世界中医药

作者	单位
王永莉1，薛明2，田新峰3	1 宝鸡市中医医院急诊科，宝鸡，721001； 2 宝鸡市中医医院儿科专家门诊，宝鸡，721001； 3 宝鸡市中医医院急诊科，宝鸡，721001

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中文摘要:

目的：截泻汤加减对急性腹泻的治疗作用及对细胞免疫功能的影响，探析其相关作用机制。方法：选取2016年1月1日至2016年12月31日宝鸡市中医医院急诊科收治的急性腹泻患者88例，随机分为观察组和对照组，每组44例；并以体检科40例健康人作为健康对照组。对照组常规干预治疗，纠正电解质紊乱和抗感染治疗，并服用消旋卡多曲；观察组在对照组基础上予以截泻汤加减，疗程7 d。对患者进行疗效评定、病原菌鉴定和症状体征记录与评估，同时采用流式细胞仪检测外周淋巴单核细胞Th1及Th2水平。结果：1）纳入的88例急性腹泻患者致病菌的组成情况，其中变性杆菌属有27株，以奇异变形杆菌为最高。2）治疗后观察组总有效率（97.73%）明显优于对照组总有效率（90.90%），但是2组差异无统计学意义（P>0.05）。3）治疗后观察组大便次数明显减少，比对照组低，差异有统计学意义（P<0.05），与健康对照组比较，差异无统计学意义（P>0.05）。治疗后观察组腹痛评分和腹泻评分均低于对照组，差异有统计学意义（P<0.05）。4）观察组患者Th1/Th2比例较对照组低，经过为期7 d的临床干预后观察组Th1/Th2比例上调，虽与健康对照组比较仍偏低，但较治疗前有明显提升，差异有统计学意义（P<0.05）。结论：截泻汤加减可有效减少患者急性腹泻的大便次数，降低其腹痛评分和腹泻评分；其机制可能与细胞免疫功能提高，Th1/Th2比例上调有关。

English Summary:

To observe the clinical effect and the cellular immune function of Jiexie decoction in treating acute diarrhea and its mechanism.Methods:A total of 88 cases with acute diarrhea in the emergency department of our hospital admitted from January 2016 to December 2016 were randomly divided into observation group and control group, with 44 cases in each group.Forty healthy cases in the department of physical examination were taken as control group.The control group was treated with conventional therapy, electrolyte disturbance and anti-infection treatment.On the basis of the control group, the observation group was given modified decoction for 7 days.The symptoms of both groups were evaluated and recorded, and the pathogen was identified.The levels of Th1 and Th2 were detected by flow cytometry.Results:1) In 88 cases of acute diarrhea, the strain of Proteus was the highest, especially Proteus mirabilis was the highest among the 27 strains.2) After treatment, the total effective rate of the observation group (97.73%) was significantly higher than that of the control group (90.90%), but there was no significant difference between the two groups (P>0.05).3) After treatment, the stool frequency of the observation group was significantly lower than that of the control group (P<0.05), but there was no significant difference compared with the healthy control group (P>0.05).After treatment, the abdominal pain score and diarrhea score of the observation group were lower than those of the control group (P<0.05).4) The proportion of Th1/Th2 patients in the observation group was lower than the control group, but it increased after intervention for a period of 7 days.Although compared with the healthy control group is still low, it improved significantly, and the difference was statistically significant (P<0.05).Conclusion:Jiexie Decoction can effectively reduce the frequency of defecation in patients with acute diarrhea, reduce abdominal pain score and diarrhea score, and its mechanism might be related to cellular immune function improvement and Th1/Th2 ratio enhancement.

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