三草化斑汤治疗小儿单纯型过敏性紫癜的临床研究

发布时间：2018-04-29 08:27

  本文选题：小儿过敏性紫癜 + 瘀热伤络型　； 参考：《广州中医药大学》2017年硕士论文

【摘要】：目的:通过观察三草化斑汤(自拟组方)对小儿单纯型过敏性紫癜(瘀热伤络型)患儿的治疗,客观评价其临床疗效、症状改善、安全性及预防复发等情况。方法:采用随机、对照临床试验,对符合纳入标准的60例符合单纯型过敏性紫癜患儿随机分配进入对照组和治疗组,每组30例。对照组给予甲氰咪胍注射液合维生素C注射液静滴,氯苯那敏片口服等治疗,治疗组给予三草化斑汤及氯苯那敏片口服治疗。观察两组患儿14天治疗前后有效率,症状积分及其各个症状改善等情况,其中主要症状包括(皮肤紫癜的分布范围、色泽程度、形态大小、消退时间等)及次要症状包括(肤痒、扁桃体、饮食、大小便等),记录两组患儿病程长短,并随访3个月,观察两组患儿复发情况,考察三草化斑汤对单纯型过敏性紫癜(瘀热伤络型)的治疗效果和优势。结果:(1)两组疗效比较:分别包括疾病临床疗效、中医症候疗效。其中患儿疾病临床疗效:治疗组治愈18例,有效10例,无效1例,总有效率96.6%;对照组治愈15例,有效9例,无效4例,总有效率85.7%;中医症候疗效:治疗组治愈16例,显效8例,有效3例,无效2例,总有效率93.1%;对照组治愈13例,显效7例,有效3例,无效5例,总有效率82.4%。结果显示治疗后两组患儿疗效均较显著,对照组有效率略高于治疗组,但经统计学检验,对照组疗效与治疗组疗效比较无统计学意义(P0.05)。(2)症状积分比较:两组患儿治疗后症状积分均比治疗前症状积分显著降低;但治疗组症状积分与对照组症状积分比较无统计学意义(P0.05)。(3)各个症状改善情况比较:与对照组比较,治疗组患儿在改善皮肤紫癜、饮食、大便等症状方面明显优于对照组,差异具有统计学意义(P0.05);但在改善瘙痒、咽痛、小便等症状方面差异无统计血意义(P0.05)。(4)病程比较:观察14天患儿病情变化,治疗组患儿病程明显比对照组患儿病程短,差异有统计学意义(P0.05)。(5)实验指标比较:具体以观察患儿血小板、大便、尿常规为主,两组患儿治疗后血小板值较治疗前比较均有明显降低,但治疗组与对照组比较无统计学意义(P0.05)。治疗前后两组患儿尿蛋白、尿隐血、大便潜血比较差异亦无统计学意义(P0.05)。(6)安全性评价:治疗前后观察有无不良反应症状,且实验指标(血常规、二便、生化等检查)均在安全范围之内。(7)预后情况比较:治疗组患儿皮肤紫癜的复发率明显低于与对照组复发率,但两组比较差异无统计学意义(P0.05)。结论:本研究结果表明:三草化斑汤联合西药口服治疗小儿单纯型过敏性紫癜(瘀热伤络型)疗效显著,在改善皮肤紫癜、饮食、大便等症状、缩短病程等方面疗效确切,安全可靠,表明以清热凉血,化瘀通络法治疗瘀热伤络型过敏性紫癜(单纯型)疗效肯定。
[Abstract]:Objective: to evaluate the clinical effect, symptom improvement, safety and recurrence of simple Henoch-Schonlein purpura in children. Methods: 60 children with simple Henoch-Schonlein purpura were randomly divided into control group and treatment group with 30 cases in each group. The control group was treated with cimetidine injection combined with vitamin C injection and chlorphenamine tablet. The treatment group was treated with Sancaohuaban decoction and chlorphenamine tablet orally. The effective rate, symptom score and improvement of symptoms were observed in the two groups before and after 14 days treatment. The main symptoms included (the distribution range of skin purpura, the degree of color and color, the size of shape, etc.) The duration of regression and secondary symptoms including skin itch, tonsil, diet, defecation and urination were recorded and followed up for 3 months to observe the recurrence of the two groups. To investigate the therapeutic effect and advantage of Sancao Huaban decoction on simple allergic purpura. Results comparison of the two groups: clinical curative effect of disease, TCM symptom curative effect. Among them, 18 cases were cured, 10 cases were effective, 1 case was ineffective, the total effective rate was 96.6 in the treatment group, 15 cases were cured, 9 cases were effective, 4 cases were ineffective, and the total effective rate was 85.7% in the control group. In the control group, 13 cases were cured, 7 cases were markedly effective, 3 cases were effective, 5 cases were ineffective, and the total effective rate was 82.4%. The results showed that the curative effect of the two groups was significant after treatment, the effective rate of the control group was slightly higher than that of the treatment group, but by statistical test, There was no significant difference between the control group and the treatment group in the symptom score: after treatment, the symptom score of the two groups were significantly lower than that before treatment. However, there was no significant difference in symptom score between the treatment group and the control group (P 0.05. 05. 3) the improvement of symptoms in the treatment group was better than that in the control group in improving the symptoms of skin purpura, diet and stool, compared with the control group. The difference was statistically significant (P 0.05), but there was no significant difference in the improvement of pruritus, pharynx pain, urine and other symptoms (P 0.05). The course of disease in the treatment group was significantly shorter than that in the control group. The difference was statistically significant (P 0.05). Comparison of experimental indexes: platelet, stool and urine routine were mainly observed in the two groups. After treatment, the platelet value of the two groups was significantly lower than that before treatment, but there was no significant difference between the treatment group and the control group (P 0.05). There was no significant difference in urine protein, urine occult blood and fecal occult blood between the two groups before and after treatment. Comparison of prognosis: the recurrence rate of skin purpura in the treatment group was significantly lower than that in the control group, but the difference between the two groups was not statistically significant (P 0.05). Conclusion: the results of this study indicate that Sancaohuaban decoction combined with western medicine is effective in the treatment of simple allergic purpura in children. It is effective in improving the symptoms of skin purpura, diet, defecation, shortening the course of disease and so on. It is safe and reliable, which indicates that the method of clearing away heat and cooling blood and removing blood stasis and dredging collaterals is effective in treating allergic purpura of blood stasis and heat injury collaterals (simple type).
【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】：R272
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本文编号：1819163