苍苓散加味对湿热型轮状病毒肠炎的疗效观察及干扰素-γ的影响

发布时间：2018-04-21 12:31

本文选题：湿热型 + 泄泻　；参考：《广州中医药大学》2015年硕士论文

【摘要】：目的：轮状病毒肠炎属小儿泄泻的范畴,“泄泻”按其不同的临床表现可分为“风寒证”、“湿热证”、“脾虚证”“伤食证”,而岭南地区,湿气困重,湿邪蕴而化热,故轮状病毒肠炎虽多集中爆发在秋冬两季,但受地理因素影响,多表现为“湿热证”。故从收集病例的可行性及代表性而言,以湿热型轮状病毒肠炎作为研究对象效果更优。导师所在课题组总结多年临床经验,认为小儿泄泻病机关键为脾虚湿盛,结合岭南地区特点,湿热型轮状病毒肠炎当以“运脾化湿,清热止泻”为治法,苍苓散具有运脾化湿之功效,加予黄芩、凤尾草、火炭母、鸡蛋花清热止泻,课题采用苍苓散加味用来治疗婴幼儿湿热证轮状病毒肠炎,并根据患儿的临床疗效观察及使用相关治疗方案前、后检测血清中干扰素γ(IFN-γ)变化,论证苍苓散加味是否通过调节IFN-γ而发挥作用,从免疫学角度探讨苍苓散加味治疗轮状病毒肠炎的作用机制。方法：1.将符合诊断标准的37例患儿按照治疗方法分别入组,组别为对照组及观察组,对照组13例,实验组24例。对照组予思密达治疗,观察组予苍苓散加味治疗,两组患儿根据病情变化给予相应的对症处理,疗程为3天。2.通过对37例患儿进行疗效对比,并检测相应治疗前、后血清IFN-γ含量的变化。3.症候积分结果：1.对照组及观察组治疗后血清IFN-γ含量均增加,相比对照组而言,观察组在治疗后血清IFN-γ含量明显增加(P0.05),差异有统计学意义。2.观察组治疗疗效为92%,明显好于对照组的545(P0.05)差异有统计学意义,且无不良反应。3.临床证候总积分：观察组治疗后的总积分要低于对照组治疗后的总积分,两者的差异具有统计学意义(P0.05)。结论：苍苓散加味对婴幼儿轮状病毒肠炎疗效显著,能明显改善轮状病毒肠炎症状,如大便次数的减少及大便性状改善等,且安全无副作用。苍苓散加味治疗本病可能是通过提高患儿IFN-γ含量而发挥疗效。
[Abstract]:Objective: rotavirus enteritis belongs to the category of infantile diarrhea. According to its different clinical manifestations, diarrhea can be divided into "wind-cold syndrome", "damp-heat syndrome", "spleen deficiency syndrome" and "injured food syndrome". Therefore, rotavirus enteritis mostly occurred in autumn and winter, but affected by geographical factors, it was characterized by dampness and heat syndrome. Therefore, from the point of view of the feasibility and representativeness of collecting cases, it is better to take the moist heat rotavirus enteritis as the research object. The teacher's research group summarized the clinical experience for many years, and considered that the key to the pathogenesis of diarrhea in children was spleen deficiency and dampness, and combined with the characteristics of Lingnan region, the damp-heat type rotavirus enteritis should be treated with "transferring spleen to dehumidification, clearing heat and stopping diarrhea" as the treatment method. Cangling Powder has the effect of transferring spleen and transforming dampness. It is added to Scutellaria baicalensis, Phellodendron chinensis, Fo Tan, Egg Hua to clear heat and stop diarrhea. The subject is to use Cangling Powder to treat rotavirus enteritis in infants with damp-heat syndrome. According to the clinical curative effect of the children and the changes of IFN- 纬 in serum before and after the use of the related treatment regimen, it was demonstrated whether Cangling Powder could play a role in regulating IFN- 纬. To explore the mechanism of treatment of rotavirus enteritis by Cangling Powder from immunological angle. Method 1: 1. 37 children who met the diagnostic criteria were divided into two groups: control group and observation group (n = 13), control group (n = 13) and experimental group (n = 24). The control group was treated with smecta, the observation group was treated with Cangling powder, and the two groups were given corresponding symptomatic treatment according to the changes of the disease. The course of treatment was 3 days. 2. The changes of serum IFN- 纬 levels before and after treatment were compared in 37 children. Symptom score: 1. Compared with the control group, the level of serum IFN- 纬 in the observation group increased significantly after treatment, the difference was statistically significant. The curative effect of the observation group was 92.It was significantly better than that of the control group (P 0.05), and there was no adverse reaction. The total integral of clinical syndrome: the total integral after treatment in the observation group was lower than that in the control group, and the difference between the two groups was statistically significant (P 0.05). Conclusion: Cangling Powder has significant curative effect on infantile rotavirus enteritis and can obviously improve the symptoms of rotavirus enteritis, such as the decrease of defecation times and the improvement of defecation character, and it is safe and has no side effect. Cangling Powder treatment of this disease may be by increasing the content of IFN- 纬 and play a therapeutic effect.
【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】：2015
【分类号】：R272

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