retinoic acid in the imprinting of gut homing IgA secreting cells[J]. Semin Immunol,2009,21(1):28-35.
[85]鞠宝玲,唐小云,张红军,等.四君子汤对脱污染小鼠肠道菌群及粘膜免疫功能影响的研究[J].中药药理与临床,2008,24(5)1-3
[86]张大鹏,周联,张志敏等.四君子汤总多糖对免疫抑制小鼠肠道SIgA的影响及其机制研究[J].中药新药与临床药理,2010,21(1)：11-14.
[87]刘良,周华,王培训,等.四君子汤复方总多糖对小鼠肠道粘膜相关淋巴组织的影响[J].中国免疫学杂志,2000,17(4)：204-207
[88]吕冠华,王长洪,杨杰,等.大承气汤对重症急性胰腺炎大鼠肠粘膜分泌性IgA及CD3、γ δ T细胞的影响[J].中国中西医结合消化杂志,2010,18(5)：281-283,287.
[89]吕冠华,王长洪,王丽新,等.大黄对重症急性胰腺炎大鼠肠粘膜分泌性IgA及 γ δ T细胞的影响[J].中国中西医结合消化杂志,2009,17(3)：153-156
[90]李文林,潘苏华,关洪月.基于Arrowsmith探讨虫草素与肠粘膜屏障功能稳定的潜在相关性[J].医学信息,2009,22,(12)：2684-2687
[91]张靖,黄裕新,高巍等.穴位电针对鼠胃肠粘膜免疫功能的影响[J].世界华人消化杂志,2001,9(10)：1116-1119.
[92]李斐,黎海芪.金银花水提物对致敏小鼠肠道黏膜炎症和SIgA抗体反应的免疫调控[J].临床儿科杂志,2007,25(7)：585-589
[93]王强,刘亚欧,李兴平.辛温解表法对小鼠粘膜免疫功能的影响[J].时珍国医国医,2009,20(12)：2994-2995
[94]王强,刘亚欧,李兴平.桂枝汤对粘膜免疫干预作用的时效性研究[J].中药药理与临床,2010,26(6)：15-17.
[95]尹军霞,林德荣.肠道菌群与疾病.生物学通报,2004；39(3)：26-28
[96]Tuohy KM, Gougoulias C, Shen Q, et al. Studying the human gut microbiota in the trans-omics era--focus on metagenomics and metabonomics. Curr Pharm Des,2009, 15(13):1415-1427.
[97]Kau AL, Ahern PP, Griff in NW, et al. Human nutrition, the gut microbiome and the immune system. Nature,2011,474(7351):327-336.
[98]金红芝,李垫宝.人肠道微生态系统的研究进展.自然杂志,2004；26(2)：88-91
[99]Nicholson, J. K., E. Holmes, and I. D. Wilson, Gut microorganisms, mammalian metabolism and personalized health care. Nat Rev Microbiol,2005.3(5):p.431-8.
[100]Tamura, Z.,Nutriology of bifidobacteria. Bifidobacteria microflora,1983.3:p.3-16.
[101]Avgustin, G.,F.Wright, and H. J. Flint,Genetic diversity and phylogenetic relationships among strains of Prevotella(Bacteroides) ruminicola from the rumen. Int J Syst Bacteriol,1994.44(2):p.246-55.
[102]Brunser,O., et al., Effects of probiotic or prebiotic supplemented milk formulas on fecal microbiota composition of infants. Asia Pac J Clin Nutr,2006.15(3):368-376.
[103]徐殿霞,李建秋,熊德鑫.腹泻儿童肠道菌群分析[J].中国微生态学杂志,1999,11(3)：163,166.
[104]Carey CM, Kirk JL, Ojha S. Current and future uses of real-time polymerase chain reaction and microarrays in the study of intestinal microbiota, and probiotic use and effectiveness. Can J Microbiol,2007,53(5):537-550.
[105]Mai V, Draganov PV. Recent advances and remaining gaps in our knowledge of associations between gut microbiota and human health. World J Gastroenterol,2009, 15(1):81-85.
[106]Human Microbiome Jumpstart Reference Strains Consortium. A catalog of reference genomes from the human microbiome. Science,2010,328(5981):994-999.
[107]Arumugam M, Raes J, Pelletier E, et al. Enterotypes of the human gut microbiome. Nature,2011,473(7346):174-180.
[108]Qin J, Li R, Raes J, et al. A human gut microbial gene catalogue established by metagenomic sequencing. Nature,2010,464(7285):59-65.
