【摘要】 目的 观察芡莲肠安胶囊联合西药治疗异基因造血干细胞移植(allo-HSCT)后肠道急性移植物抗宿主病(aGVHD)的临床疗效。方法 将54例allo-HSCT后肠道aGVHD患者按照随机数字表法分为观察组与对照组，每组27例。对照组予西药常规治疗，观察组在对照组治疗基础上加用芡莲肠安胶囊，治疗疗程1个月。比较2组治疗前后中医症状评分、肠道菌群变化情况，并评估中医证候疗效和临床疗效，比较2组治疗期间发生肠道等各种感染需要应用抗生素的例数及治疗后见效的时间。结果 治疗后，2组腹痛、恶心呕吐、腹泻频率、食欲减退、四肢无力评分均较本组治疗前显著降低(均P<0.05),且观察组恶心呕吐、腹泻频率、食欲减退、四肢无力评分均较对照组更低(均P<0.05)。治疗后，2组肠道菌群失调程度均较本组治疗前好转(P<0.05),且观察组正常(0度)比率高于对照组(P<0.05)。治疗后，2组肠道革兰阳性(G~+)杆菌菌落计数占比均较本组治疗前显著升高(均P<0.05),G~+球菌菌落计数占比均较本组治疗前显著降低(均P<0.05),且观察组G~+杆菌菌落计数占比高于对照组(P<0.05),G~+球菌菌落计数占比低于对照组(P<0.05)。观察组中医证候总有效率为66.67%(18/27),对照组为44.44%(12/27),观察组高于对照组(P<0.05)。2组临床疗效、治疗期间发生肠道等各种感染需要应用抗生素的例数及治疗后见效的时间比较差异均无统计学意义(P>0.05)。结论 芡莲肠安胶囊联合西药治疗allo-HSCT后肠道aGVHD,能够调节肠道菌群，并明显改善患者的症状。更多还原

【Abstract】 Objective To observe the clinical efficacy of Qianlian Changan Capsule combined with Western medicine(WM) for intestinal acute graft-versus-host disease(aGVHD) after allogeneic hematopoietic stem cell transplantation(allo-HSCT). Methods A total of 54 patients with intestinal aGVHD after allo-HSCT were randomly assigned into the observation group(n=27) and the control group(n=27). All patients were managed by conventional Western medicine, and those in the observation group were additionally treated with Qianlian Changan Capsule. The treatment period was 1 month, traditional chinese medicine(TCM) symptom score, intestinal flora changes, the proportion of patients requiring antibiotics for various intestinal infections, time to achieve effective after treatment were included as comparators; the clinical efficacy were assessed. Results After treatment, TCM symptom(abdominal pain, nausea and vomiting, diarrhea frequency, loss of appetite, limb weakness) scores in groups were notably decreased(all P<0.05), TCM symptom(nausea and vomiting, diarrhea frequency, loss of appetite, limb weakness) scores were decreased in the observation group compared with the control group(all P<0.05); the intestinal flora disorder in groups was improved compared with before treatment(P<0.05), the normal ratio(0 degree) was higher in the observation group than in the control group(P<0.05); the proportion of G~+ bacillus in groups was increased(P<0.05), the observation group was more common(P<0.05); the proportion of G~+ bacteria in groups was decreased(P<0.05), which in the observation group was more prevalent(P<0.05). The overall effective rate of TCM syndromes in the observation group was better than that in the control group(66.67% [18/27] vs 44.44% [12/27], [P<0.05], respectively). The difference was not statistically significant in the clinical efficacy, the proportion of patients requiring antibiotics for various intestinal infections, time to achieve effective after treatment between groups(P>0.05). Conclusion For patients with intestinal aGVHD after allo-HSCT, Qianlian Changan Capsule combined with WM is capable of regulating intestinal flora and significantly improving symptoms.更多还原