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目的观察参苓白术散汤剂治疗小儿腹泻脾胃虚弱型的临床疗效及对血浆中血管活性肽(VIP)、神经肽Y(NPY)及肠黏膜中5-羟色胺(5-HT)的影响。方法选取我院2014年4月至2015年3月收治的136例小儿腹泻脾胃虚弱型患儿作为研究对象,随机分为对照组与治疗组,各68例。对照组给予乳酸菌素片治疗,治疗组采用参苓白术散汤剂治疗。观察2组患儿的临床疗效、临床症状消失时间以及治疗前后VIP,NPY,5-HT水平的变化。结果治疗组总有效率为95.59%,对照组为83.82%,经统计学分析,差异有统计意义(P<0.05);治疗组大便次数恢复正常时间、性状变稠时间、腹泻停止时间分别为(2.01±0.88)d,(2.09±0.84)d,(2.57±0.99)d,均短于对照组的(4.64±0.77)d,(3.18±0.75)d,(4.78±0.69)d,差异均有统计意义(P<0.05);治疗后,治疗组VIP和5-HT水平下降幅度及NPY上升幅度均高于对照组,2组比较差异有统计意义(P<0.05)。结论参苓白术散汤剂治疗小儿腹泻效果显著,其作用机制可能与调节血浆VIP,NPY,5-HT水平有关。
Objective To observe the clinical effect of Shenling Baizhu San decoction on the treatment of infantile diarrhea with spleen and stomach deficiency and its effect on plasma vasoactive peptide (VIP), neuropeptide Y (NPY) and serotonin (5-HT) in intestinal mucosa. Methods A total of 136 pediatric patients with spleen and stomach deficiency infantile diarrhea treated in our hospital from April 2014 to March 2015 were randomly divided into control group and treatment group, with 68 cases in each group. The control group was treated with lactic acid bacteria tablets, the treatment group treated with Shenling Baizhu decoction. The clinical efficacy, the disappearance of clinical symptoms and the changes of VIP, NPY and 5-HT before and after treatment were observed in two groups. Results The total effective rate was 95.59% in the treatment group and 83.82% in the control group. The statistical analysis showed that the difference was statistically significant (P <0.05); the stool frequency returned to normal, the thickening time and the diarrhea stopping time in the treatment group were ( (2.01 ± 0.88) d, (2.09 ± 0.84) d, (2.57 ± 0.99) d respectively, which were all shorter than those in the control group (4.64 ± 0.77) days and (3.18 ± 0.75 days) and (4.78 ± 0.69) days respectively (P <0.05). After treatment, the decrease of the level of VIP and 5-HT and the increase of NPY in the treatment group were higher than those in the control group. There was significant difference between the two groups (P <0.05). Conclusion Shenling Baizhu San decoction is effective in treating children with diarrhea, and its mechanism may be related to the regulation of plasma VIP, NPY and 5-HT levels.