苏神方治疗小儿轮状病毒肠炎的疗效观察

发布时间：2018-04-13 09:09

本文选题：苏神方 + 轮状病毒肠炎　；参考：《广州中医药大学》2017年硕士论文

【摘要】：目的:通过平行设计随机对照实验,运用中药特色复方治疗轮状病毒肠炎,观察余德钊教授的经验方苏神方对儿童轮状病毒肠炎的临床疗效及其对主要症状体征的改善情况,为小儿轮状病毒肠炎的治疗提供更安全有效的选择。方法:本实验按照小儿轮状病毒肠炎的中医及西医诊断标准,共纳入60例患儿,通过应用平行设计随机对照实验,将60例患儿分为治疗组与对照组2组,每组30例。对照组给予口服补液盐、蒙脱石散治疗;治疗组在对照组的基础上,给予口服苏神方治疗。观察两组患儿的总有效率、退热时间、止泻时间、中医临床证候量化积分及其他次要症状的改善情况,考察苏神方对小儿轮状病毒肠炎的治疗作用及优势。结果:1.治疗后,治疗组患儿的总有效率为93.33%,对照组患儿总有效率为66.67%,经Mann-Whitney U检验,两组疗效比较有显著性差异(Mann-Whitney U=250.00,P=0.000.05);经Fisherχ2检验,治疗组的总有效率优于对照组,差异存在显著统计学意义(χ2=0.58,P=0.020.05)。2.治疗前,治疗组和对照组在中医临床证候量化总积分的比较,经方差齐性检验,方差齐(P=0.53,P=0.470.05),经独立样本t检验,治疗组患儿中医临床证候量化积分无显著性差异(t=-0.39,P=0.690.05),具有可比性。治疗后,经方差齐性检验,方差不齐(F=13.59,P=0.000.05),经独立样本t'检验,治疗组患儿中医临床证候量化积分有显著性差异(t'=-3.48,P=0.000.05)。治疗前后的差值方面,经方差齐性检验,方差齐(F=1.48,P=0.230.05),经独立样本t检验,治疗组患儿中医临床证候量化积分有显著性差异(t=4.32,P=.000.05),提示治疗组患儿中医临床证候改善情况优于对照组。治疗组治疗前后中医临床证候量化积分有显著性差异(t=19.57,P=0.000.05);对照组治疗前后中医临床证候量化积分有显著性差异(t=10.57,P=0.000.05)提示治疗组和对照组的治疗均可改善中医临床证候。3.在退热方面,治疗组和对照组的退热时间,经方差齐性检验,方差不齐(F=9.08,P=0.000.05),经独立样本t'检验,治疗组患儿退热时间有显著性差异(t'=-4.59,P=0.000.05),提示治疗组在退热时间方面较对照组具有明显的优势。4.在止泻方面,治疗组和对照组的止泻时间,经方差齐性检验,方差齐(F=0.04,P=0.850.05),经独立样本t检验,治疗组患儿止泻时间有显著性差异(t=-4.14,P=0.000.05),提示治疗组在止泻时间方面较对照组具有明显的优势。5.治疗后,在食欲不振方面,治疗组评分经McNemar检验,相比治疗前具有显著性差异(P=0.000.05);对照组评分经McNemar检验,相比治疗前无显著性差异(P=0.130.05);两组间食欲不振的症状经Fisherχ2检验比较,差异有统计学意义(χ2=5.01,P=0.040.05),提示治疗组和对照组在治疗后,食欲不振的症状均得到改善,但是治疗组的改善情况较对照组具有明显的优势。6.治疗后,在恶心呕吐方面,治疗组经McAeemar检验,相比治疗前具有显著性差异(P=0.000.05);对照组经McNemar检验,相比治疗前具有显著性差异(P=0.010.05);两组间恶心呕吐的症状经Fisher χ2检验比较,差异无统计学意义(χ2 = 1.38,P=0.280.05),提示治疗组和对照组在治疗后,恶心呕吐的症状均得到改善,且治疗组的改善情况较对照组并无明显的优势。7.治疗结束后,两组患儿均无明显不良反应出现。结论:通过中医特色治疗,苏神方可显著提高治疗患儿的总有效率,迅速缓解轮状病毒肠炎患儿的相关临床症状,缩短病程,减少发热时间、腹泻时间,同时,中医相关临床症候得到明显改善,此外,尚可有效减少病程后期患儿食欲不振、恶心呕吐等情况,为小儿胃肠道系统的恢复和免疫系统的重新建立提供可能,降低继发其他胃肠系统疾病的风险,临床价值较高,值得推广。
[Abstract]:Objective: through the design of parallel randomized controlled trials, using the characteristics of traditional Chinese medicine compound in the treatment of rotavirus enteritis, observe the clinical curative effect of the experience of Professor Yu Dezhao, Su God of children rotavirus enteritis and its improvement on the main symptoms and signs, provide a safe and effective alternative for treatment of rotavirus enteritis in children. Methods: according to the experiment of traditional Chinese medicine and Western medicine diagnostic criteria of rotavirus enteritis, 60 cases were included, through the application of parallel design, randomized controlled trial, 60 patients were randomly divided into treatment group and control group 2 groups, 30 cases in each group. The control group was given oral rehydration salts, Montmorillonite powder treatment; the treatment group in the control group on the basis of God, give oral Su treatment. The efficiency of the total, observed two groups of children with fever time, antidiarrheal time, improve the situation of TCM clinical syndrome quantitative integral and other minor symptoms, Su God for children study The treatment effect and advantage of rotavirus enteritis. Results: 1. after treatment, the total effective rate in treatment group was 93.33%, control group total effective rate was 66.67%, by Mann-Whitney U test, two groups had significant difference (Mann-Whitney, U=250.00, P=0.000.05); the Fisher 2 test, the treatment group the total efficiency is better than the control group, the differences were statistically significant (2=0.58, P=0.020.05).2. before treatment, the treatment group and control group in TCM clinical syndrome quantitative total score, by variance homogeneity test, Fang Chaqi (P=0.53, P=, 0.470.05) with independent sample t test, the treatment group with TCM syndrome symptom score had no