[109]王茉琳,李晓光,王建杰,等.党参合剂对多器官功能障碍综合征菌群失调及免疫功能的调整[J].中国微生态学杂志,2011,23(7)：586-588.
[110]李秋明,张亚杰,张大方,等.健脾止泻颗粒对脾虚证及抗生素肠道菌群失调模型小鼠的微生态调节作用[J].中国中医基础医学杂志,2010,16(12)：1119-1120.
[111]胡新俊,李春香,王广,等.马齿苋多糖对肠道微生态失调小鼠的调整作用研究[J].中国微生态学杂志,2010,22(9)：781-783.
[112]李安德,崔宁,苌颖等.急性感染性腹泻的证候分布特点[J].北京中医药大学学报(中医临床版),2011,(5)：5-8.
[113]崔宁,谢春娥,李安德等.急性腹泻中医证候季节性分布规律的临床研究[J].世界中西医结合杂志,2011,06(7)：567-571.
[114]孙浩.江育仁教授“运脾法属于和法”之浅识[J].江苏中医药,2002,23(2)：173.
[115]国家药典委员会.中国药典,1部[S].北京：化学工业出版社,2000.
[116]宋小珍,杨秀江,王恬,等.4种中药提取物对大鼠小肠上皮细胞IEC26增殖及葡萄吸收的影响[J].中草药,2009,40(8)：1263-1266.
[117]谢露.苍术的药理研究.中医药研究,1992,(2)：59
[118]青木俊二.苍术还有效成分β 2桉叶醇及茅苍术醇对肠道平滑肌的作用[J].国外医学.中国中药分册,1991.13(2)：59
[119]国家中医药管理局.中华本草.上海科技出版社,187-193；
[120]江苏新医学院.中药大辞典.上海人民出版社,1596-1600
[121]张明发,沈雅琴,朱自平,等.辛温(热)合归脾胃经中药药性研究(Ⅴ)抗腹泻作用[J].中药药理与临床,1997,13(5)：2-5.
[122]张文芝.陈皮水煎液对离体唾液淀粉酶活性的影响[J].辽宁中医药杂志,1989,(4)：30.
[123]官福兰,王汝俊,王建华,等.陈皮及橙皮苷对离体肠管运动影响[J].时珍国医国药,2002,13(2)：65-67.
[124]国家药典委员会.中华人民共和国药典：Ⅰ部[M].北京：化学工业出版社,2005：22.
[125]Sun Cui-yu. The research progress of hawrhorn [J]. Primary Journal of Chinese Materia Medica,2001,15(5):53-54(In Chinese)
[126]Huang Xie-cai. Study of the original plants of Chinese drugs hawthorn[J]. GuanXi plants,1989,9(4):303-310(In Chinese
[127]黄珊珊,林原,刁云鹏等.焦山楂醇提取物对大鼠离体胃肠平滑肌条收缩性的影响.现代生物医学进展,2009,9(4)：612-614
[128]国家中医药管理局中华本草编委会.中华本草(第2卷)[M].上海：上海科学技术出版社,1999：647-649.
[129]谢贤强,吴萍,林立东,等.火炭母化学成分的研究[J].热带亚热带植物学报,2007,15(5)450-454.
[130]李安红.中国植物志(第25卷第一分册)[M].北京：科学出版社,1998：1-118.
[131]向红,林长松,左经会,等.水城蓼科植物资源及其药用价值研究[J].黔西南民族师范高等专科学校学报,2003(3)：81-88.
[132]包骏.贵州苗族医药研究与开发[M].贵州：贵州科学技术出版社,1998：491
[133]Kus J, Maziarka D. Common variable immunodeficiency-analysis of the clinical aspects and results of substitution treatment [J].Pneumonol Alergol Pol,1997,65(3-4):187-197.
[134]Bogstedt AK, Johansen K, Hatta H, et al. Passive immunity against diarrhea [J]. Acta Pediatr 1996,85 (2):125-128.
[135]Honorio-Franca AC, Carvalho MP, Isaac L, et al. Colostral mononuclear phagocytes are able to kill enteropathogenic Escherichia coli opsonized with colstral IgA [J]. Scand Immunol,1997,46(1):59-66.
[136]Ruggeri FM, Johansen K, Basile G, et al. Antirotavirus immunoglobul in A neutralizes virus in vitro after transcytosis through epithelial cell and protects infant mice from diarrhea [J]. J Virol,1998,72(4):2708-2714.
