目的 观察肠炎宁颗粒联合蒙脱石散治疗小儿轮状病毒性肠炎的临床情况。方法 选取2020年3月—2021年7月海南医学院第二附属医院收治的130例小儿轮状病毒性肠炎患儿，采用随机数字表法将所有患儿随机分为对照组和治疗组，每组各65例。对照组口服蒙脱石散，6个月以下患儿每次1/3袋，1～2岁患儿每次2/3袋，3岁以上患儿每次1袋，3次/d。治疗组在对照组基础上口服肠炎宁颗粒，6个月以下患儿每次1/3袋，1～2岁患儿每次2/3袋，3岁以上患儿每次1袋，3次/d。两组患儿治疗时间均为5 d。比较两组临床疗效、主要症状改善时间、中医症候评分、血清炎症因子和肠道菌群。结果 治疗后，治疗组患儿总有效率显著高于对照组，差异有统计学意义（P＜0.05）。治疗后，治疗组的退热时间、止泻时间、止吐时间明显短于对照组（P＜0.05）。治疗后，两组患儿大便清稀、低热、呕吐、食欲不振、腹胀、口渴评分较治疗前下降明显（P＜0.05），且治疗组中医症候评分降低更显著（P＜0.05）。治疗后，两组血清C反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平均显著降低（P＜0.05），治疗组血清炎症因子水平较对照组更低（P＜0.05）。经治疗，两组双歧杆菌、嗜酸乳杆菌较治疗前显著增加，大肠杆菌均显著下降（P＜0.05），治疗组双歧杆菌、嗜酸乳杆菌较对照组更高，大肠杆菌较对照组更低（P＜0.05）。结论 肠炎宁颗粒联合蒙脱石散可有效治疗小儿轮状病毒性肠炎，改善临床症状和中医症候，其作用机制可能与调节肠道菌群、抑制炎症等有关。

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

海南省卫生健康行业科研项目（20A200095）