摘要
目的观察姜芡止泻汤治疗抗生素相关性腹泻(AAD)脾肾阳虚证的疗效及对肠道菌群结构的影响。方法采用随机数字表法将120例患者分为治疗组及对照组各60例。治疗组予姜芡止泻汤,每日1剂,每日2次,口服或鼻饲;对照组予甲硝唑片+双歧杆菌三联活菌,每日3次,口服或鼻饲。2组均连续治疗7 d。观察2组临床疗效、中医症状评分、西医症状评分,抽取治疗组5例进行高通量基因测序评价肠道菌群状态。结果对照组脱落2例。治疗组总有效率为70.00%(42/60),对照组为46.55%(27/58),2组比较差异有统计学意义(P<0.05)。治疗组治疗前后中医症状评分(大便泄泻、腹胀腹痛、肠鸣、脘腹痞满、食欲不振、畏寒肢冷、腰膝酸痛)及西医症状评分(腹泻次数、大便性状)差值高于对照组(P<0.05)。肠道菌群α多样性分析显示,AAD患者香农指数均值为5.71,推测肠道菌群物种多样性远低于正常个体。样品操作分类单元(OTUs)水平分析及主成分分析显示,患者治疗后肠道微生态结构改变:门水平上,厚壁菌门减少,变形菌门及拟杆菌门增加;属水平上,丰度减少的有肠球菌属、梭菌属、粪芽孢菌属、肠杆菌科等,增加的有毛螺菌科、瘤胃球菌科、颤螺菌属等,差异无统计学意义(P>0.05)。结论姜芡止泻汤治疗AAD脾肾阳虚证临床疗效较好,可显著改善患者临床症状,抑制致病菌异常繁殖,扶植益生菌生长,从而调整肠道菌群结构,促进胃肠功能恢复。
Objective To observe the clinical efficacy of Jiangqian Zhixie Decoction in treating antibiotic associated diarrhea(AAD)with spleen-kidney yang deficiency syndrome and its effects on intestinal flora structure.Methods Totally 120 patients were divided into treatment group and control group(60 cases in each group)according to random number table method.The treatment group was treated with Jiangqian Zhixie Decoction,one dosage per day,twice a day,orally or nasal feeding;and the control group was treated with metronidazole tablets+bifidobacterium triplex viable bacteria,three times a day,orally or nasal feeding.Treatment for both groups lasted for 7 d.The clinical efficacy,TCM symptom score and Western medicine symptom score were observed.Five cases in the treatment group were selected for high-throughput gene sequencing to evaluate the status of the intestinal flora.Results The control group lost 2 cases.The total effective rate was 70.00%(42/60)in the treatment group and 46.55%(27/58)in the control group,with statistical significance(P<0.05).TCM symptom scores(stool diarrhea,bloating and abdominal pain,bowel irritation,fullness of the abdomen,loss of appetite,chills and cold limbs,waist and knee pain)and Western medicine symptom scores(number of diarrhea,stool characteristics)decreased better than the control group(P<0.05).The analysis of intestinal floraαdiversity showed that the average Shannon index of AAD patients was 5.71.It was speculated that the species diversity of intestinal flora was much lower than that of normal individuals.The OTUs level analysis and principal component analysis of the samples showed that the intestinal microecological structure of the patients changed after treatment.At phylum level,Firmicutes phyla decreased,and Proteobacteria and Bacteroidetes increased.At the genus level,the decreased abundance included Enterococcus,Clostridium,Faecalis,Enterobacteriaceae,etc.,and the increased abundance included Lacetospirillaceae,Rumenococcus,Oscillospirillum,etc.,with no statistical significa
作者
卢恩仕
于红建
刘峰
张杰
孙娜娜
苏春燕
刘祖发
王蓓
LU Enshi;YU Hongjian;LIU Feng;ZHANG Jie;SUN Nana;SU Chunyan;LIU Zufa;WANG Bei(Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China)
出处
《中国中医药信息杂志》
CAS
CSCD
2022年第3期124-130,共7页
Chinese Journal of Information on Traditional Chinese Medicine
基金
中国中医科学院“优势病种-医院制剂-新药”研发专项(ZZ15-XY-CT-08)
中国中医科学院望京医院科研课题(WJYY2016-PY-01)。
关键词
姜芡止泻汤
抗生素相关性腹泻
脾肾阳虚证
微生态评价
肠道菌群多样性
Jiangqian Zhixie Decoction
antibiotic-related diarrhea
spleen-kidney yang deficiency syndrome
micro-ecological evaluation
diversity of intestinal flora