[137]Burns JW, Siadat-Pajouh M, Krishnaney AA, et al. Protective effect of rotavirus VP6-specific IgA monoclonal antibodies that lack neutralizing activity [J]. Science, 1996,272(5258):104-107.
[138]金玉,薛立军.轮状病毒性肠炎粪便中SIgA水平的变化[J].小儿急救医学2004,11(2)：96-98.
[139]煨葛根茯苓汤对小儿轮状病毒肠炎肠道分泌型IgA的影响以及对心肌损害的保护研究[J].中医儿科杂志,2006,2(6)：38-40.
[140]杜惠敏,陈颖虹,陈俊仪,等.轮状病毒感染与健康儿童肠道菌群结构的比较[J].实用儿科临床杂志,2006,21(9)：1237-1238.
[141]张琳,邱学,李素娥.婴幼儿轮状病毒肠道菌群的动态变化[J].中华儿科杂志,1994,32(5)：282-284.
[142]江月斐,劳绍贤,邝枣园,等.腹泻型肠易激综合征脾胃湿热证肠道菌群的变化.中国中西医结合杂志,2006,26(3)：218-220.
[143]陈晓刚.小儿再发性腹痛的脾胃湿热证与肠道微生态关系的研究.2007年广州中医药大学博士论文,61-64.
[144]胡小英,丘小汕,陈晓刚,等.调肠缓激方对儿童肠易激综合征肠道微生态的影响.广州中医药大学学报.2008,25(1)：63-67.
[145]王卓,彭颖,李晓波.四君子汤对两种脾虚模型大鼠肠道菌群紊乱的影响.中国中西医结合杂志,2009,29(9)：825-829.
[146]CEBRA J J. Influences ofmicrobiota on intestinal immune system de2, velopment[J]. Am J Clin Nutr,1999,69 (5):1046-1051.
[147]王友湘,陈庆森.瑞士乳杆菌菌体的分离以及对小鼠肠道粘膜SIgA影响的研究[J].食品研究与开发,2008,29(5)：50-53.
[2]Santosham M. Rotavirus vaccine--a powerful tool to combat deaths from diarrhea. N Engl J Med,2010,362 (4):358-360.
[3]Glass RI, Patel M, Parashar U. Lessons from the US rotavirus vaccination program. JAMA, 2011,306(15):1701-1702.
[4]陈忠龙.肠黏膜屏障与胃肠道疾病[J].海峡预防医学杂志,2007,13(2)：31-32.
[5]孙涛.唾液SIgA的结构及功能研究[J].北京口腔医学,2000,8(4)：200-203.
[6]Brandtazeg P. the secretory immunoglobulin system:regulation and biogicol significance, Focusing on human mammary gland. Adv Exp Med Bio,2002,503:1-16.
[7]Diebel LN, Liberati DM, Dulchavsky SA, et al. Surgery,2003; 134:574-581.
[8]王静安,王泽涵,王雪梅.王静安医学新书[M].成都：成都时代出版社,2007：120-121.
[9]史字广,单书健.当代名医临证精华小儿腹泻专辑[M].北京：中医古籍出版社,1988：57,109.
[10]季之颖,陈芳,杨燕.陈昭定教授治疗小儿久泻经验[J].中国中医急症,2005,14(2)：157.
[11]滕旭.王雪峰治疗小儿泄泻经验[J].辽宁中医杂志,2003,30(11)：925.
[12]马凤彬.何炎乐老中医治疗小儿腹泻经验[J].新中医,1997,29(8)：8-9
[13]罗云坚,儿科专病中医临床诊治[M].北京：人民卫生出版社,2000：219-220
[14]徐金星,马斯风.王烈教授治疗小儿轮状病毒感染性腹泻经验[J].中国中西医结合儿科学,2011,03(1)：19-20.
[15]郑宏,郑攀.郑启仲教授从燥论治秋季腹泻经验[J].中医研究,2010,23(10)：71-73.
[16]张艳.藿朴夏苓汤加减治疗小儿秋季腹泻疗效观察[J].中国中医急,2010,19(1)：33-34.
[17]伍向滨.葛根芩连汤加减治疗小儿轮状病毒肠炎[J].现代医院,2011,11(9)：43-44.
[18]加味葛根芩连汤治疗急性小儿湿热型秋季腹泻临床观察[J].现代中西医结合杂志,2006,15(16)：2185-2186.
[19]曾菊香.葛根芩连汤加味治疗婴幼儿腹泻60例[J].现代中西医结合杂志,2011,20(17)：2156-2157.
[20]葛洋新,谢本昌.参苓白术散治疗秋季腹泻的疗效[J].实用临床医学,2011,12(2)：76-77.
