目的 觀察腸炎寧顆粒聯(lián)合蒙脫石散治療小兒輪狀病毒性腸炎的臨床情況。方法 選取2020年3月—2021年7月海南醫(yī)學(xué)院第二附屬醫(yī)院收治的130例小兒輪狀病毒性腸炎患兒，采用隨機(jī)數(shù)字表法將所有患兒隨機(jī)分為對照組和治療組，每組各65例。對照組口服蒙脫石散，6個月以下患兒每次1/3袋，1～2歲患兒每次2/3袋，3歲以上患兒每次1袋，3次/d。治療組在對照組基礎(chǔ)上口服腸炎寧顆粒，6個月以下患兒每次1/3袋，1～2歲患兒每次2/3袋，3歲以上患兒每次1袋，3次/d。兩組患兒治療時間均為5 d。比較兩組臨床療效、主要癥狀改善時間、中醫(yī)癥候評分、血清炎癥因子和腸道菌群。結(jié)果 治療后，治療組患兒總有效率顯著高于對照組，差異有統(tǒng)計學(xué)意義（P＜0.05）。治療后，治療組的退熱時間、止瀉時間、止吐時間明顯短于對照組（P＜0.05）。治療后，兩組患兒大便清稀、低熱、嘔吐、食欲不振、腹脹、口渴評分較治療前下降明顯（P＜0.05），且治療組中醫(yī)癥候評分降低更顯著（P＜0.05）。治療后，兩組血清C反應(yīng)蛋白（CRP）、白細(xì)胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）水平均顯著降低（P＜0.05），治療組血清炎癥因子水平較對照組更低（P＜0.05）。經(jīng)治療，兩組雙歧桿菌、嗜酸乳桿菌較治療前顯著增加，大腸桿菌均顯著下降（P＜0.05），治療組雙歧桿菌、嗜酸乳桿菌較對照組更高，大腸桿菌較對照組更低（P＜0.05）。結(jié)論 腸炎寧顆粒聯(lián)合蒙脫石散可有效治療小兒輪狀病毒性腸炎，改善臨床癥狀和中醫(yī)癥候，其作用機(jī)制可能與調(diào)節(jié)腸道菌群、抑制炎癥等有關(guān)。

Objective To observe the efficacy of Changyanning Granules combined with Montmorillonite Powder in treatment of children with rotavirus enteritis. Methods Children (130 cases) with rotavirus enteritis in the Second Affiliated Hospital of Hainan Medical University from March 2020 to July 2021 were divided into control and treatment groups using the random number table method, and each group had 65 cases. Children in the control group were orally administered Montmorillonite Powder, under 6 months: 1/3 bag/time, 1 — 2 years old: 2/3 bag/time, over 3 years old: 1 bag/time, three times daily. Children in the treatment group were orally administered Changyanning Granules on the basis of the control group, under 6 months: 1/3 bag/time, 1 — 2 years old: 2/3 bag/time, over 3 years old: 1 bag/time, three times daily. Patients in two groups were treated for 5 d. After treatment, the clinical efficacies, the improvement time of main symptoms, symptom score of traditional Chinese medicine, serum inflammatory factors, and intestinal microbiota in two groups were compared. Results After treatment, the total effective rate in the treatment group was significantly higher than that in the control group, with a statistically significant difference (P < 0.05). After treatment, the fever relieving time, diarrhea stopping time, and vomiting stopping time in the treatment group were significantly shorter than those in the control group (P < 0.05). After treatment, the scores of defecation, low fever, vomiting, loss of appetite, abdominal distension, and thirst in two groups decreased significantly compared to before treatment (P < 0.05), and the score of traditional Chinese medicine symptoms in the treatment group significantly decreased (P < 0.05). After treatment, the serum levels of CRP, IL-6, and TNF-α in two groups were significantly decreased (P < 0.05), and the serum levels of inflammatory factors in the treatment group were lower than those in the control group (P < 0.05). After treatment, the Bifidobacterium and Lactobacillus in two groups significantly increased compared to before treatment, while Escherichia coli significantly decreased (P < 0.05). Bifidobacterium and Lactobacillus in the treatment group were higher than those in the control group, but Escherichia coli in the treatment group was lower than those in the control group (P < 0.05). Conclusion The combination of Changyanning Granules and Montmorillonite Powder can effectively treat children with rotavirus enteritis, improve clinical symptoms and traditional Chinese medicine symptoms. Its mechanism may be related to regulating intestinal microbiota and inhibiting inflammation.

R975；R985

海南省衛(wèi)生健康行業(yè)科研項(xiàng)目（20A200095）