健脾温通方敷脐与百笑灸联合常规西药治疗小儿肠系膜淋巴结炎临床研究
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R272

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国家卫生发展科研专项计划项目(21-1-0-08-YHC)


Clinical Study on Applying Umbilical Compress with Jianpi Wentong Prescription Combined with Baixiao Moxibustion for Children with Mesenteric Lymphadenitis
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    摘要:

    目的:观察健脾温通方敷脐与百笑灸联合常规西药治疗肠系膜淋巴结炎寒积腹痛证患儿的临床疗 效。方法:将94例肠系膜淋巴结炎寒积腹痛证患儿以随机数字表法分为参照组与治疗组各47例。参照组给予 双歧杆菌乳杆菌三联活菌片和头孢克洛干混悬剂治疗,治疗组在双歧杆菌乳杆菌三联活菌片、头孢克洛干混悬 剂治疗的基础上给予健脾温通方敷脐与百笑灸治疗。2组均治疗7 d。治疗前、治疗7 d后检测血清核因子- κB(NF-κB)、白细胞介素-10(IL-10)、绛钙素原(PCT)、可溶性髓系细胞触发受体-1(sTREM-1)、血浆内 皮素-1 (ET-1)、降钙素基因相关肽(CGRP)、乳酸(Lac)、二胺氧化酶(DAO)、CD4+ T淋巴细胞、CD8+ T 淋巴细胞、免疫球蛋白G(IgG)、免疫球蛋白A(IgA) 水平,测定肠道肠杆菌、葡萄球菌、双歧杆菌、乳酸杆 菌的菌群数量,统计肠系膜淋巴结的纵径、横径,观察患儿食欲不振、腹泻、腹痛、发热、恶心呕吐消失的时 间,比较2组的临床疗效。结果:治疗后,治疗组总有效率高于参照组(P<0.05)。2组血清NF-κB、PCT、 sTREM-1水平均较治疗前降低(P<0.05),血清IL-10水平均较治疗前升高(P<0.05)。治疗组血清NF-κB、 PCT、sTREM-1水平均低于参照组(P<0.05),血清IL-10水平高于参照组(P<0.05)。2组血清IgG、IgA水平 均较治疗前降低(P<0.05)。治疗组血清IgG、IgA水平均低于参照组(P<0.05)。2组血清CD4+ T淋巴细胞水 平均较治疗前升高(P<0.05),血清CD8+ T淋巴细胞水平均较治疗前降低(P<0.05)。治疗组血清CD4+ T淋巴 细胞水平高于参照组(P<0.05),血清CD8+ T淋巴细胞水平低于参照组(P<0.05)。2组血清DAO、ET-1、 Lac水平均较治疗前降低(P<0.05),血清CGRP水平均较治疗前升高(P<0.05)。治疗组血清DAO、ET-1、 Lac水平均低于参照组(P<0.05),血清CGRP水平高于参照组(P<0.05)。2组肠道肠杆菌、葡萄球菌菌群数 量均较治疗前减少(P<0.05),双歧杆菌、乳酸杆菌菌群数量均较治疗前增多(P<0.05)。治疗组肠杆菌、葡 萄球菌菌群数量均少于参照组(P<0.05),双歧杆菌、乳酸杆菌菌群数量均多于参照组(P<0.05)。2组肠系 膜淋巴结纵径、横径均较治疗前缩短(P<0.05)。治疗组纵径、横径均短于参照组(P<0.05)。治疗组食欲不 振、腹泻、腹痛、发热、恶心呕吐消失的时间均短于参照组(P<0.05)。结论:采用健脾温通方敷脐与百笑灸 联合常规西药治疗肠系膜淋巴结炎寒积腹痛证患儿,可有效减轻炎症反应,改善患儿的肠黏膜屏障功能及肠道 微生态,提升患儿的免疫功能,提高临床疗效。

    Abstract:

