中药外洗治疗肺脾湿热型手足口病的疗效观察

发布时间：2018-04-18 21:36

本文选题：中药外洗 + 肺脾湿热　；参考：《广州中医药大学》2012年硕士论文

【摘要】：研究背景：手足口病是由肠道病毒引起的急性传染病,多发生于学龄前儿童,尤以3岁以下年龄组发病率最高。目前西医治疗手足口病尚无特效药物,对于普通型主要采用对症及中西医结合治疗,重症采用综合疗法。中医药治疗本病已有20余年的历史,主要是采用辨证施治、分期论治等方法,可达标本兼顾、减轻症状、缩短病程之功效。由于中药饮片制剂煎煮、口感、气味等原因,小儿服用时存在一定困难,影响了临床的使用与治疗,因此选择更为方便而有效的给药途径成为临床亟待解决的问题。外洗法克服了口服药物的困难,使药物透入皮损,有效改善皮损局部肌肤的血液循环和促进机体代谢,有利于药物直接吸收而发挥药物的局部治疗作用,收到外治内调之功效。研究目的：本研究通过观察中药外洗治疗肺脾湿热型手足口病的疗效,评价中药外洗治疗肺脾湿热型手足口病的有效性及安全性,为临床应用提供依据。研究方法：本研究采用随机分组对照试验的方法,将2011年3月至2012年3月入住南海妇产儿童医院儿内科符合纳入标准的手足口病患儿80例,随机分成对照组(40例),中药外洗组(40例),两组均进行常规治疗(予床边隔离,避免交叉感染：适当休息,清淡饮食,做好口腔和皮肤护理；发热、呕吐、腹泻等症状给予相应处理；对合并细菌感染者酌情加用抗生素)；中药外洗组在常规治疗基础上加中药外洗治疗。于治疗开始前进行基线资料分析、证候评分及检测两组患儿三大常规,C反应蛋白,心肌酶谱,肝肾功能,血糖。观察并记录治疗后皮疹及口腔疱疹消退时间、痊愈时间,比较两组病例上述临床表现及各指标水平变化情况,建立数据库,进行统计分析,观察中药外洗治疗肺脾湿热型手足口病的疗效,评价中药外洗治疗肺脾湿热型手足口病的有效性及安全性。研究结果：本研究表明,两组患儿在皮疹、口腔疱疹消退时间及痊愈时间的比较中,中药外洗组与对照组比较差异有统计学意义(P0.01),提示中药外洗可以促进肺脾湿热型手足口病患儿皮疹及口腔疱疹的消退,缩短病程：在治疗后证候积分比较中,两组组内及组间比较差异均有统计学意义(P0.01),提示中药外洗组对临床不适症状有史加明显的缓解及治疗作用：在疗效指标的比较中,痊愈率、显效率、有效率、无效率中药外洗组为12.5%、60%、27.5%、0%；对照组为0%、25%、75%、0%；两组疗效比较差异有统计学意义(P0.01),提示中药外洗组治疗效果优于对照组。治疗过程中中药外洗组患儿无出现不良反应。研究结论：中药外洗治疗肺脾湿热型手足口病,可以促进皮疹、口腔疱珍消退,缩短病程，对临床不适症状有着明显的缓解及治疗作用,安全有效。
[Abstract]:Background:Hand, foot and mouth disease (HFMD) is an acute infectious disease caused by enterovirus.At present, there is no special medicine for hand, foot and mouth disease treated by western medicine. The common type is mainly treated with syndrome and combination of traditional Chinese medicine and western medicine, and the severe type is treated with comprehensive therapy.Chinese medicine has been used for treating this disease for more than 20 years. It mainly adopts the methods of syndrome differentiation and treatment by stages, which can take into account the symptoms, reduce the symptoms and shorten the course of the disease.Because of the reasons of decoction, taste, smell and so on, it is difficult for children to take it, which affects the clinical use and treatment. Therefore, the choice of more convenient and effective way of administration has become a clinical problem to be solved urgently.The external washing method overcomes the difficulty of oral medicine, makes the drug penetrate into the skin lesion, effectively improves the blood circulation of the skin and promotes the metabolism of the body, which is beneficial to the direct absorption of the drug and exerts the local therapeutic effect of the drug, and receives the effect of external treatment and internal regulation.Objectives of the study:The purpose of this study was to evaluate the efficacy and safety of external washing of traditional Chinese medicine in the treatment of hand, foot and mouth disease with dampness and heat of lung and spleen, and to provide the basis for clinical application.Research methods:In this study, 80 children with hand, foot and mouth disease who were admitted to Nanhai Gynecology and Childhood Hospital from March 2011 to March 2012 were randomly divided into two groups.They were randomly divided into control group (n = 40) and external washing group (n = 40). The two groups were treated with routine therapy (bedside isolation to avoid cross infection: proper rest, light diet, oral and skin care, fever, vomiting, etc.)The symptoms such as diarrhea should be treated accordingly; the patients with bacterial infection should be treated with antibiotics as appropriate; the external washing group of traditional Chinese medicine should be treated with Chinese medicine on the basis of routine treatment.Baseline data, syndromes score and three major routine C-reactive protein, myocardial enzyme spectrum, liver and kidney function and blood sugar were analyzed before treatment.To observe and record the receding time and recovery time of rash and oral herpes after treatment, to compare the changes of the above clinical manifestations and indexes between the two groups, and to establish a database for statistical analysis.To observe the efficacy and safety of external washing of traditional Chinese medicine in the treatment of hand-foot-mouth disease with damp-heat of lung and spleen and to evaluate the efficacy and safety of external washing of traditional Chinese medicine in treating hand-foot-mouth disease of damp-heat type of lung and spleen.Results of the study:This study shows that the two groups of children in the rash, oral herpes regression time and recovery time comparison,There was significant difference between the Chinese medicine external washing group and the control group (P 0.01), which suggested that the Chinese medicine external washing could promote the disappearance of skin rash and oral herpes in children with hand, foot and mouth disease of damp-heat type of lung and spleen, and shorten the course of disease: in the comparison of syndrome score after treatment,The differences between the two groups were statistically significant (P 0.01), which suggested that the external washing group had a history of relief and treatment of clinical symptoms: in the comparison of the curative effects, the cure rate, the effective rate, and the effective rate were significant.The effective rate of external washing group was 12.5%, and that of the control group was 25.75%. The difference between the two groups was statistically significant, indicating that the treatment effect of the external washing group was better than that of the control group (P < 0.05), which indicated that the treatment effect of the external washing group was better than that of the control group.There were no adverse reactions in the treatment group.The study concluded that:The treatment of hand, foot and mouth disease with dampness and heat of lung and spleen by external washing of traditional Chinese medicine can promote rash, recede of oral blister, shorten the course of disease, have obvious relief and therapeutic effect on clinical unwell symptoms, and it is safe and effective.
【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

【引证文献】