[21]王惠.参苓白术散联合丁桂儿脐贴治疗小儿秋季腹泻50例[J].中医中药,2011,9(10)：69.
[22]陈军林.中西医结合治疗小儿难治性腹泻54例[J].中国中西医结合杂志,2000,20(1)：55-56.
[23]金爱军.七味白术散治疗婴幼儿秋季腹泻临床疗效观察[J].浙江中医药大学学报,2010,34(2)：871-872.
[24]施贻杰.辨证分型治疗小儿秋季腹泻76例疗效观察[J].河北中医,1997,19(4)：18
[25]王树山,杨松等.双苓止泻口服液治疗小儿轮状病毒性肠炎的临床研究[J].中国中酉医结合杂 志,1995,15(5)：284.
[26]江育仁.脾健不在补贵再运.上海中医药杂志[J],2002(1)：4-7.
[27]肖健.健脾祛湿汤治疗婴幼儿秋季腹泻80例临床疗效观察[J].四川中医,2012,30(1)：95-96.
[28]许华,曾繁冬等.苍苓散治疗婴幼儿轮状病毒肠炎临床研究[J].中药新药与临床药理,1997(3)：81-83.
[29]王丽,彭芝配,滕久祥等.秦香颗粒对人轮状病毒(HRV)感染乳鼠小肠黏膜淋巴细胞的影响[J].中国实验方剂学杂志,2011,17(2)：173-176.
[30]殷坚,彭芝配,滕久祥等.秦香颗粒对人轮状病毒感染乳鼠血清IFN-γ的影响[J].湖南中医药大学学报,2010,30(1)：25-27.
[31]彭芝配,王丽,章琼等.秦香颗粒对轮状病毒感染乳鼠粪便病毒抗原及小肠粘膜SIgA的影响[J].湖南中医药大学学报,2010,30(3)：17-19.
[32]李文英,傅万海,陈国新等.参芪扶正注射液对轮状病毒感染性肠炎小鼠血清IL-2、INF-γ的影响[J].海南医学,2010,21(14)：29-31.
[33]季红梅,许正香,王艳玲.自拟中药贴敷神阙穴佐治小儿轮状病毒性肠炎[J].中医中药,2011,35(12)：106-107
[34]卢乐声,孙亚锋.中药穴位贴敷辅助治疗轮状病毒肠炎88例[J].浙江中医杂志,2011,46(1)：34
[35]吴瑛,陈万强,金玉.轮泻停敷脐辅助治疗小儿轮状病毒肠炎的临床观察[J].中国中西医结合杂志,2011,30(12)：1275-1278.
[36]邢燕如,张瑾宜,孙亚锋.秋泻敷剂敷脐治疗婴幼儿轮状病毒性腹泻153例[J].浙江中医杂志,2011,45(12)：899
[37]杨晓仙.运脾调中推拿法治疗小儿轮状病毒肠炎临床观察[J].长春中医药大学学报,2011,27(5)：814-815.
[38]张子燕,沈红岩.运脾止泻推拿法治疗小儿轮状病毒肠炎临床观察[J].辽宁中医杂志,2011,38(5)：967-968.
[39]徐光宇,隆红艳.俞募穴推拿治疗婴幼儿轮状病毒肠炎50例[J].江西中医药,2011,42(6)：54-55.
[40]徐玲,李志山,陈光明等.推拿治疗小儿泄泻(湿热证)临床研究[J].长春中医药大学学报,2011,(5)：725-726.
[41]沈玉鹏.肠灵液灌肠治疗小儿病毒性腹泻100例疗效观察[J]甘肃中医,2004,17(2)：19-20.
[42]杨森,郭淑梅.中药灌肠治疗儿童秋季腹泻60例疗效观察[J]河北中医,2005,27(9)：663-664.
[43]安福宁,朱连科,何秀文.化湿解毒汤灌肠治疗轮状病毒性肠炎临床观察[J].中国中医急症,2010,19(12)：2037,2076.
[44]吴建荣,王荣茂.针灸加思密达治疗婴幼儿秋季腹泻54例[J].江苏中医药,2006,27(3)：49.
[45]于竹力.针灸治疗小儿腹泻32例[J].针灸临床杂志,2006,2(10)：19-20.
[46]程红云,周春清,王霖.隔药灸治疗小儿轮状病毒腹泻疗效观察[J].光明中医,2011,26(12)：2480-2481.
