Objective  To explore the application effect of traditional Chinese medicine rolling egg therapy in the treatment of infantile diarrhea.

Methods  A retrospective analysis was conducted on the clinical data of children with diarrhea in Dongguan People's Hospital from April 2022 to April 2024. According to the treatment methods, they were divided into the control group and the combination group. The control group was treated with western medicine, while the combination group was combined with traditional Chinese medicine rolling egg therapy on the basis of the control group. 7 d was a course of treatment, and a total of 2 courses of treatment was conducted. The clinical efficacy was evaluated, and the durations of clinical symptom changes after treatment were compared. The intestinal flora, immune function [immunoglobulin (Ig) A, IgG, IgM] and inflammatory factors [interleukin (IL)-6, IL-17, tumor necrosis factor (TNF) α] were observed before and after treatment. The treatment safety was analyzed, and the recurrence within 6 months of follow-up was counted.

Results  A total of 180 patients were included in the study, with 106 in the control group and 74 in the combination group. The total effective rate of the combination group was higher than that of the control group (P<0.05). After treatment, the time to stop diarrhea, reduce fever and change stool properties to normal in the combination group was lower than that in the control group (P<0.05); the number of Bifidobacteria and Lactobacilli in both groups was higher than that before treatment, and the number of combination group was higher than that of the control group (P<0.05); the number of Enterococcus faecalis and the levels of TNF-α, IL-6 and IL-17 were lower than those before treatment in both groups, and these in the combination group were lower than those in the control group (P<0.05); the levels of IgA, IgG and IgM were higher than those before treatment in the combination group (P<0.05), and the IgA level was significantly higher than that of the control group (P<0.05). At 6 months, the recurrence rate of the combination group was lower than that of the control group (P<0.05).

Conclusion  Traditional Chinese medicine rolling egg therapy combined with western medicine is effective in the treatment of children with diarrhea, and its mechanism may be related to the improvement of immune function, inflammatory response and intestinal flora.

1.闫永彬, 丁樱, 郑海涛, 等. 参苓健脾胃颗粒治疗小儿腹泻病(脾虚泻)119例多中心随机对照双盲临床研究[J]. 中医杂志, 2021, 62(8): 677-682. [Yan YB, Ding Y, Zheng HT, et al. Shenling Jianpiwei granules in treating 119 cases of children's diarrhea with spleen deficiency pattern: a multi-center, randomized, double-blind placebo-controlled trial[J]. Journal of Traditional Chinese Medicine, 2021, 62(8): 677-682.] DOI: 10.13288/j.11-2166/r.2021.08.008.

2.马萍萍, 徐新齐, 曹小彩, 等. 复方嗜酸乳杆菌联合蒙脱石散治疗小儿腹泻临床疗效及安全性分析 [J]. 数理医药学杂志, 2022, 35(6): 881-883. [Ma  PP, Xu  XQ, Cao XQ, et al. Clinical efficacy and safety analysis of compound lactobacillus acidophilus combined with montmorillonite powder in the treatment of pediatric diarrhea[J]. Journal of Mathematical Medicine, 2022, 35(6): 881-883.] DOI: 10.3969/j.issn.10044337.2022. 06.029.

3.刘盼盼. 联用双歧杆菌四联活菌片与单用蒙脱石散治疗小儿腹泻的疗效及安全性比较[J]. 沈阳药科大学学报, 2021, 38(12): 1334-1338. [Liu PP. Efficacy and safety evaluation of bifidobacterium tetralogy tablet combined with montmorillonite powder in the treatment of infantile diarrhea[J]. Journal of Shenyang Pharmaceutical University, 2021, 38(12): 1334-1338.] DOI: 10.14066/j.cnki.cn211349/r.2021.0024.

4.邱亿明, 王泽宇, 帅艳常. 浮针疗法结合隔药灸脐治疗腹泻型肠易激综合征及对患者胃肠激素水平和菌群结构的影响[J]. 陕西中医, 2023, 44(2): 250-254. [Qiu YM, Wang ZY, Shuai YC, et al. Effeets of floating acupuneture therapy combined with herb partitioned moxibustionon the umbilicus in the treatment of diarrhea type irritable bowel syndromeon the levels of gastrointestinal hormones and flora structure in patients[J]. Shaanxi Journal of Traditional Chinese Medicine, 2023, 44(2): 250-254.] DOI: 10.3969/i.issn.1000-7369.2023.02.026.

