加味葛根芩连汤治疗小儿湿热型泄泻的临床观察

发布时间：2018-08-08 13:02

【摘要】：目的:小儿腹泻病为多病原、多因素引起的以大便次数增多和大便性状改变为特点的一组疾病,它是小儿常见疾病之一，是当今世界公共卫生领域的重要问题之一。全球每年约150-200万儿童死于与腹泻相关的疾病或是并发症，其发病率仅次于呼吸道感染，居第二位。我国是一个发展中国家，经济基础相对薄弱，幅员辽阔，人口众多，各地差异大，发展不均衡，经过半个世纪的努力，国家在环境、饮食和水质等方面做了大量的工作，但腹泻依然是我国影响群众生活生产最普遍的一组疾病。本病往往病程长，反复发作，缠绵难愈，可导致儿童营养不良、免疫力低下、生长发育障碍等，严重影响儿童的身心健康。西医学多采用维持水电解质、酸碱平衡等支持疗法，对于本病在治疗上无特效手段。传统医学在治疗小儿腹泻病方面具有疗效确切、副作用小等优点，显示出中医药的优势，取得了较好的临床疗效。中医常分为风寒型、伤食型、湿热型、脾虚型和脾肾阳虚型，其中湿热型泄泻为最常见证型，主方葛根芩连汤亦为研究重点。本研究就以盐酸小蘖碱片作为对照组，客观评价加味葛根芩连汤治疗小儿泄泻(湿热证)的临床疗效。方法:将60例符合标准的患儿随机分成2组，治疗组和对照组各30例。治疗组给予加味葛根芩连汤，对照组给予盐酸小蘖碱片，总疗程为3天。采用SPSS13.0统计软件，建立数据库，计数资料采用卡方检验，计量资料先进行正态性检验和方差齐性检验，满足要求者用t检验，未满足要求者用秩和检验。两组患儿在年龄、性别、主要症状积分等方面的比较，无统计学意义，具有可比性。以患儿的大便次数、大便性状、腹痛为主要疗效指标，对两组患儿的主要症状进行组间比较，对其治疗前后总积分进行组间、组内比较，综合评价两组总有效率、痊愈率。结果:经过3天的治疗，两组在大便次数、大便性状方面比较，无显著性差异(P0.05)。两组腹痛症状相比较，经统计学处理，，差别具有统计学意义(P0.05)，两组总症状积分进行组间比较，无显著性差异。治疗组的总有效率93.3%，对照组总有效率90.0%，两组的差别无统计学意义(P0.05)。治疗组痊愈率为40.0%，对照组为16.7%，两组差别有统计学意义(P0.05)。结论:加味葛根芩连汤治疗小儿泄泻(湿热证)，能够改善患儿的腹泻、腹痛症状。与对照组相比较，治疗组在改善小儿腹痛方面的疗效更显著。两组患儿的总有效率无明显差异，但治疗组的痊愈率高于对照组。证明加味葛根芩连汤是治疗小儿泄泻(湿热证)的有效药物。
[Abstract]:Objective: diarrhea in children is a group of diseases characterized by the increase of defecation frequency and the change of defecation character. It is one of the common diseases in children and one of the most important problems in the field of public health in the world. About 150-2 million children worldwide die from diarrhoeal diseases or complications every year, ranking second only to respiratory infections. China is a developing country with a relatively weak economic base, a vast territory, a large population, large regional differences and uneven development. After half a century of efforts, the country has done a great deal of work in the areas of environment, diet and water quality. However, diarrhea is still the most common group of diseases affecting the life and production of the masses in our country. The disease often has a long course, repeated attacks, lingering and difficult to heal, which can lead to malnutrition, low immunity, growth and development disorders, and seriously affect the physical and mental health of children. Western medicine is mostly used to maintain water electrolyte, acid-base balance and other support therapy, for this disease in the treatment of no special means. Traditional medicine has the advantages of definite curative effect and little side effect in the treatment of infantile diarrhea disease. It shows the advantage of traditional Chinese medicine and obtains better clinical effect. TCM is often divided into wind-cold type, food injury type, damp-heat type, spleen deficiency type and spleen and kidney Yang deficiency type, in which damp-heat type diarrhea is the most common type, the main prescription Gegen Qinlian decoction is also the focus of research. In this study, berberine hydrochloride tablets were used as control group to objectively evaluate the clinical efficacy of modified Gegen Qinlian decoction in treating children with diarrhea (damp-heat syndrome). Methods: 60 children who met the standard were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). The treatment group was treated with Gegen Qinlian decoction and the control group with berberine hydrochloride tablets for 3 days. Using SPSS13.0 statistical software, the database is established, the counting data is checked by chi-square test, the measurement data is tested by normality test and variance homogeneity test, those who meet the requirements are tested by t test, and those who do not meet the requirements use rank sum test. There was no statistical significance and comparability between the two groups in terms of age, sex, main symptom score and so on. Taking the number of defecation, defecation character and abdominal pain as the main curative index, the main symptoms of the two groups were compared between groups, and the total scores before and after treatment were compared, and the total effective rate and cure rate of the two groups were comprehensively evaluated. Results: after 3 days of treatment, there was no significant difference between the two groups in defecation frequency and defecation traits (P0.05). The symptoms of abdominal pain in the two groups were compared, and the difference was statistically significant (P0.05). There was no significant difference in the total symptom score between the two groups. The total effective rate of the treatment group was 93. 3%, the total effective rate of the control group was 90. 0%, the difference between the two groups was not statistically significant (P0.05). The cure rate of treatment group was 40.0 and that of control group was 16.7.The difference between the two groups was statistically significant (P0.05). Conclusion: modified Gegen Qinlian decoction can improve diarrhea and abdominal pain in children with diarrhea (damp-heat syndrome). Compared with the control group, the treatment group was more effective in improving abdominal pain in children. There was no significant difference in the total effective rate between the two groups, but the cure rate in the treatment group was higher than that in the control group. It is proved that Jiawei Gegen Qinlian decoction is an effective drug for treating diarrhea (damp-heat syndrome) in children.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R272

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