[47]Kapikian AZ, Hoshino Y, Chanock RM. Roraviruses [A]//KnipeDM,Howley PM. Fields Virology[M]. Fourth ed. Philadelphia:lppincott williams & willians,2001:1787-1833.
[48]常如需,潘瑞芳,朱冰,等.广州地区婴幼儿腹泻轮状病毒感染及型别的研究[J].中华儿科杂志,2002,40(7)：405-407.
[49]曾玫,陈洁,龚四堂等.我国五所城市儿童医院诺如病毒和轮状病毒腹泻的流行病学监测[J].中华儿科杂志,2010,48(8)：564-570.
[50]童美琴,陈黎勤,尚世强,等.2001—2003年杭州地区婴幼儿腹泻VP7型别分型[J].中华儿科杂志,2005,43(8)：595-598.
[51]尹应先,肖密丝,欧志英等.2005-2007年广州地区腹泻儿童感染轮状病毒情况分析[J].热带医学杂志,2009,9(7)：757-759.
[52]谢华萍,耿进妹,伍业健,等.2009年广州地区轮状病毒分子流行病学研究[J].预防医学情报志,2011,27(10)：773-776.
[53]Sandhu BK. European Society of Paediatric Gastroen-terology, Hepatology, and Nutrition Working Group on Acute Diarrhoea. Rationale for early feeding in childhood gastroenteritis[J]. J Pediatr Gastroenterol Nutr,2001,33(Suppl 2):S13-S16.
[54]Duggan C, Nurko S. "Feeding the gut":the scientific basis for continued enteral nutrition during acute diarrhea[J]. J Pediatr,1997,131(6):801-808
[55]顾蓁,沈华琴.喂养方式对婴幼儿轮状病毒腹泻的影响[J].临床儿科杂志,2010,28(1)：57-60.
[56]Wobudeya E, Bachou H, Karamagi CK, et al. Breastfeeding and the risk of rotavirus diarrhea in hospitalized infants in Uganda:a matched case control study [J]. BMC Pediatr. 2011 (17):11-17.
[57]中华医学会儿科学会分会消化学组.儿童腹泻病诊断治疗原则的专家共识.中华儿科杂志,2009,47(8)：634-636
[58]Hahn, S, Kim Y, Garner P. Reduced osmolatity oral fehydration solution for treating dehydration due to diarrhea in children:systematic review[J]. BMJ,2001,323(7304): 81-85.
[59]Szajewska H, Dziechciarz P, Mrukowicz J. Meta-analysis. Smectite in the treatment of acute infectious diarrhea in children[J].Aliment Pharmacol Ther,2006,23(2):217-227.
[60]Chernenko VV, Kharchenko NV. Cytoprotective properties of smecta on the intestinal mucosa of the alimentary canal [J].Lik Sprava.,2001, (5-6):164-166.
[61]张振,王晓梅,汤建桥等.鼠李糖乳杆菌对感染人轮状病毒乳鼠空肠黏膜上皮细胞的保护作用[J].华中科技大学学报(医学版),2012,41(1)：67-71.
[62]石海矾,陈益平,徐志伟等.嗜酸乳杆菌对人轮状病毒感染乳鼠小肠黏膜白细胞黏附分子-1、 γ-干扰素表达的影响[J].实用医学杂志,2010,26(8)：1314-1317.
[63]World Health Organization, United Nations Children's Fund. WHO/UNICEF Joint Statement:Clinical Management of Acute Diarrhoea[R]. The United Nations Children's Fund/World Health Organization,2004.
[64]Sachdev I-IP, Mittal NK, Mittal SK, et al. A controlled trial on utility of oral zinc supplementation in acute dehydrating diarrhea in infants[J]. J Pediatr Gastroenterol Nutr,1988,7(6):877-881.
[65]王丽娟,袁嘉丽.中医药调节黏膜免疫防治感染的研究与展望[J].现代中西医结合杂志,2010,19(34)：4504-4505,4510
[66]Brandtzage P, Fastad IN,Haraldsen G.Regional specialization in the mucosal immune system:primed cells do not always home along the same track[J]. Immunal Today,1999,20:267-277
[67]高杰英：粘膜上皮细胞与粘膜免疫：上皮细胞生物学——初探[M]：北京：军事医学科学院出版社,2000：213-216
[68].朱高发.神经-内分泌-免疫网络研究进展[J].中国实验临床免疫学杂志,1989,1(6)：421.
[69]付凯飞,彭瑞云.肠免疫组织对肠上皮细胞生长的影响[J].国外医学(免疫学分册),2005,28(6)：328-331.
