小儿脾胃乐颗粒治疗小儿厌食脾失健运证临床研究

发布时间：2018-04-15 06:11

本文选题：小儿脾胃乐 + 厌食症　；参考：《湖北中医药大学》2012年硕士论文

【摘要】：目的：厌食是小儿的常见病、多发病之一,国内专家将其归属于消化功能紊乱、功能性消化不良或进食障碍之中。目前西医治疗缺乏针对性,且疗效欠佳,而中医药治疗注重整体辨证施治,对本病的治疗积累了丰富的经验。小儿脾胃乐颗粒是安徽省名老中医张琼林主任的临床经验方,本研究是在中医基础理论的指导下运用小儿脾胃乐颗粒治疗证属脾失健运的厌食患儿,使其脾复健运、胃复腐熟,从而达到阴平阳秘,并探讨小儿脾胃乐颗粒治疗小儿厌食脾失健运证的疗效及其作用机制,同时初步评价其安全性。方法：收集临床西医诊断为厌食、中医证属脾失健运的患儿36例,年龄在1～7岁之间,随机分为治疗组18例和对照组18例。治疗组给予小儿脾胃乐颗粒口服,对照组给予安慰剂口服。用量：1～3岁每次0.5袋,3+～7岁每次1袋,一日3次,开水冲服。疗程为4周。用药期间,不得使用助消化、止泻类西药及健脾益气、化食消积中药。观察治疗前后两组患儿食欲不振、食量减少、体重、尿D-木糖排泄率、中医证候、主症计分和与证候计分和等疗效评价指标及生命体征(体温、脉搏、呼吸、血压)和常规生化检查(血常规、肝肾功能、粪常规、尿常规、心电图)等安全性评价指标。结果：临床研究显示,治疗组痊愈8例,显效4例,愈显率66.66%,对照组痊愈0例,显效2例,愈显率为11.76%,结果表明治疗组明显优于对照组。两组主症积分和、证候积分和等级之间比较,差异有统计学意义(P0.01)。治疗组食量减少,食欲减退,腹胀,体重等情况均较对照组为优。食欲减退,食量减少,腹胀,体重等情况与对照组比较,差异有统计学意义(P0.01)。治疗全过程中未发现不良反应,治疗前后肝肾功能比较,肝肾功能各项指标未见异常变化,前后比较差异无统计学意义(P0.05)。结论：用小儿脾胃乐颗粒治疗小儿厌食脾失健运证有较好的疗效,其服用方便,口感好,患儿易接受,且十分安全。是中医辨证施治的一个典范,值得推广、应用。
[Abstract]:Objective: anorexia is a common disease in children, which is classified by domestic experts as digestive disorders, functional dyspepsia or eating disorders.At present, the western medicine treatment lacks pertinence, and the curative effect is poor, and the traditional Chinese medicine treatment pays attention to the whole syndrome differentiation treatment, has accumulated the rich experience to the treatment of this disease.This study is based on the basic theory of traditional Chinese medicine to treat children with anorexia due to spleen failure, so that the spleen will recover and the stomach will decay.In order to achieve Yin Pingyang constipation, and to explore the treatment of infantile spleen anorexia syndrome and its mechanism of action, at the same time preliminary evaluation of its safety.Methods: a total of 36 children, aged between 1 and 7 years, who were diagnosed as anorexia by western medicine and who were diagnosed as incapacitated by traditional Chinese medicine, were randomly divided into treatment group (n = 18) and control group (n = 18).The treatment group was given the children spleen-Weiling granule orally, and the control group was given placebo.Dosage: 1: 1, 3 years old, 0.5 bags, 3 / 7 years old, 1 bag, 3 times a day, boiled water.The course of treatment was 4 weeks.During the use of drugs, not to use digestive aid, anti-diarrhea type of western medicine and invigorate spleen and qi, traditional Chinese medicine.Before and after treatment, two groups of children were observed, such as loss of appetite, food loss, weight, urine D-xylose excretion rate, TCM syndromes, scores of main symptoms and syndromes, and vital signs (body temperature, pulse, respiration, etc.)Blood pressure) and routine biochemical examination (blood routine, liver and kidney function, fecal routine, urine routine, electrocardiogram) and other safety indicators.Results: the clinical study showed that 8 cases were cured in the treatment group, 4 cases were markedly effective, and the recovery rate was 66.66%. In the control group, 0 cases were cured, 2 cases were obviously effective, and the effective rate was 11.76%. The results showed that the treatment group was obviously superior to the control group.The difference between the two groups was statistically significant (P 0.01).The diet, appetite, abdominal distension and body weight in the treatment group were better than those in the control group.Compared with the control group, there were significant differences in appetite loss, appetite loss, abdominal distension, weight and so on.No adverse reactions were found in the whole course of treatment. There were no abnormal changes in the indexes of liver and kidney function before and after treatment, and there was no significant difference between the two groups before and after treatment (P 0.05).Conclusion: the treatment of infantile anorexia and spleen disabling syndrome with children's spleen stomach granule has better curative effect, its use is convenient, taste is good, the child is easy to accept, and is very safe.It is a model of syndrome differentiation and treatment of TCM, which is worth popularizing and applying.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R272

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