| OBJECTIVE:1.Exploring the therapeutic effect of the Pediatric Yunpi Tuina for children created with the spleen as the core on the core symptoms of autism spectrum disorder and gastrointestinal symptoms.2.To explore the therapeutic effect of the combined use of the Pediatric Yunpi Tuina and Chinese medicine Yunpi Formula on the core symptoms of autism spectrum disorder and gastrointestinal symptoms,and the influence on the gut microbiota.METHODS:This study included 2 to 6-year-old patients who attended the Pediatric Clinic of Dongzhimen hospital of Beijing University of Chinese Medicine from December 2019 to January 2021.They met the diagnostic criteria for autism spectrum disorder and were previously diagnosed in specialized hospitals.A total of 24 children were randomly divided into test group and control group.The control group received conventional education and training combined with Yunpi Formula.In the test group,on the basis of regular education and training and treatment with Yunpi Formula,the Pediatric Yunpi Tuina was used for 12 weeks of treatment.Fill in the Child Autism Rating Scale(CARS),Autism Behavior Scale(ABC),Rome Children's GI Disorder Questionnaire,and Gastrointestinal Disorders TCM Symptom Scale in the 0th week and 12th week respectively.In the test group,Stool is collected before and after treatment to test the gut microbiota.RESULTS:A total of 19 children met the requirements and completed the test,including 8 in the test group and 11 in the control group.In terms of core symptoms,the CARS and ABC scale scores after treatment in the two groups were lower than before.The total score of the test group before ABC scale treatment is 47.25±10.65,the total score of the control group is 59.82±31.37;the total score of the test group after treatment is 37.00±15.01;the total score of the control group is 45.82±25.34.The difference within the group was statistically significant(P<0.05),and the difference between the groups was not statistically significant(P>0.05).The test group improved significantly in exercise and self-care ability,and the difference within the group was statistically significant(P<0.05);the control group improved significantly in exercise and communication skills,and the difference within the group was statistically significant(P<0.05).There was no statistically significant difference between the five-factor groups(P>0.05).The CARS scale evaluates the treatment effect.In the test group,4 cases were markedly effective,2 cases were effective,and 2 cases were ineffective,with an effective rate of 75.0%;in the control group,5 cases were markedly effective,4 cases were effective,and 2 cases were ineffective,with an effective rate of 81.8%.To compare the difference in total scores before and after treatment,the test group had atotal score of 35.94±5.29 before treatment and a total score of 32.88±3.14 after treatment;the control group had a total score of 43.36±4.86 before treatment and a total score of 32.23±5.16 after treatment.It is of scientific significance(P<0.05),and there is no statistically significant difference between the groups(P>0.05).In terms of gastrointestinal symptoms,the results of the Rome Children's GI Disorder Questionnaire showed that functional constipation was the most common comorbid subtype of functional gastrointestinal diseases.In addition,functional abdominal pain,gas inhalation,non-retention fecal incontinence,etc.were also seen.It can also be seen that multiple functional gastrointestinal disease subtypes coexist.Using the TCM symptom score table for gastrointestinal diseases to judge the effect of treatment,the test group was markedly effective in 2 cases and effective in 6 cases;the control group was markedly effective in 1 case and effective in 10 cases.The total scores of the two groups before and after treatment were significantly lower than those before treatment.The total score of the test group before treatment was 81.75±15.16,and the total score after treatment was 24.00±7.45;the total score of the control group before treatment was 67.91±12.31,and the total score after treatment was 26.45±7.06.The differences within the groups were statistically significant(P<0.000),and the differences between the groups were statistically significant(P<0.05).In terms of gut microbiota,the abundance of Fusobacterium after treatment was higher than before treatment,and the difference was statistically significant(P<0.05).The abundance of Subdoligranulum variabile decreased after treatment,and the difference was statistically significant(P<0.05)CONCLUSIONS:The Pediatric Yunpi Tuina,created with the spleen as the core is not effective in treating the core symptoms of autism spectrum disorder,and has a significant effect in improving gastrointestinal symptoms.The Pediatric Yunpi Tuina combined with Yunpi Formula and Yunpi Formula alone can improve the core symptoms of autism and gastrointestinal symptoms,and improve self-care ability and exercise ability.The most common functional gastrointestinal disease subtype is functional constipation.The therapeutic mechanism of the Pediatric Yunpi Tuina and Yunpi Formula for the core symptoms and gastrointestinal symptoms of children with spleen deficiency autism spectrum disorder may be related to the changes in the abundance of gut microbiota,improving the intestinal mucosal barrier function,and the secretion of hormones related to metabolism,and reducing the immune inflammatory response in the intestinal tract. |
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