补肾止遗配方颗粒合敷脐疗法治疗小儿肾气不足型遗尿症的临床研究

发布时间：2018-01-13 15:18

本文关键词：补肾止遗配方颗粒合敷脐疗法治疗小儿肾气不足型遗尿症的临床研究　出处：《北京中医药大学》2013年硕士论文　论文类型：学位论文

【摘要】：研究背景：小儿遗尿症(NE),俗称“尿床”,是儿科临床上的常见疾病,是指儿童到了能够控制膀胱排尿的年龄而仍不能从夜间睡眠中醒来而发生的无意识排尿行为。其病程多较长,影响小儿的精神和生活,也给患儿家长带来诸多不便和苦恼,因此小儿遗尿症的有效防治意义重大。目前西医治疗小儿遗尿症有一定不良反应,停药后易反复,尚无明显有效且无不良反应的治疗方法,主要以行为干预为主,中医药在治疗方面有一定的优势。本课题根据导师长期治疗小儿遗尿的临床经验,提出在治疗时运用宣肺益气补肾法,研制出补肾止遗配方颗粒,重点在补肾止遗的基础上,加用宣肺益气药物,关注气在治疗小儿遗尿方面的作用,并配合止遗尿外敷药物,采用中医内外治相结合的方法,在临床上取得了良好的疗效。研究目的：观察补肾止遗配方颗粒合敷脐疗法治疗小儿遗尿症的临床疗效及临床安全性。研究方法：按照纳入和排除标准,选取东直门医院儿科2011年3月到2013年2月时间段,西医诊断为小儿遗尿症,中医诊断为小儿遗尿症肾气不足型的门诊患儿48例,采用意愿随机方法,治疗组25例,对照组23例。治疗组口服补肾止遗配方颗粒,且配合敷脐疗法。对照组口服缩泉颗粒制剂。2周为1疗程,连续用2个疗程。治疗期间,若出现病情加重或外敷过敏的情况,予以停药。治疗过程中随时搜集临床相关资料,观察并记录疗程中患儿的遗尿次数、睡眠深度,小便情况,患儿面色、舌苔脉象等情况,治疗2个疗程后,评价疗程前后患儿疗效。研究结果： 1.两组基本资料比较：两组患儿在性别、年龄、隐裂及病情轻重等方面进行比较,没有明显差异,具有可比性(p0.05) 2.总疗效比较：治疗组总有效率为96%,对照组总有效率78.26%,两组总疗效相比具有显著差异,有统计学意义(p0.05) 3.主症遗尿次数及睡眠深度改善比较：两组在治疗后遗尿次数的改善方面比较无差异,没有统计学意义(p0.05),但是治疗组在睡眠深度的改善方面优于对照组,有显著差异,具有统计学意义(p0.05) 4.症状改善比较：在尿量清多、神疲乏力、形寒肢冷、面色淡白、异常脉象方面,两组比较有明显差异(p0.05),在异常舌象的改善方面,两组无显著性差异(p0.05)。 5.药物安全性：在临床观察期间,常规使用剂量范围内,未发现胸闷、心慌、病情加重等临床症状,仅有少数患儿在外敷药物时出现发红、疼痛情况,不予特殊处理,减少外敷时间的情况下症状可缓解,未发现明显不良反应及事件。结论： 1.补肾止遗配方颗粒合敷脐疗法组对于治疗小儿遗尿在总体疗效、睡眠深度及其他次症尿量清多、神疲乏力、形寒肢冷、面色淡白、异常脉象等症状体征方面有显著差异,优于缩泉丸组,具有良好的临床疗效,可有效改善症状。在主症遗尿次数方面及次症舌淡苔白方面,与对照组相对比无显著差异。 2.治疗组补肾止遗配方颗粒合敷脐疗法对治疗小儿遗尿疾病疗效及证候疗效肯定,不仅可以改善患儿遗尿的相关主症,而且可以改善诸多次症,能够提高患儿体质。 3.仅有少数患儿在外敷药物时出现发红、疼痛情况,未发现明显不良反应及事件,安全性和耐受性较好。
[Abstract]:Background: nocturnal enuresis (NE), commonly known as "wet", is a common disease in pediatrics, unconscious behavior refers to the children to urinate can control bladder age still can not wake up from sleep at night and happen. Its course is long, affects children's spirit and life, but also to the children parents bring a lot of inconvenience and trouble, so the significance of effective prevention and treatment of infantile enuresis. At present the major medical treatment of children with enuresis has some adverse reactions, after discontinuation of easy relapse, there is no obvious effective treatment and no adverse reactions, mainly in behavior intervention, traditional Chinese medicine has certain advantages in the treatment. According to clinical experience the tutor of long-term treatment of enuresis in children, put forward to use the method in the treatment of kidney qi Xuanfei, developed kidney Zhiyi granules, based on the key in the kidney Zhiyi, with lung qi medicine Things, pay attention to the role in the treatment of infantile enuresis in terms of gas, and with arresting enursis topical drugs by using the method of combining traditional Chinese medicine and external treatment, achieved good curative effect in clinic.
Objective: To observe the clinical effect of Bushen granule combined check left umbilical therapy treatment of infantile enuresis and clinical safety.
