| 邱甜甜,司秋霞,彭树攀.葛根芩连汤加味联合肠内营养治疗炎症性肠病 36例临床观察[J].安徽医药,2025,29(7):1376-1381. |
| 葛根芩连汤加味联合肠内营养治疗炎症性肠病 36例临床观察 |
| Clinical observation of Gegen Qinlian decoction combined with enteral nutrition in the treatment of children with inflammatory bowel disease |
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| DOI：10.3969/j.issn.1009-6469.2025.07.022 |
| 中文关键词: 炎症性肠病(IBD) 葛根芩连汤 肠内营养 肠道菌群 粪便炎症指标 肠黏膜 mRNA表达 儿童 |
| 英文关键词: Inflammatory bowel disease(IBD) Gegen Qinlian decoction Enteral nutrition Intestinal flora Fecal inflammation indicators Intestinal mucosal mRNA expression Children |
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| 中文摘要: |
| 目的探讨葛根芩连汤加味联合肠内营养治疗炎症性肠病病儿临床疗效。方法 2021年 2月至 2023年 3月选取在河北省沧州中西医结合医院就诊的炎症性肠病病儿 72例进行前瞻性随机对照研究，按随机数字表法分为研究组( n=36)、对照组(n=36)。对照组给予肠内营养治疗，研究组在对照组基础上给予葛根芩连汤加味治疗，均治疗 1个月。观察两组临床疗效与治疗前后血常规指标［外周血红蛋白( Hb)，白细胞计数，血小板计数、平均血小板体积( MPV)、血小板分布宽度( PDW)及血小板压积( PCT)］、肠道菌群(大肠杆菌、肠球菌、双歧杆菌、乳酸杆菌)、粪便炎症指标［粪便钙卫蛋白( calprotectin，CALP)及血清胆碱酯酶( cholinesterase，ChE)、降钙素原( procalcitonin，PCT)］、肠黏膜 mRNA表达( NLRP3 mRNA、NLRP1 mRNA、caspase-1 mRNA)水平。结果研究组治疗后总有效率 91.67%(33/36)高于对照组69.44%(25/36)(P<0.05)；两组治疗后血小板计数、 PCT、肠道菌群数量、 CALP、ChE、PCT水平、肠黏膜 NLRP3 mRNA、NLRP1 mRNA、caspase-1 mRNA表达水平均较治疗前降低，且研究组低于对照组(P<0.05)两组治疗后 Hb、双歧杆菌、乳酸杆菌数量较治疗前升高，且研究组高于对照组( P<0.05)，治疗后研究组和对照组白细胞计数分，别为( 6.28±1.59)×109/L和( 9.19±1.44)×109/L，均较治疗前降低，且研究组低于对照组( P<0.05)。两组治疗后 MPV、PDW、大肠杆菌数量、较治疗前差异无统计学意义( P>0.05)。结论葛根芩连汤加味联合肠内营养治疗可有效降低炎症反应，改善肠道菌群，通过降低肠黏膜 mRNA表达以发挥肠道屏障保护作用，临床疗效显著。 |
| 英文摘要: |
| Objective To explore the clinical efficacy of Gegen Qinlian decoction combined with enteral nutrition in the treatment of children with inflammatory bowel disease.Methods From February 2021 to March 2023, a prospective randomized controlled study of72 children with inflammatory bowel disease treated in Cangzhou Hospital of Integrated TCM-WM·Hebei was conducted. The random number table was adopted to divide the patients into a study group (n=36) and a control group (n=36). The control group was given en-teral nutrition therapy, while the study group was given an additional Gegen Qinlian decoction based on enteral nutrition therapy, bothof which were treated for 1 month. An observation was made regarding the clinical efficacy and blood routine indexes before and aftertreatment in the two groups [peripheral hemoglobin (Hb), white blood cell count (WBC), platelet count (PLT), average platelet volume(MPV), platelet distribution width (PDW) and platelet packed volume (PCT)], intestinal flora (E. coli, Enterococcus, Bifidobacterium, Lactobacillus), fecal inflammation indicators [fecal calprotectin (CALP) and serum cholinesterase (ChE), procalcitonin (PCT)], and intes-tinal mucosal mRNA expression (NLRP3 mRNA, NLRP1 mRNA, caspase-1 mRNA) levels. Results The total effective rate of the study group after treatment was 91.67% (33/36), which were higher than that of the control group 69.44% (25/36)(P<0.05). PLT, PCT, intestinal flora number, CALP, ChE, intestinal mucosa NLRP3 mRNA, NLRP1 mRNA and caspase-1 mRNA expression levels aftertreatment were lower than those before treatment in both groups, and the study group showed lower levels than the control group (P< 0.05). The levels of Hb, Bifidobacterium and Lactobacillus in the two groups after treatment were higher than those before treatment,and the study group showed higher levels than the control group (P<0.05). After treatment, the WBC in the study group and the control group were (6.28±1.59)×109/L and (9.19±1.44)×109/L, all of them decreased compared to before treatment, and the study group was low-er than the control group(P<0.05). The levels of MPV, PDW, and E. coli after treatment in the two groups showed no statistical differ-ence from those before treatment (P>0.05).Conclusion Gegen Qinlian decoction combined with enteral nutrition therapy can effec-tively reduce inflammation, improve intestinal flora, and play the role of intestinal barrier protection by reducing intestinal mucosalmRNA expression, which demonstrated significant clinical effectiveness. |
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