[70]. Gill SR, Pop M, Deboy RT, Eckburg PB, Turnbaugh PJ, Samuel BS, et al. Metagenomic analysis of the human distal gut microbiome[J]. Science 2006;312:1355-1359.
[71]. Mestecky J, Lamm ME, McGhee JR, Bienenstock J, Mayer L, Strober W:Mucosal Immunology San Diego, CA:Academic Press,3 2005.
[72]杜瑞亭,托娅,张和平等.干酪乳杆菌Zhang对小鼠肠道免疫功能的影响[J].营养学报,2009,31(4)：396-399.
[73]王友湘,陈庆森.瑞士乳杆菌菌体的分离以及对小鼠肠道粘膜SIgA影响的研究[J].食品研究与开发,2008,29(5)：50-53.
[74]杨慧.芽孢杆菌制剂对小鼠小肠粘膜结构及粘膜免疫的影响研究[D].四川农业大学,2007.
[75]王忠堂,姚咏明,肖光夏等.补充双歧杆菌可促进烫伤大鼠肠道SIgA合成与分泌[J].感染、炎症、修复,2002,3(4)：232-235,封三.
[76]袁亚杰,杨毅,王卫平等.维生素A缺乏对肠粘膜树突状细胞的影响[J].营养学报,2011,33(4)：358-361,366.
[77]贺南方,姚洪森,张健等.维生素A与儿童呼吸道免疫功能[.门.河北医药,2005,27(2)：142.
[78]艾国平,粟永萍,刘晓宏等.重组人白细胞介素-4对儿类损伤时受损小肠粘膜免疫功能的促恢复作用[J].第三军医大学学报,1999,21(1)：1-4.
[79]钟波,徐辉,粟永萍等.重组人白细胞介素-11对放射后小鼠肠道枯膜免疫系统的保护作用的实验研究[J].第三军医大学学报,2005,27(12)：1256-1258.
[80]罗治彬,吴嘉惠,史景泉等.高锌对大鼠肠粘膜免疫的影响[J].中国药理学与毒理学杂志,2000,14(1)：36-39.
[81]Rey J, Garin N, Spertini F, et al. J Immumol,2004,172:3026-3033
[82]冯小燕,陈贻骥.维生素A在分泌型免疫球蛋白A生成中的作用[J].儿科药学杂志,2009,15(4)：56-59.
[83]Nikawa T, Odahara K, Koizumi H, et al. Vitamin A prevents the decline in immunoglobulin A and Th2 cytokine levels in small intsetinal mucosa of protein-malnourished mice[J]. J Nutr,1999,129(5):934-941.
[84]Mora J R, von Andrian U H. Role of retinoic acid in the imprinting of gut homing IgA secreting cells[J]. Semin Immunol,2009,21(1):28-35.
[85]鞠宝玲,唐小云,张红军,等.四君子汤对脱污染小鼠肠道菌群及粘膜免疫功能影响的研究[J].中药药理与临床,2008,24(5)1-3
[86]张大鹏,周联,张志敏等.四君子汤总多糖对免疫抑制小鼠肠道SIgA的影响及其机制研究[J].中药新药与临床药理,2010,21(1)：11-14.
[87]刘良,周华,王培训,等.四君子汤复方总多糖对小鼠肠道粘膜相关淋巴组织的影响[J].中国免疫学杂志,2000,17(4)：204-207
[88]吕冠华,王长洪,杨杰,等.大承气汤对重症急性胰腺炎大鼠肠粘膜分泌性IgA及CD3、γ δ T细胞的影响[J].中国中西医结合消化杂志,2010,18(5)：281-283,287.
[89]吕冠华,王长洪,王丽新,等.大黄对重症急性胰腺炎大鼠肠粘膜分泌性IgA及 γ δ T细胞的影响[J].中国中西医结合消化杂志,2009,17(3)：153-156
[90]李文林,潘苏华,关洪月.基于Arrowsmith探讨虫草素与肠粘膜屏障功能稳定的潜在相关性[J].医学信息,2009,22,(12)：2684-2687
[91]张靖,黄裕新,高巍等.穴位电针对鼠胃肠粘膜免疫功能的影响[J].世界华人消化杂志,2001,9(10)：1116-1119.
[92]李斐,黎海芪.金银花水提物对致敏小鼠肠道黏膜炎症和SIgA抗体反应的免疫调控[J].临床儿科杂志,2007,25(7)：585-589
[93]王强,刘亚欧,李兴平.辛温解表法对小鼠粘膜免疫功能的影响[J].时珍国医国医,2009,20(12)：2994-2995
[94]王强,刘亚欧,李兴平.桂枝汤对粘膜免疫干预作用的时效性研究[J].中药药理与临床,2010,26(6)：15-17.