significant difference (t=-0.39, P=0.690.05), comparable. After treatment, the difference of homogeneity test of homogeneity of variance (F=13.59, P=0.000.05), with independent sample t'test, the treatment group with TCM syndrome score was significant The difference (t'=-3.48, P=0.000.05). The difference before and after treatment, by variance homogeneity test of variance (F=1.48, P=0.230.05), with independent sample t test, the treatment group with TCM syndrome score had significant difference (t=4.32, P=.000.05), indicating that the treatment group clinical syndromes of TCM were better than that of the control group. The treatment group before and after treatment of TCM clinical syndrome quantitative integral had significant difference (t=19.57, P=0.000.05); the control group before and after treatment of TCM syndrome score had significant difference (t=10.57, P=0.000.05) prompt treatment group and control group in the treatment of Chinese medicine can improve the clinical syndrome of.3. in the fever, and the treatment group the control group of the pyretolysis time, by variance homogeneity test of variances (F=9.08, P=0.000.05), with independent sample t'test, the treatment group in pyretolysis time had significant difference (t'=-4.59, P=0.000.05), suggesting that the pyretolysis Time has the advantage of.4. in diarrhea than the control group, diarrhea treatment group and control group, by variance homogeneity test, Fang Chaqi (F=0.04, P=0.850.05), with independent sample t test, the treatment group of children with diarrhea time had significant difference (t=-4.14, P=, 0.000.05), the treatment group in time of diarrhea as compared with the control group,.5. treatment has the advantage of obvious, in the loss of appetite, the treatment group were tested by McNemar, compared with before treatment with significant difference (P=0.000.05); the control group were tested by McNemar, compared with before treatment there was no significant difference between the two groups (P=0.130.05); anorexia symptoms by Fisher 2 test comparison, the difference was statistically significant (2=5.01, P=0.040.05), the treatment group and control group after treatment, the symptoms of anorexia were improved, but the improvement in the treatment group than the control group has the obvious advantages of.6. After treatment, nausea and vomiting in the treatment group, by McAeemar test, compared with before treatment with significant difference (P=0.000.05); the control group by McNemar test, compared with before treatment with significant difference (P=0.010.05) between the two groups; nausea and vomiting symptoms by Fisher 2 test was compared, the difference was not statistically significant (x 2 = 1.38, P=0.280.05), the treatment group and control group after treatment, the symptoms of nausea and vomiting were improved, the improvement of the treatment group than in the control group had no obvious advantage over.7. after treatment, two groups were no obvious adverse reactions. Conclusion: the characteristics of traditional Chinese Medicine treatment, Su God can have total efficiency of treatment were significantly improved, quickly relieve clinical symptoms in children with rotavirus, shorten the course, reduce the duration of fever, diarrhea, and related TCM clinical symptoms improved significantly, in addition, can effectively reduce the In the late stage of illness, children's loss of appetite, nausea and vomiting can provide a possibility for the recovery of gastrointestinal system and the establishment of immune system, and reduce the risk of other gastrointestinal diseases.

【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】：2017
【分类号】：R725.1

【参考文献】