调肝理脾汤配合小儿推拿治疗小儿疳气型疳证的临床研究

发布时间：2017-12-30 21:19

本文关键词：调肝理脾汤配合小儿推拿治疗小儿疳气型疳证的临床研究　出处：《广州中医药大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：疳证是一种慢性疾病,大都是由于喂养的不当或疾病的影响,从而使患儿的脾胃受损,气液耗伤所形成的,属于现代医学在儿童蛋白质一能量营养不良(PEM),6岁以下的儿童更常见,特别是3岁以下的婴幼儿。对小儿生长发育影响较大,给患儿及家长带来生理、心理及经济上多重负担。导师胡小英总结多年的经验,认为脾虚肝旺是小儿疳气型疳证的主要病机,自拟“调肝理脾汤"配合小儿推拿治疗本病,取得了良好疗效。本研究拟通过采用随机对照方法进行调肝理脾汤配合小儿推拿治疗小儿疳气型疳证的临床研究,用口服赖氨葡锌颗粒与之进行对比,并通过研究治疗后对患儿血液中前白蛋白(PA)水平的影响,观察及客观评估其临床疗效,为调肝理脾汤配合小儿推拿治疗小儿疳证(疳气型)在临床上的推广提供更为可靠的依据。方法： 1.采用简单随机对照试验法,将符合诊断标准的60例患儿分为观察组及对照组。观察组给予调肝理脾汤,配合小儿推拿治疗；对照组予赖氨葡锌颗粒。 2.对60例患儿进行临床疗效观察,疗程为4周,记录并对比其临床证候积分。 3.观察并对比观察组与对照组治疗前、后血清前白蛋白水平的变化。结果： 1.观察组及对照组经过治疗后血清前白蛋白均有升高(P0.05),经统计学组内比较,两组治疗前后均有统计学意义,经组间比较,观察组对患儿体内前白蛋白水平的改善明显优于对照组。 2.观察组总有效率为86.67%,优于对照组的56.67%(P0.05)；治疗后证候总积分低于对照组(P0.05)； 3.对比各临床证候积分,观察组治疗后面色证候积分改善无统计学意义(P0.05),观察组及对照组治疗后精神状态、食量及体重等证候的积分均有改善,且观察组优于对照组,两组均无不良反应。结论：调肝理脾汤配合小儿推拿对小儿疳气型疳证有良好疗效,能明显改善患者的体重、食量、精神与情绪等证候以及前白蛋白水平,具有疗效好,无不良反应等,可被大多数患儿接受,应在临床实践中的推广。
[Abstract]:Objective: Chancre syndrome is a chronic disease, mostly due to improper feeding or disease, so that the child's spleen and stomach damage, qi and fluid consumption injury formed. Modern medicine is more common in children under 6 years of age with protein-energy malnutrition, especially in children under 3 years of age, which has a greater impact on the growth and development of children. To bring physiological, psychological and economic burden to the children and parents. Hu Xiaoying, a mentor, summed up the experience for many years and thought that spleen deficiency and liver prosperity were the main pathogenesis of chancroid Qi type chancroid syndrome in children. "Tiaogan Lipi decoction" combined with pediatric massage treatment of this disease, achieved good results. This study is to adopt a randomized control method for the treatment of infantile chancroid Qi type chancroid syndrome clinical study of Tiaogan Lipi decoction combined with pediatric massage. The clinical efficacy was evaluated by observing and objectively evaluating the effect of oral lysopectin granule on serum prealbumin (PAA) level in children by studying the effect of treatment on the level of prealbumin. It provides a more reliable basis for the clinical application of Tiaogan Lipi decoction combined with Pediatric Massage in the treatment of infantile chancre syndrome (chancre qi type). Methods: 1. 60 children who met the diagnostic criteria were divided into the observation group and the control group by a simple randomized controlled trial. The observation group was given Tiaogan Lipi decoction, combined with children massage treatment, and the control group was given Laimaosuozin granule. 2. The clinical curative effect of 60 children was observed for 4 weeks, and the clinical syndromes were recorded and compared. 3. Observe and compare the changes of serum prealbumin before and after treatment between the observation group and the control group. Results: 1. After treatment, the serum prealbumin in the observation group and the control group were all increased (P 0.05), compared with each other before and after treatment in the statistical group, and there were significant differences between the two groups. The level of prealbumin in the observation group was significantly better than that in the control group. 2. The total effective rate of the observation group was 86.67, which was better than that of the control group (56.67) and the total score of syndrome after treatment was lower than that of the control group. 3.Compared with the scores of clinical symptoms, there was no significant improvement in the score of facial color syndrome after treatment in the observation group and the control group, and the mental state of the observation group and the control group after treatment. The scores of food intake and body weight were improved, and the observation group was superior to the control group, and there were no adverse reactions in both groups. Conclusion: Tiaogan lipi decoction combined with pediatric massage has a good curative effect on chancroid type chancroid syndrome in children. It can obviously improve the patients' body weight, food intake, mental and emotional symptoms and prealbumin level. It has good curative effect and no adverse reactions. It can be accepted by most children and should be popularized in clinical practice.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R272

【参考文献】