七味白术散加味治疗小儿脾虚泄泻的临床研究

发布时间：2018-07-10 15:14

本文选题：七味白术散 + 小儿　；参考：《广州中医药大学》2012年硕士论文

【摘要】：目的：泄泻是婴幼儿时期常见的多发病,是造成小儿营养不良、生长发育障碍的主要原因之一。其中脾虚泄泻更是迁延难愈,严重影响患儿及其家长的身心健康。近年来,应用微生态制剂治疗腹泻得到了国内外的肯定,但目前益生菌的应用还存在剂量、存活率,以及工业标准的缺乏、潜在安全隐患等问题。本课题旨在通过对七味白术散深入系统研究的基础上,进行七味白术散加味、微生态制剂、及西医常规治疗脾虚泄泻患儿的临床疗效对比观察及分析,为七味白术散对肠道微生态影响的实验研究奠定基础,从而为该方的临床应用提供更多的理论依据,更好的发挥祖国医学的优势。方法：选取辨证属于脾虚型泄泻患儿90例,均为广州中医药大学第三附属医院门诊病人,并经纳入排除标准所选合格者随机分成3组,分别为治疗组、对照组1、对照组2。所有实验组均给予西医常规治疗；治疗组在此基础上给予七味白术散制剂口服进行治疗；对照组1给予微生态制剂培菲康散治疗,治疗5天后进行疗效评价。疗效评价采取对各组患儿治疗前后中医证候积分、主症积分以及单项症状或体征积分的变化及各实验组间进行比较,分析其是否存在统计学意义。成果：治疗组临床治愈22例,显效4例,有效2例,无效2例,总有效率93.3%；对照组1临床治愈18例,显效6例,有效2例,无效4例,总有效率86.7%：对照组2临床治愈10例,显效4例,有效6例,无效10例,总有效率66.7%。说明总体疗效七味白术散与培菲康散相当,明显优于单纯西医常规治疗效果(P0.05,差异有统计学意义),但七味白术散组与培菲康散组疗效无明显差异(P0.05,差异无统计学意义)。且不同喂养方式及兼夹证型对该药的疗效可能存在一定影响。结论：本课题采用七味白术散加味治疗小儿脾虚泄泻。七味白术散以健脾益气治其本,除湿止泻,生津止渴治其标,本研究不拘泥于原方,在结合临床辩证基础上进行药物加味。研究结果表明,该方在改善脾虚泄泻中医临床症状及体征方面有效,疗效与肠道微生态制剂相当,均优于单纯西医常规治疗,研究过程未发现不良反应。该方是治疗小儿脾虚泄泻的有效方剂,体现了中医辨证施治的优势,且无副作用,可代替微生态制剂,值得临床推广应用。其是否对肠道微生态有影响,及不同喂养方式与兼夹证型与该药疗效是否存在相关影响,有待于进一步深入研究。
[Abstract]:Purpose :

Diarrhea is a common disease in infants and infants . It is one of the main causes of malnutrition and development disturbance in children . In recent years , the application of micro - ecological agents in the treatment of diarrhea has been recognized at home and abroad , but the application of probiotics also has the problems of dosage , survival rate , lack of industrial standards , potential safety hazards , etc .

The purpose of this research is to study the clinical curative effect of Qiwei Baiyunsan additive , micro - ecological preparation and western medicine in the treatment of diarrhea of spleen deficiency and diarrhea , and to lay a foundation for the experimental study on the effect of Qiwei Baiyunsan on the intestinal microecological effect , thus providing more theoretical basis for clinical application of the prescription and better playing the superiority of the motherland medicine .

Method :

90 cases of children with spleen deficiency and diarrhea were selected and divided into three groups randomly divided into three groups : treatment group , control group 1 , and control group 2 . All experimental groups were given routine treatment of western medicine .
on the basis of the treatment group , seven Chinese medicinal powder preparations are administered orally for treatment ;
In the control group , the therapeutic effect was evaluated after 5 - day treatment with micro - ecological preparation . The curative effect was evaluated by the changes of TCM syndrome score , main symptom score , single symptom or sign integral before and after treatment in each group and the comparison between the experimental groups , and whether there was statistical significance .

Outcome :

In the treatment group , 22 cases were cured , 4 cases were markedly effective , 2 cases were effective , 2 cases were ineffective and the total effective rate was 93 . 3 % .
In the control group , 18 cases were cured , 6 cases were markedly effective , 2 cases were effective , 4 cases were ineffective , the total effective rate was 86 . 7 % . In the control group , 10 cases were cured , 4 cases were markedly effective , 6 cases were ineffective , 10 cases were ineffective , the total effective rate was 66.7 % . and the curative effect of different feeding mode and syndrome type on the medicine may have certain influence .

Conclusion :

The research results show that the prescription is effective in improving the clinical symptoms and signs of spleen deficiency and diarrhea , and has no side effect . It has no side effect . It has no side effect . It has no side effect . It has no side effect . It has no side effect . It has no side effect . It has no side effect . It has no side effect . It has no side effect . It has no side effect . It has no side effect . It has no side effect . It has no side effect . It has no side effect . It has no side effect . It has no side effect . It has no side effect . It has no side effect . It has no side effect . It has no side 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】：2012
【分类号】：R272

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