To investigate the effects of Gegen Decoction combined with probiotics on symptom scores, time to negative conversion of fecal reducing substances, fecal pH value, and microbiome-related indicators in pediatric acute diarrhea.

A total of 98 children with acute diarrhea treated at Qinhuangdao Hospital of Traditional Chinese Medicine from January 2024 to July 2024 were randomly divided into an experimental group (Gegen Decoction Granules + probiotics) and a control group (probiotics alone), with 49 cases in each group. During follow-up, 3 cases dropped out in the experimental group and 2 cases in the control group, resulting in 46 cases in the experimental group and 47 cases in the control group completing the study. Both groups received oral rehydration and dietary management according to clinical guidelines. The treatment duration was 5 days. Traditional Chinese medicine (TCM) syndrome scores, time to negative conversion of fecal reducing substances, fecal pH value, number of bowel movements within 24 hours, fecal calprotectin, short-chain fatty acids (SCFAs), and fecal secretory immunoglobulin A (sIgA) levels were compared between the two groups before and after treatment. Adverse events were also recorded.

The experimental group showed significantly greater improvements than the control group in terms of symptom score reduction, time to negative conversion of fecal reducing substances, restoration of fecal pH value, increase in total SCFAs, butyrate proportion, and fecal sIgA, as well as reduction in fecal calprotectin (P < 0.05, P < 0.01). The overall response rate was 93.48% (43/46) in the experimental group and 80.85% (38/47) in the control group (P <0.05). There was no significant difference in the incidence of adverse events between the two groups (P > 0.05).

Gegen Decoction combined with probiotics can significantly alleviate symptoms of acute diarrhea in children, promote recovery of carbohydrate absorption, correct the acidic intestinal environment, and modulate microbiome and mucosal immunity indicators, with a favorable safety profile. It represents an effective integrated treatment strategy.