[95]尹军霞,林德荣.肠道菌群与疾病.生物学通报,2004；39(3)：26-28
[96]Tuohy KM, Gougoulias C, Shen Q, et al. Studying the human gut microbiota in the trans-omics era--focus on metagenomics and metabonomics. Curr Pharm Des,2009, 15(13):1415-1427.
[97]Kau AL, Ahern PP, Griff in NW, et al. Human nutrition, the gut microbiome and the immune system. Nature,2011,474(7351):327-336.
[98]金红芝,李垫宝.人肠道微生态系统的研究进展.自然杂志,2004；26(2)：88-91
[99]Nicholson, J. K., E. Holmes, and I. D. Wilson, Gut microorganisms, mammalian metabolism and personalized health care. Nat Rev Microbiol,2005.3(5):p.431-8.
[100]Tamura, Z.,Nutriology of bifidobacteria. Bifidobacteria microflora,1983.3:p.3-16.
[101]Avgustin, G.,F.Wright, and H. J. Flint,Genetic diversity and phylogenetic relationships among strains of Prevotella(Bacteroides) ruminicola from the rumen. Int J Syst Bacteriol,1994.44(2):p.246-55.
[102]Brunser,O., et al., Effects of probiotic or prebiotic supplemented milk formulas on fecal microbiota composition of infants. Asia Pac J Clin Nutr,2006.15(3):368-376.
[103]徐殿霞,李建秋,熊德鑫.腹泻儿童肠道菌群分析[J].中国微生态学杂志,1999,11(3)：163,166.
[104]Carey CM, Kirk JL, Ojha S. Current and future uses of real-time polymerase chain reaction and microarrays in the study of intestinal microbiota, and probiotic use and effectiveness. Can J Microbiol,2007,53(5):537-550.
[105]Mai V, Draganov PV. Recent advances and remaining gaps in our knowledge of associations between gut microbiota and human health. World J Gastroenterol,2009, 15(1):81-85.
[106]Human Microbiome Jumpstart Reference Strains Consortium. A catalog of reference genomes from the human microbiome. Science,2010,328(5981):994-999.
[107]Arumugam M, Raes J, Pelletier E, et al. Enterotypes of the human gut microbiome. Nature,2011,473(7346):174-180.
[108]Qin J, Li R, Raes J, et al. A human gut microbial gene catalogue established by metagenomic sequencing. Nature,2010,464(7285):59-65.
[109]王茉琳,李晓光,王建杰,等.党参合剂对多器官功能障碍综合征菌群失调及免疫功能的调整[J].中国微生态学杂志,2011,23(7)：586-588.
[110]李秋明,张亚杰,张大方,等.健脾止泻颗粒对脾虚证及抗生素肠道菌群失调模型小鼠的微生态调节作用[J].中国中医基础医学杂志,2010,16(12)：1119-1120.
[111]胡新俊,李春香,王广,等.马齿苋多糖对肠道微生态失调小鼠的调整作用研究[J].中国微生态学杂志,2010,22(9)：781-783.
[112]李安德,崔宁,苌颖等.急性感染性腹泻的证候分布特点[J].北京中医药大学学报(中医临床版),2011,(5)：5-8.
[113]崔宁,谢春娥,李安德等.急性腹泻中医证候季节性分布规律的临床研究[J].世界中西医结合杂志,2011,06(7)：567-571.
[114]孙浩.江育仁教授“运脾法属于和法”之浅识[J].江苏中医药,2002,23(2)：173.
[115]国家药典委员会.中国药典,1部[S].北京：化学工业出版社,2000.
[116]宋小珍,杨秀江,王恬,等.4种中药提取物对大鼠小肠上皮细胞IEC26增殖及葡萄吸收的影响[J].中草药,2009,40(8)：1263-1266.
[117]谢露.苍术的药理研究.中医药研究,1992,(2)：59
[118]青木俊二.苍术还有效成分β 2桉叶醇及茅苍术醇对肠道平滑肌的作用[J].国外医学.中国中药分册,1991.13(2)：59
[119]国家中医药管理局.中华本草.上海科技出版社,187-193；
[120]江苏新医学院.中药大辞典.上海人民出版社,1596-1600
[121]张明发,沈雅琴,朱自平,等.辛温(热)合归脾胃经中药药性研究(Ⅴ)抗腹泻作用[J].中药药理与临床,1997,13(5)：2-5.
