煨葛根穴位贴敷辅助治疗小儿轮状病毒肠炎的临床观察

发布时间：2018-02-01 06:27

本文关键词： 煨葛根穴位敷贴小儿轮状病毒肠炎临床观察　出处：《广州中医药大学》2012年硕士论文　论文类型：学位论文

【摘要】：研究背景小儿轮状病毒肠炎是由轮状病毒感染引起的急性自限性疾病,以6月至2岁的小儿发病率最高,传播迅速,流行广泛,常合并有心肌损害,会造成婴幼儿不同程度的脱水征,对婴幼儿的健康危害较大。目前西医治疗本病尚无特效药物,中医药在治疗本病方面具有一定优势；而穴位贴敷疗法治疗疾病及调理体质的历史悠久,且能克服小儿口服药物的困难,避免肝脏首过效应,并通过穴位的敏感性而发挥药物的局部治疗作用,收到外治内调之功效。目前穴位贴敷疗法的研究多以成方为主,药量及药性不能确定,难以做到质量控制。笔者所在医院在“治未病”理念下广泛开展调理体质及穴位贴敷,并根据临床经验筛选穴位贴敷的药物,在临床实践中广受群众欢迎。研究目的本课题从治疗小儿泄泻的常用药物葛根着手,通过观察在常规治疗的基础上应用煨葛根穴位敷贴辅助治疗小儿轮状病毒肠炎患儿的临床疗效与其安全性初步探讨,以期为治疗小儿轮状病毒肠炎提供更好的药物进行穴位贴敷,提高治疗小儿轮状病毒肠炎的疗效,减少患儿服药、打针带来的痛苦。研究方法采用前瞻性随机对照临床试验设计方法,将2011年1月至2012年1月入住广州中医药大学附属南海妇产儿童医院儿内科,符合诊断标准及纳入标准的小儿轮状病毒肠炎患儿59例,利用随机数字表随机分成煨葛根观察组、糊精对照组。两组均采用液体疗法、消化道黏膜保护剂、对症处理等常规治疗,煨葛根观察组加用煨葛根穴位敷贴神阙穴、双侧天枢穴及双侧脾俞穴：糊精对照组加用与煨葛根等量的糊精制作成的贴敷膏贴神阙穴、双侧天枢穴及双侧脾俞穴,一天一次,疗程为3天。结合量表观察两组患儿大便次数及性状恢复正常的天数,治疗前后大便的次数、性状、发热、呕吐、皮肤弹性、肛周皮肤等症状及体征及证候积分改善情况,并检测两组患儿的大便轮状病毒抗原、心肌酶谱等相关实验室指标,建立数据库,使用SPSS13.0进行统计分析。研究结果本试验研究前的一般资料中性别、月龄、入院前病程、证候类型、观察的症状体征分级及证候积分和CK-MB检测结果及其异常率,经统计分析,两组间均无显著性差异,具有可比性。研究结束后,煨葛根观察组30例、糊精对照组29例,两组疗效构成分别为：显效20例、有效9例、无效1例,显效2例、有效21例、无效6例,总有效率96.7%;79.3%,提示煨葛根观察组在临床疗效优于糊精对照组,p0.05,两组差异有统计学意义；两组治疗后大便次数及性状恢复正常的天数经统计分析,P(0.05,提示差异具有统计学意义,提示煨葛根观察组大便情况恢复正常的时间较糊精对照组短：两组轮状病毒转阴率比较,经卡方检验p0.05,差异具有统计学意义,提示煨葛根观察组在轮状病毒转阴率上优于糊精对照组：通过两组治疗前后CK-MB值及异常率的比较,p均0.05,差异均具有统计学意义,提示煨葛根观察组在辅助治疗心肌受损方面上优于糊精对照组：治疗后两组症候积分减少率经统计学分析比较,p0.05,差异具有统计学意义,提示煨葛根观察组在证候积分改善上较糊精对照组有优势；经观察,无安全性指标异常及不良反应。研究结论煨葛根穴位贴敷能提高治疗小儿轮状病毒肠炎的临床疗效,缩短小儿轮状病毒肠炎的大便情况恢复正常的时间,促进大便轮状病毒抗原转阴,促进心肌损害的改善,促进病情恢复,无不良反应。
[Abstract]:Research background
Children with rotavirus enteritis is caused by rotavirus infection caused by acute self limiting disease, from June to 2, the highest rate of pediatric onset, rapid spread and widely popular, often associated with myocardial damage, can cause dehydration in different degrees of infant syndrome, health hazard of infants is large. The traditional Chinese medicine treatment of this disease there is no effective drugs, traditional Chinese medicine has certain advantages in the treatment of the disease; and acupoint therapy in the treatment of diseases and physical conditioning has a long history, and can overcome the difficulties of oral drug, avoid the liver first pass effect, and the acupoint sensitivity play a role in local treatment of drugs, efficacy in the treatment received at present. The research of acupoint sticking therapy by Decoction, and drug resistance can not be determined, it is difficult to achieve quality control. The hospital widely carried out in the "disease" under the concept of physical conditioning and acupoint Application, and according to clinical experience screening acupoint application of drug, in clinical practice widely popular with the masses.
research objective
This topic from the commonly used drugs for the treatment of infantile diarrhea to investigate clinical curative effect of puerarin, with adjuvant treatment of pediatric rotavirus enteritis by observing weigegen Acupoint Application on the basis of routine treatment and safety, in order for the treatment of infantile rotavirus enteritis provided for better drugs to improve the curative effect of acupoint application. The treatment of rotavirus enteritis, reduce the pain of patients taking injections.
research method