    Abstract: Objective: To observe the clinical effect of applying umbilical compress with the Jianpi Wentong Prescription combined with Baixiao moxibustion on children with mesenteric lymphadenitis with the syndrome of cold accumulation and abdominal pain. Methods: A total of 94 children with mesenteric lymphadenitis with the syndrome of cold accumulation and abdominal pain were divided into the control group and treatment group by random number table method, with 47 cases in each group. The control group was given conventional western medicine for treatment, and the treatment group was given umbilical compress with theJianpi Wentong Prescription combined with Baixiao moxibustion on the basis of the control group. The following indexes were compared between the two groups before and after treatment: serum nuclear factor- κB (NF- κB), interleukin-10 (IL-10), procalcitonin (PCT), soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), endothelin-1 (ET-1), calcitonin generelated peptide (CGRP), lactic acid (Lac), diamine oxidase (DAO), CD4+ T lymphocyte, CD8+ T lymphocyte, immunoglobulin G (IgG), immunoglobulin A (IgA), enterobacterium, staphylococcus, bifidobacterium, lactobacillus and longitudinal and transverse diameter of mesenteric lymph nodes. The disappearance time of following symptoms were compared between the two groups: poor appetite, diarrhea, abdominal pain, fever, nausea and vomiting. The clinical effects in the two groups were also compared. Results:After treatment,the total effective rate in the treatment group was higher than that in the control group (P<0.05). The levels of serum NF- κB, PCT and sTREM-1 in both groups were decreased when compared with those before treatment (P<0.05),and the levels of serum IL-10 in both groups were increased when compared with those before treatment (P<0.05). The levels of serum NF-κB, PCT and sTREM-1 in the treatment group were lower than those in the control group (P<0.05), and the serum IL-10 level in treatment group was higher than that in the control group (P<0.05). The levels of serum IgG,IgA in both groups were decreased when compared with those before treatment (P<0.05). The levels of serum IgG,IgA in the treatment group were lower than those in the control group (P<0.05). The levels of serum CD4+ T lymphocyte in both groups were increased when compared with those before treatment (P<0.05), and the levels of serum CD8+ T lymphocyte in both groups were decreased when compared with those before treatment(P<0.05). The levels of serum CD4+ T lymphocyte in the treatment group was higher than that in the control group (P<0.05),and the levels of serum CD8+ T lymphocyte in the treatment group was lower than that in the control group (P<0.05). The levels of serum DAO, ET-1 and Lac in both groups were decreased when compared with those before treatment(P<0.05),and the serum CGRP levels in both groups were increased when compared with those before treatment(P<0.05). The levels of serum DAO,ET-1 and Lac in the treatment group were lower than those in the control group (P< 0.05),and the CGRP level in the treatment group was higher than that in the control group (P<0.05). The bacterial counts of enterobacteria and staphylococcus in both groups were decreased when compared with those before treatment(P<0.05),and the bacterial counts of intestinal bifidobacterium and lactobacillus in both groups were increased when compared with those before treatment(P<0.05). The bacterial counts of enterobacteria and staphylococcus in the treatment group were less than those in the control group (P< 0.05), and the bacterial counts of intestinal bifidobacterium and lactobacillus in the treatment group were more than those in the control group (P<0.05). The longitudinal and transverse diameter of mesenteric lymph nodes in both groups were shortened when compared with those before treatment(P<0.05). The longitudinal and transverse diameter of mesenteric lymph nodes in the treatment group were shorter than those in the control group (P<0.05). The disappearance time of poor appetite,diarrhea,abdominal pain, fever,nausea and vomiting in the treatment group were shorter than those in the control group (P<0.05). Conclusion: In the treatment of children with mesenteric lymphadenitis with the syndrome of cold accumulation and abdominal pain, the use of Jianpi Wentong Prescription applied to the navel, Baixiao moxibustion, and conventional western medicine can effectively reduce inflammatory reactions, improve the intestinal mucosal barrier function and intestinal microbiota of children,enhance their immune function, and improve clinical effects.

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赵文鸽,何春荣,张哲.健脾温通方敷脐与百笑灸联合常规西药治疗小儿肠系膜淋巴结炎临床研究[J].新中医,2024,56(17):132-138

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  • 在线发布日期: 2024-09-11
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