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从脾论治儿童抗生素相关性腹泻

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儿童抗生素相关性腹泻(antibiotic-associated diarrhea，AAD)是儿童使用抗菌药后而出现的腹泻，其发病机制与肠道菌群密切相关，抗生素可通过影响肠道菌群的代谢功能及免疫功能导致AAD。中医认为，儿童AAD的病位主要在脾脏，病因不外素体脾胃虚弱、疫毒侵袭、药毒蓄积等，病机以脾虚湿盛、脾气亏虚、脾阳不足为特点。脾虚为小儿AAD发病之本，且脾与肠道菌群具有共通性，故临床治疗小儿AAD可从脾论治。从脾论治儿童ADD以健运脾脏为原则，采用健脾渗湿、健脾益气、健脾温阳等治法，分别以参苓白术散、四君子汤、附子理中丸等为基础方，调理脾脏以达治病求本之目的。
Exploration of the Treatment of Antibiotic-Associated Diarrhea in Children from the Perspective of Spleen
Antibiotic-associated diarrhea(AAD)in children is a type of diarrhea that occurs after the use of antibiotics in children,and its pathogenesis is closely related to the intestinal flora.The medication of antibiotics can affect the metabolic function of the intestinal flora and the immune function of the body,and then leads to the occurrence of AAD.In the view of Chinese medicine,AAD in children is mainly involved the spleen,and the etiology of the disease is due to the weakness of the spleen and stomach of the body constitution together with the attack of the pestilential pathogen and the accumulation of drug toxin.The pathogenesis of ADD in children is characterized by spleen deficiency with predominant dampness,deficiency of spleen qi,and insufficiency of spleen yang.Spleen deficiency is the root cause of pediatric AAD,and spleen and intestinal flora have commonality,so the treatment of pediatric AAD can be performed from the perspective of the spleen.The treatment of pediatric ADD from the spleen follows the principle of strengthening and activating the spleen,and the regulation of the spleen for achieving the purpose of treating the disease from the root can be achieved by the methods of strengthening spleen and draining dampness,strengthening spleen and replenishing qi,and strengthening spleen and warming yang separately with the fundamental prescriptions of Shenlin Baizhu Powder,Sijunzi Decoction,and Fuzi Lizhong Pills.

antibiotic-associated diarrheachildrenspleen deficiencyintestinal florastrengthening spleen and draining dampnessstrengthening spleen and replenishing qistrengthening spleen and warming yang

苏浩东、郑浩铃、刘灵娟、罗菲、董秀兰

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广州中医药大学,广东广州 510405

广州中医药大学第一附属医院儿科,广东广州 510405

抗生素相关性腹泻 儿童 脾虚 肠道菌群 健脾渗湿 健脾益气 健脾温阳

广东省自然科学基金广东省中医药局科研项目

2017A03031007320202054

2024

10.13359/j.cnki.gzxbtcm.2024.04.037

广州中医药大学学报
广州中医药大学

广州中医药大学学报

CSTPCD
影响因子：1.055
ISSN：1007-3213
年,卷(期)：2024.41(4)
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