A prospective randomized controlled clinical trial design method, the affiliated Nanhai maternity and children's Hospital from January 2011 to January 2012 in Guangzhou University of Chinese Medicine, and meet the diagnostic criteria of pediatric rotavirus enteritis in 59 cases using the standard, were randomly divided into observation group weigegen dextrin, control group. Two groups were treated with fluid therapy, digestion intestinal mucosa protective agent, symptomatic treatment and routine treatment, the observation group added with weigegen weigegen acupoint Shenque, spleen and bilateral Tianshu Yu Xue: the control group was treated with dextrin with weigegen amounts of dextrin into the sticking plaster Tianshu Shenque, spleen and bilateral Yu Xue, a one day, 3 days for a course. Combined with the scale of days observation frequency and characters of two groups of children defecate normal, the number of stool before and after the treatment of fever, vomiting, traits, skin elasticity, perianal skin And other symptoms and signs and syndrome integral improvement, and detection of stool rotavirus antigen, myocardial enzymes and other related laboratory indicators in two groups, establish database, use SPSS13.0 for statistical analysis.
Research results
Gender, general details of the study in the months before admission, the course of disease, syndrome type, classification and syndrome symptom scores and the test results of CK-MB observation and abnormal rate, through statistical analysis, there was no significant difference between the two groups were comparable. After the end of the study, 30 patients with weigegen the observation group, dextrin 29 cases in the control group, two groups were formed: 20 cases markedly effective 9 cases, invalid 1 cases, 2 cases were cured, 21 cases effective, 6 cases ineffective, the total efficiency of 96.7%; 79.3%, prompting weigegen in the observation group, the clinical curative effect of dextrin in control group, there were P0.05 significant differences between the two groups; two days after treatment in stool returned to normal after statistical analysis, P (0.05, suggested that the difference was statistically significant, suggesting that the observation group weigegen stool recovery time than the control group: two short dextrin rotavirus negative rate compared by chi square test P0 .05, the difference was statistically significant, suggesting that weigegen in the observation group was better than that of rotavirus negative rate on the dextrin control group: through comparison and the abnormal rate of the CK-MB value of the two groups before and after treatment, P was 0.05, the difference was statistically significant, suggesting that weigegen observed in the adjuvant treatment of heart muscle damage is superior to the control group of dextrin after treatment, symptom scores of two groups reduced rate by statistical analysis and comparison, P0.05, the difference was statistically significant, suggesting that weigegen syndrome in the observation group than the control group the scores of dextrin have advantages; it was observed that no abnormal safety indicators and adverse reactions.
research conclusion
Acupoint application of roasted Pueraria lobata can improve the clinical efficacy of rotavirus enteritis in children, shorten the stool condition of children with rotavirus enteritis, return to normal time, promote the conversion of stool rotavirus antigen, promote the improvement of myocardial damage, and promote the recovery of the disease without adverse reactions.

【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】：2012
【分类号】：R272

【参考文献】