小建中汤加减治疗小儿肠系膜淋巴结炎（脾胃虚寒型）的临床疗效观察

发布时间：2018-02-12 19:31

本文关键词： 小建中汤加减小儿肠系膜淋巴结炎脾胃虚寒　出处：《黑龙江中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的研究小建中汤加减对脾胃虚寒型小儿肠系膜淋巴结炎的近期疗效以及远期疗效。方法本课题的临床病例均来自于黑龙江中医药大学附属第一医院儿科门诊。随机选取前来就诊的符合中医辨证分型和西医诊断标准的患儿62例。采取随机分组的方法,对照组30人,治疗组32人。对照组患儿应用头孢丙烯颗粒口服10天。治疗组给予小建中汤加减温服,疗程为10天。治疗期间腹痛严重者加用消旋山莨菪碱片。观察治疗前后患儿症状和体征变化情况。采用SPSS 19.0统计软件,建立数据库,进行数据分析。结果(1)总疗效比较:治疗组和对照组总有效率分别为93.8%、73.3%,治疗组总疗效要明显优于对照组(p0.05);(2)中医证候总积分:治疗组疗前总积分与疗后比较p0.05,说明治疗组有效;对照组疗前总积分与疗后比较p0.05,说明对照组有效;治疗后治疗组与对照组比较p0.05,具有统计学意义,提示治疗组效果要优于对照组;(3)治疗后主症比较:治疗期间患儿腹痛发生次数,治疗组与对照组比较,p0.05,治疗组改善腹痛对照组效果更明显;(4)治疗后次症比较:面色少华、手足不温、食少纳呆、食后腹胀方面,p值均小于0.05,差异显著,提示治疗组优于对照组;(5)两组患儿腹部超声结果比较:治疗组治疗后肠系膜淋巴结体积与治疗前比较p0.05,治疗组治疗方案有效;对照组治疗后肠系膜淋巴结体积与治疗前比较p0.05,对照组治疗方案有效;治疗组与对照组相比较p0.01,在改善淋巴结大小方面明显优于对照组;(6)两组患儿腹痛复发情况比较:治疗后对临床治愈随患儿访2个月,治疗组随访19人,复发1人,对照组随访6人,复发3人,(p0.05)差异有统计学意义,即治疗组在减少腹痛复发方面具有明显优势。结论(1)小建中汤加减治疗小儿肠系膜淋巴结炎有效。治疗组总有效率为93.8%。(2)小建中汤加减在改善患儿腹痛程度、乳食减少、腹胀、便溏便秘等方面均明显优于抗生素。(3)小建中汤加减在改善淋巴结肿大方面优于对照组。(4)小建中汤加减在减少肠系膜淋巴结复发方面具有明显优势。
[Abstract]:Objective to study the short term and long term effect of Xiaojianzhong decoction (XJD) on mesenteric lymphadenitis of children with deficiency of spleen and stomach. Methods all the clinical cases in this study came from the pediatric outpatient clinic of the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine. Randomly selected 62 children who met the criteria of TCM syndrome differentiation and western medicine diagnosis, and adopted the method of random grouping. 30 patients in the control group and 32 in the treatment group. The children in the control group were treated with cefpropene granules for 10 days. The treatment group was given Xiaojianzhong decoction for 10 days. The course of treatment was 10 days. The patients with severe abdominal pain were treated with racemic anisodamine tablets. The changes of symptoms and signs of children before and after treatment were observed. SPSS 19.0 statistical software was used to establish the database. Data analysis. Results: the total effective rate of treatment group and control group were 93.8 and 73.3, respectively. The total curative effect of treatment group was significantly better than that of control group (p0.05). The total integral of TCM syndromes: the total score before and after treatment in the treatment group was p0.05, which indicated that the treatment group was effective; The total score of the control group before and after treatment was p0.05, which showed that the control group was effective, and the treatment group had statistical significance compared with the control group. The results indicated that the effect of the treatment group was better than that of the control group (P < 0.05). After treatment, the frequency of abdominal pain in the treatment group was higher than that in the control group (P 0.05), and the effect in the treatment group was more obvious than that in the control group (P < 0.05). There were significant differences in the values of P < 0.05 in abdominal distension after eating, the difference was significant. The results showed that the volume of mesenteric lymph nodes in the treatment group was better than that in the control group (p0.05). The mesenteric lymph node volume in the control group was higher than that before treatment (p0.05), and the control group was effective. Compared with the control group, the treatment group was significantly better than the control group in improving the size of lymph nodes. (2 months after treatment, 19 patients in the treatment group were followed up and 1 patient had relapsed. In the control group, 6 patients were followed up and 3 patients had recurrence (P 0.05). Conclusion Xiaojianzhong decoction is effective in the treatment of mesenteric lymphadenitis in children. The total effective rate of the treatment group is 93.80.The total effective rate of the treatment group is 93.80.The total effective rate of the treatment group is 93.80.The total effective rate of the treatment group is 93.80.The total effective rate of the treatment group is 93.80.The total effective rate of the treatment group is 93.8%. Loose stools constipation was obviously superior to antibiotics. 3) Xiaojianzhong decoction was superior to control group in improving lymphadenopathy. Xiaojianzhong decoction had obvious advantages in reducing the recurrence of mesenteric lymph nodes.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R272

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