[122]张文芝.陈皮水煎液对离体唾液淀粉酶活性的影响[J].辽宁中医药杂志,1989,(4)：30.
[123]官福兰,王汝俊,王建华,等.陈皮及橙皮苷对离体肠管运动影响[J].时珍国医国药,2002,13(2)：65-67.
[124]国家药典委员会.中华人民共和国药典：Ⅰ部[M].北京：化学工业出版社,2005：22.
[125]Sun Cui-yu. The research progress of hawrhorn [J]. Primary Journal of Chinese Materia Medica,2001,15(5):53-54(In Chinese)
[126]Huang Xie-cai. Study of the original plants of Chinese drugs hawthorn[J]. GuanXi plants,1989,9(4):303-310(In Chinese
[127]黄珊珊,林原,刁云鹏等.焦山楂醇提取物对大鼠离体胃肠平滑肌条收缩性的影响.现代生物医学进展,2009,9(4)：612-614
[128]国家中医药管理局中华本草编委会.中华本草(第2卷)[M].上海：上海科学技术出版社,1999：647-649.
[129]谢贤强,吴萍,林立东,等.火炭母化学成分的研究[J].热带亚热带植物学报,2007,15(5)450-454.
[130]李安红.中国植物志(第25卷第一分册)[M].北京：科学出版社,1998：1-118.
[131]向红,林长松,左经会,等.水城蓼科植物资源及其药用价值研究[J].黔西南民族师范高等专科学校学报,2003(3)：81-88.
[132]包骏.贵州苗族医药研究与开发[M].贵州：贵州科学技术出版社,1998：491
[133]Kus J, Maziarka D. Common variable immunodeficiency-analysis of the clinical aspects and results of substitution treatment [J].Pneumonol Alergol Pol,1997,65(3-4):187-197.
[134]Bogstedt AK, Johansen K, Hatta H, et al. Passive immunity against diarrhea [J]. Acta Pediatr 1996,85 (2):125-128.
[135]Honorio-Franca AC, Carvalho MP, Isaac L, et al. Colostral mononuclear phagocytes are able to kill enteropathogenic Escherichia coli opsonized with colstral IgA [J]. Scand Immunol,1997,46(1):59-66.
[136]Ruggeri FM, Johansen K, Basile G, et al. Antirotavirus immunoglobul in A neutralizes virus in vitro after transcytosis through epithelial cell and protects infant mice from diarrhea [J]. J Virol,1998,72(4):2708-2714.
[137]Burns JW, Siadat-Pajouh M, Krishnaney AA, et al. Protective effect of rotavirus VP6-specific IgA monoclonal antibodies that lack neutralizing activity [J]. Science, 1996,272(5258):104-107.
[138]金玉,薛立军.轮状病毒性肠炎粪便中SIgA水平的变化[J].小儿急救医学2004,11(2)：96-98.
[139]煨葛根茯苓汤对小儿轮状病毒肠炎肠道分泌型IgA的影响以及对心肌损害的保护研究[J].中医儿科杂志,2006,2(6)：38-40.
[140]杜惠敏,陈颖虹,陈俊仪,等.轮状病毒感染与健康儿童肠道菌群结构的比较[J].实用儿科临床杂志,2006,21(9)：1237-1238.
[141]张琳,邱学,李素娥.婴幼儿轮状病毒肠道菌群的动态变化[J].中华儿科杂志,1994,32(5)：282-284.
[142]江月斐,劳绍贤,邝枣园,等.腹泻型肠易激综合征脾胃湿热证肠道菌群的变化.中国中西医结合杂志,2006,26(3)：218-220.
[143]陈晓刚.小儿再发性腹痛的脾胃湿热证与肠道微生态关系的研究.2007年广州中医药大学博士论文,61-64.
[144]胡小英,丘小汕,陈晓刚,等.调肠缓激方对儿童肠易激综合征肠道微生态的影响.广州中医药大学学报.2008,25(1)：63-67.
[145]王卓,彭颖,李晓波.四君子汤对两种脾虚模型大鼠肠道菌群紊乱的影响.中国中西医结合杂志,2009,29(9)：825-829.
[146]CEBRA J J. Influences ofmicrobiota on intestinal immune system de2, velopment[J]. Am J Clin Nutr,1999,69 (5):1046-1051.
[147]王友湘,陈庆森.瑞士乳杆菌菌体的分离以及对小鼠肠道粘膜SIgA影响的研究[J].食品研究与开发,2008,29(5)：50-53.