目的 研究槐杞黃顆粒聯(lián)合聚乙二醇4 000散治療兒童便秘療效及對患兒腸道菌群、免疫功能的影響。方法 選擇2016年4月-2019年2月邢臺市人民醫(yī)院收治的便秘患兒96例，采用隨機(jī)數(shù)表法分為對照組和觀察組，每組各48例。對照組患兒分兩次溫水沖服聚乙二醇4000散，1.5 g/（kg·d），并根據(jù)患兒糞便嵌塞情況逐漸減量。觀察組患兒在對照組的基礎(chǔ)上溫水沖服槐杞黃顆粒，10 g/次，2次/d。2周為1個療程，兩組患兒均治療2個療程。觀察兩組患者的臨床療效，比較兩組患兒治療前后免疫功能、腸道菌群水平、臨床癥狀評分、中醫(yī)證候總分、生存質(zhì)量評分（HRQOL）及不良反應(yīng)發(fā)生情況。結(jié)果 治療后，對照組總有效率為79.17%，低于試驗(yàn)組總有效率93.75%，差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組CD3⁺、CD4⁺、CD4⁺/CD8⁺水平升高，CD8⁺水平降低（P<0.05），其中觀察組CD3⁺、CD4⁺、CD4⁺/CD8⁺水平高于對照組，CD8⁺水平低于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組腸道內(nèi)雙歧桿菌、乳酸桿菌水平升高，葡萄球菌、大腸桿菌水平降低（P<0.05）；其中觀察組雙歧桿菌、乳酸桿菌水平高于對照組，葡萄球菌、大腸桿菌水平低于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組排便次數(shù)、排便難度、排便時間和大便性狀等評分均降低（P<0.05）；其中觀察組排便次數(shù)、排便難度、排便時間和大便性狀評分低于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組中醫(yī)癥候總分明顯減少，HRQOL評分升高（P<0.05），其中觀察組中醫(yī)癥候總分低于對照組，HRQOL評分高于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。兩組不良反應(yīng)發(fā)生率無明顯差異。結(jié)論 槐杞黃顆粒聯(lián)合聚乙二醇4000散治療便秘患兒，能夠顯著改善患兒便秘癥狀和生存質(zhì)量，提高免疫功能，調(diào)節(jié)腸道內(nèi)菌群水平，效果顯著。

Objective To study the therapeutic effect of Huaiqihuang Granules combined with Macrogol 4 000 Powder on constipation, intestinal flora, and immune function in children. Methods A total of 96 children with constipation admitted to Xingtai People's Hospital fromApril 2016 to February 2019 were randomly divided into control group and observation group, and each group had 48 cases. In the control group, children were po administered with Macrogol 4000 Powder in warm water for twice, 1.5 g/(kg·d), and the amount was gradually reduced according to the fecal impaction of the children. In the observation group, the children were po administered with Huaiqihuang Granules with warm water on the basis of the control group, 10 g/time, and twice daily. 2 weeks for a course of treatment, children were treated for two courses of treatment. The clinical efficacy in two groups was observed, and the immune function, intestinal flora level, clinical symptom score, total TCM syndrome score, HRQOL score, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the total effective rate in the control group was 79.17%, which was lower than 93.75% in the observation group, the difference was statistically significant (P<0.05). After treatment, the levels of CD3⁺, CD4⁺, CD4⁺/CD8⁺ in two groups were increased, and the levels of CD8⁺ were decreased (P<0.05). And the levels of CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in the observation group were significantly higher than those in the control group (P<0.05), the level of CD8⁺ was lower than those in the control group, the difference was statistically significant (P<0.05). After treatment, the levels of bifidobacteria and lactobacillus in the intestines of two groups were increased, while the levels of staphylococcus and escherichia coli were decreased (P<0.05). And the levels of bifidobacteria and lactobacillus in the observation group were higher than those in the control group, the levels of staphylococcus and escherichia coli were lower than those in the control group, with statistically significant differences (P<0.05). After treatment, the score of defecation frequency, defecation difficulty, defecation time, and defecation character in two groups were all decreased (P<0.05). And the defecation frequency, defecation difficulty, defecation time and stool character score in the observation group were lower than those in the control group, with statistically significant differences (P<0.05). After treatment, the total score of TCM syndromes in two groups were significantly decreased, and the HRQOL score were increased (P<0.05). And the total score of TCM syndromes in the observation group was lower than that in the control group, while the HRQOL score was higher than that in the control group, with statistically significant differences (P<0.05). There was no significant difference in the incidence of adverse reactions between two groups. Conclusion Huaiqihuang Granules combined with Macrogol 4000 Powder can significantly improve the constipation symptoms and quality of life of children with constipation, improve the immune function, and regulate the level of intestinal flora, the effect is significant.

R985

河北省中醫(yī)藥管理局科研計劃項(xiàng)目（2019572）