5.茅伟达, 蒋立新, 胡星, 等. 健脾止泻汤联合针灸对结肠癌术后急性腹泻患者胃肠功能和胃肠激素的影响[J]. 陕西中医, 2022, 43(10): 1459-1462. [Mao WD, Jiang LX, Hu X, et al. Effects of Jianpi Zhixie decoction combined with acupuncture on gastrointestinal functionand gastrointestinal hormones in patients with acute diarrhea after colon cancer operation[J]. Shaanxi Journal of Traditional Chinese Medicine, 2022, 43(10): 1459-1462.] DOI: 10.3969/j.issn.1000-7369.2022.10.034.

6.马金鑫, 唐旭东, 王凤云, 等. 从脾论治功能性腹泻机制探析[J]. 中华中医药杂志, 2020, 35(8): 3828-3830. [Ma JX, Tang XD, Wang FY, et al. Analysis on the treatment mechanism of functional diarrhea from spleen[J]. China Journal of Traditional Chinese Medicine and Pharmacy, 2020, 35(8): 3828-3830.] https://med.wanfangdata.com.cn/Paper/Detail?id=PeriodicalPaper_zgyyxb202008010&dbid=WF_QK.

7.方鹤松. 小儿腹泻病的诊断和治疗[J]. 实用儿科临床杂志, 2011, 26(19): 1537-1540. [Fang HS. Diagnosis and treatment of childhood diarrhea disease[J]. Chinese Journal of Applied Clinical Pediatrics, 2011, 26(19): 1537-1540.]DOI: 10.3969/j.issn.1003-515X.2011.19.025.

8.中华中医药学会. 中医儿科常见病诊疗指南[M]. 北京: 中国中医药出版社, 2012: 132-133.

9.中华人民共和国卫生部. 中药新药临床研究指导原则 [M]. 北京: 中国医药科技出版社, 2002: 143.

10.Iddrisu I, Monteagudo-Mera A, Poveda C, et al. Malnutrition and gut microbiota in children[J]. Nutrients, 2021, 13(8): 2727. DOI: 10.3390/nu13082727.

11.Sathiyasekaran M, Ganesh R, Natarajan S. Other causes of chronic diarrhea in children[J]. Indian J Pediatr, 2024, 91(6): 606-613. DOI: 10.1007/s12098-023-04918-w.

12.牛志新, 何峰, 宋春光, 等. 胶质细胞系源性神经营养因子/胶质细胞系源性神经营养因子受体信号通路在乳鼠先天性巨结肠相关性小肠结肠炎中的作用实验研究[J]. 陕西医学杂志, 2024, 53(1): 19-22. [Niu ZX, He F, Song CG, et al. Role of GDNF/GFRal signaling pathway in neonatal ratswith Hirschsprung-associated enterocolitis[J]. Shaanxi Medical Journal, 2024, 53(1): 19-22.] DO1: 10.3969/j.issn.1000-7377.2024.01.004.

13.Huong BT, Hien NM, Dung NT, et al. Role of calprotectin, IL-6, and CRP in distinguishing between inflammatory bowel disease and diarrhea predominant irritable bowel syndrome[J]. Med Arch, 2024, 78(2): 105-111. DOI: 10.5455/medarh.2024.78.105-111.

14.侯晓婷, 孟欢, 薛佳辰, 等. 关于炎症性肠病发病机制的研究进展[J]. 中国比较医学杂志, 2023, 33(9): 138-148. [Hou XT, Meng H, Xue JC, et al. Research progress in the pathogenesis of inflammatory bowel disease[J]. Chin J Comp Med, 2023, 33(9): 138-148.] DOI: 10.3969/i.issn.1671-7856.2023.09.016.

15.Li Y, Xia S, Jiang X, et al. Gut microbiota and diarrhea: an updated review[J]. Front Cell Infect Microbiol, 2021, 11: 625210. DOI: 10.3389/fcimb.2021.625210.

16.Zhao L, Zhang T, Zhang K. Pharmacological effects of ginseng and ginsenosides on intestinal inflammation and the immune system[J]. Front Immunol, 2024, 15: 1353614. DOI: 10.3389/fimmu.2024.1353614.

