Clinical Observation of Addition and Subtraction Therapy of Shenling Baizhu San to Antibiotic-associated Diarrhea with Spleen-stomach Deficiency and Cold Syndrome

Guang-yu ZHANG; Qin-sheng ZHANG; Xiao-na SUI; Yu-feng ZHANG; Zhen-hua LI; Yong-liang LI; Yan-mei WANG; Zhi-xia SUN

doi:10.13422/j.cnki.syfjx.20191835

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Clinical Observation of Addition and Subtraction Therapy of Shenling Baizhu San to Antibiotic-associated Diarrhea with Spleen-stomach Deficiency and Cold Syndrome

Clinic | 更新时间：2021-02-09

- Clinical Observation of Addition and Subtraction Therapy of Shenling Baizhu San to Antibiotic-associated Diarrhea with Spleen-stomach Deficiency and Cold Syndrome
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 25, Issue 19, Pages: 74-79(2019)
- 作者机构：
  
  河南省中医院，郑州　 450002
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20191835
  CLC： R289; R25; R256; R256.3
- Received：22 April 2019，
  
  Published Online：28 May 2019，
  
  Published：05 October 2019
- 稿件说明：
移动端阅览
Guang-yu ZHANG, Qin-sheng ZHANG, Xiao-na SUI, et al. Clinical Observation of Addition and Subtraction Therapy of Shenling Baizhu San to Antibiotic-associated Diarrhea with Spleen-stomach Deficiency and Cold Syndrome[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(19): 74-79.
DOI：

Guang-yu ZHANG, Qin-sheng ZHANG, Xiao-na SUI, et al. Clinical Observation of Addition and Subtraction Therapy of Shenling Baizhu San to Antibiotic-associated Diarrhea with Spleen-stomach Deficiency and Cold Syndrome[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(19): 74-79. DOI： 10.13422/j.cnki.syfjx.20191835.

摘要

目的：

探讨参苓白术散加减治疗抗生素相关性腹泻(AAD)脾胃虚寒证的疗效及对免疫功能、肠道菌群的影响。

方法：

随机115例患者按数字表法分为对照组57例和观察组58例。对照组采用双歧杆菌三联活菌散，2包/次，2次/d，温水冲服；蒙脱石散，1包/次，3次/d，温水冲服，并给予防止水、电解质与酸碱平衡紊乱措施，营养支持等处理。观察组在对照组治疗的基础上，给予内服参苓白术散加减，1剂/d。两组疗程均为连续治疗7 d。进行治疗前后症状评分和肠道分泌型免疫球蛋白(SIgA)检测；检测治疗前后外周血免疫球蛋白A(IgA)，免疫球蛋白G(IgG)，免疫球蛋白M(IgM)水平和T淋巴细胞亚群(CD3

＋

，CD4

＋

，CD8

＋

和CD4

＋

/CD8

＋

)，检测治疗前后粪便中粪便球杆菌，并行细菌培养，鉴定并计数双歧杆菌、乳酸杆菌、肠球菌数量；检测治疗前后二胺氧化酶(DAO)和

-乳酸水平。

结果：

经秩和检验分析，观察组临床疗效优于对照组(

＝2.268，

0.05)；观察组主要症状、次要症状评分和脾胃虚寒证积分均低于对照组(

0.01)；观察组肠道SIgA水平高于对照组(

0.01)；观察组患者IgA，IgG水平均高于对照组(

0.01)；观察组患者CD3

＋

，CD4

＋

，CD4

＋

/CD8

＋

均高于对照组(

0.05)，CD8

＋

低于对照组(

0.05)；观察组患者粪便球杆菌低于对照组(

0.01)，肠球菌计数低于对照组(

0.05)，双歧杆菌、乳酸杆菌计数均高于对照组(

0.05)；观察组患者血清DAO和

-乳酸水平均低于对照组(

0.01)。

结论：

在益生菌等常规治疗的基础上，加服参苓白术散加减治疗AAD脾胃虚寒证患者，可进一步的减轻症状，提高临床疗效，并能提高机体免疫功能，调节肠道菌群，促进肠黏膜屏障的修复。

Abstract

Objective:

To discussed the clinical efficacy of addition and subtraction therapy of Shenling Baizhu San to antibiotic-associated diarrhea (AAD) with spleen-stomach deficiency and cold syndrome

and to investigate its effects on immune function and intestinal flora.

Method:

One hundred and fifteen patients were randomly divided into control group (57 cases) and observation group (58 cases) by random number table. Patients in control group got Shuangqi Ganjun Sanlian Huojun San

2 bags/time

2 times/days. Mengtuoshi San

1 bag/time

3 times/days

and they also got measures to prevent disturbance of water

electrolyte

acid-base balance and nutritional support. Based on the treatment in control group

patients in observation group also got addition and subtraction therapy of Shenling Baizhu San

1 dose/day. The course of treatment was 7 days in both groups. Before and after treatment

scores of symptoms

intestinal secretory immunoglobulin (SIgA) levels

peripheral blood immunoglobulin A (IgA)

G (IgG)

M (IgM) and T lymphocyte subsets (CD3

CD4

CD8

and CD4

/CD8

). Detection of bacillus faccalis in feces before and after treatment and the bacteria were cultured to identify and count bifidobacterium

lactobacillus and enterococcus. In addition

diamine oxidase (DAO) and D-lactic acid levels were detected before and after treatment.

Result:

In rank sum test

clinical efficacy in observation group was better than that in control group (

=2.268

0.01). Scores of main symptoms

secondary symptoms

spleen-stomach deficiency and cold syndrome were lower than those in control group(

0.01). Levels of SIgA

IgA and IgG were significantly higher than those in the control group (

0.01). Levels of CD3

CD4

and CD4

/CD8

were higher than those in control group (

0.05)

while level of CD8

was lower than that in control group (

0.05). Bacillus in faeces was significantly lower than that in control group(

0.01). Count of enterococcus was lower than that in control group (

0.05)

while counts of bifidobacterium and lactobacillus were higher than those in control group (

0.05). In addition

levels of DAO and

-lactic acid were significantly lower than those in control group (

0.01).

Conclusion:

Based on conventional treatment

addition and subtraction therapy of Shenling Baizhu San can alleviate symptoms

improve clinical efficacy

improve immune function

regulate intestinal flora and promote the repair of intestinal mucosal barrier in the treatment of antibiotic-associated diarrhea (AAD) with spleen-stomach deficiency and cold syndrome.

关键词

Keywords

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