Methods: according to the inclusion and exclusion criteria, select the Dongzhimen pediatric hospital from March 2011 to February 2013 period, western medicine for the diagnosis of infantile enuresis, traditional Chinese medicine diagnosis of infantile enuresis of kidney qi deficiency in children with 48 cases, using random method, 25 cases in the treatment group, 23 cases in the control group. The treatment group oral Bushen bushenzhiyi granules, and with the umbilical therapy. Control group was treated with Suoquan granules and.2 weeks for 1 courses, with 2 consecutive treatment. During the treatment, if illness or topical allergy, to stop drug treatment process. The related clinical data collected at any time, observe and record the treatment of children with enuresis times, sleep, urine the situation of children, complexion, tongue and pulse, after 2 courses of treatment, evaluation of curative effect before and after the treatment.
The results of the study:
1. comparison of the basic data of the two groups: the two groups of children were compared in terms of sex, age, cleavage, and the severity of the disease, and there was no significant difference (P0.05).
2. comparison of total curative effect: the total effective rate in the treatment group was 96%, the total effective rate of the control group was 78.26%. The total curative effect of the two groups was significantly different, with statistical significance (P0.05).
The 3. main symptoms of enuresis times and sleep improvement depth had no significant difference between the two groups after treatment the number of enuresis improvement was not statistically significant (P0.05), but the treatment group in the depth of sleep improvement than the control group, there were significant differences, with statistical significance (P0.05)
4., the improvement of symptoms was compared: there was a significant difference between the two groups (P0.05). There was no significant difference in the abnormal tongue improvement between the two groups (P0.05).
5. drug safety: in the clinical observation period, routine dose range, not found in chest, palpitation, illness and other clinical symptoms, only a small number of children in the external medicine when redness, pain, not special treatment, reduce the external time situation can alleviate the symptoms, no obvious adverse reactions and events.
Conclusion:
1. kidney Zhiyi granules and umbilicus therapy group for the treatment of infantile enuresis in general curative effect, the depth of sleep and other symptoms of urine clear, lassitude, cold limbs, pale white complexion, there is a significant difference of abnormal pulse and other symptoms and signs, is better than that of suoquanwan group, has good clinical curative effect that can effectively improve the symptoms. The main symptoms and secondary symptoms times of enuresis in pale tongue with white fur, compared with that in control group had no significant difference.
2. treatment group kidney Zhiyi granules with certain umbilicus therapy curative effects in the treatment of infantile enuresis disease and syndromes related symptoms can not only improve the children with enuresis, but also can improve the lot of disease, can improve children's physique.
3. only a few children were red, pain, no obvious adverse reactions and events were found in external application, and the safety and tolerance were better.

【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R272.6

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