17.原宁, 宁萍. 微生态制剂联合奥美拉唑序贯治疗幽门螺旋杆菌阳性消化性溃疡效果及对患儿丙二醛、转化生长因子β1蛋白水平和肠道菌群的影响[J]. 陕西医学杂志, 2021, 50(4): 472-475. [Yuan N, Ning P. Effect of probiotics combined with omeprazole sequential therapyin treatment of Helicobacter pylori-positive peptic ulcer and its influence on MDA, TGF-β1, protein levels and intestinal flora in children[J]. Shaanxi Medical Journal, 2021, 50(4): 472-475.] DOI: 10.3969/j.issn.1000-7377.2021.04.023.

18.Dong N, Li X, Xue C, et al. Astragalus polysaccharides attenuated inflammation and balanced the gut microflora in mice challenged with Salmonella typhimurium[J]. Int Immunopharmacol, 2019, 74: 105681. DOI: 10.1016/j.intimp.2019.105681.

19.Dong N, Li X, Xue C, et al. Astragalus polysaccharides alleviates LPS-induced inflammation via the NF-κB/MAPK signaling pathway[J]. J Cell Physiol, 2020, 235(7- 8): 5525-5540. DOI: 10.1002/jcp.29452.

20.刘艳玲, 袁娟, 郭敏, 等. 基于TLR4/MyD88/NF-κB信号通路探讨黄芪多糖对肺癌小鼠免疫功能的影响及对Th1/Th2的调节作用[J]. 中国免疫学杂志, 2021, 37(6): 676-682. [Liu YL, Yuan J, Guo M, et al. Effect of astragalus polysaccharides based on TLR4/MyD88/NF-κB signaling pathway on immune function of lung cancer mice and its regulatory effect on Th1/Th2[J]. Chinese Journal of Immunology, 2021, 37(6): 676-682.] DOI: 10.3969/j.issn.1000-484X.2021.06.008.

21.陈冬梅, 刘佳佳, 蒙洁, 等. 基于lncRNA-mRNA共表达网络探讨党参增强衰老小鼠免疫功能的机制[J]. 中药新药与临床药理, 2021, 32(3): 307-315. [Chen MD, Liu JJ, Meng J, et al. Study on the Mechanism of codonopsis pilosula enhancing immune function of aging mice based on lncRNA-mRNA co-expression network[J]. Traditional Chinese Drug Research & Clinical Pharmacology, 2021, 32(3): 307-315.] DOI: 10.19378/j.issn.1003-9783.2021.03.002.

22.李德需, 张新文. 参苓白术散加减辅助治疗卒中相关性肺炎肺脾气虚证的临床观察[J]. 中国实验方剂学杂志, 2020, 26(5): 75-80. [Li DX, Zhang XW. Clinical efficacy of modified shenling baizhusan on stroke-associated pneumonia with lung-qi deficiency syndrome[J]. Chinese Journal of Experimental Traditional Medical Formulae, 2020, 26(5): 75-80.] DOI: 10.13422/j.cnki.syfjx.20192233.

23.金海平, 刘丁乙. 丁桂散联合蒙脱石散对腹泻患儿的疗效及细胞因子的影响[J]. 广东医学, 2020, 41(22): 2366-2370. [Jin HP, Liu DY. Effect of Dinggui powder combined with montmorillonite powder on children with diarrhea and its influence on cytokines[J]. Guangdong Medical Journal, 2020, 41(22): 2366-2370.] DOI: 10.13820/j.cnki.gdyx.20200568.

24.鲁慧东, 李艳梅. 白术内酯Ⅲ通过调节JAK2/STAT3信号通路减轻溃疡性结肠炎模型小鼠肠道损伤[J]. 中国病理生理杂志, 2023, 39(1): 142-149. [Lu HD, Li YM. Atractylenolide III attenuates intestinal damage in ulcerative colitis model mice by regulating JAK2/STAT3 signaling pathway[J]. Chinese Journal of Pathophysiology, 2023, 39(1): 142-149.] DOI: 10.3969/j.issn.1000-4718. 2023.01.017.

25.张敏, 王凤云, 唐旭东, 等. 麸炒白术水提液对实验性功能性腹泻脾虚证大鼠结肠上皮Cl-、K+转运的影响 [J]. 中华中医药杂志, 2023, 38(2): 593-597. [Zhang  M, Wang YF, Tang XD, et al. Effects of Atractylodes macrocephala aqueous extract on colonic epithelial Cl- and K+ ion transport in rats with experimental functional diarrhea in spleen deficiency syndrome[J]. China Journal of Traditional Chinese Medicine and Pharmacy, 2023, 38(2): 593-597.] https://med.wanfangdata.com.cn/Paper/Detail/PeriodicalPaper_zgyyxb202302033.