运脾化湿方加味对小儿脾虚泻疗效及体液免疫的影响
发布时间：2019-01-26 12:27
【摘要】：目的： 泄泻是小儿常见病,其中脾虚泻多病程较长,症状迁延反复,伴有腹胀、纳差、神疲倦怠、形体消瘦等证候,对小儿生长发育影响较大,给患儿及家长带来生理、心理及经济上多重负担。导师所在课题组总结多年临床经验,认为“脾虚湿胜”是小儿泄泻主要病机,以“运脾化湿”为治法治疗小儿泄泻均取得良好效果。本课题以运脾化湿方加味治疗小儿脾虚泻,通过观察临床疗效及治疗前、后患儿血清IgA、IgG、IgM、粪便SIgA含量的变化,从体液免疫学角度探讨运脾化湿方加味治疗小儿脾虚泻的作用机制。 方法： 1.收集20例健康婴幼儿进行血清IgA、IgG、IgM及粪便SIgA含量检测 2.采用简单随机对照试验法,将符合诊断标准的60例患儿分为观察组及对照组。观察组给予运脾化湿方加味；对照组予思密达,两组均根据病情给予必要的对症处理和液体疗法,疗程5天。 3.对60例患儿进行临床疗效观察,并观察治疗前、后血清IgA、IgG、IgM及粪便SIgA含量的变化。 结果： 1.脾虚泻患儿较健康对照组的血清IgM、IgA及粪便SIgA降低(P0.05),而血清IgG无变化(P0.05)。 2.观察组治疗后血清IgM、IgA及粪便SIgA增加(P0.05),血清IgG无变化(P0.05)。其中SIgA恢复至健康对照组水平,IgM, IgA则仍低于健康对照组(P0.05) 3.对照组治疗后粪便SIgA下降(P0.05)；血清IgG、IgA、IgM无变化(P0.05) 4.观察组总有效率为83.33%,优于对照组的56.67%(P0.05)；治疗后证候总积分低于对照组(P0.05),尤其在改善大便次数、腹胀、食欲下降的3个证候上优于对照组,且无不良反应。 结论： 运脾化湿方加味对小儿脾虚泻有良好疗效,能明显改善症状,如大便次数、腹胀、食欲下降,且作用安全。脾虚泻患儿体液免疫功能降低,表现在血清IgA、IgM及粪便SIgA含量的下降。运脾化湿方加味治疗本病可能是通过提高患儿体液免疫功能而发挥疗效。
[Abstract]:Objective: diarrhea is a common disease in children, in which spleen deficiency and diarrhea have a long course of disease, symptoms have been delayed and repeated, accompanied by abdominal distension, anorexia, fatigue, body wasting and other syndromes, which have great influence on the growth and development of children, and bring physiology to the children and their parents. Psychological and economic burdens. The teacher's group summarized the clinical experience for many years and concluded that "spleen deficiency and dampness victory" was the main pathogenesis of infantile diarrhea and the treatment of infantile diarrhea by "transferring spleen and removing dampness" had achieved good results. In this study, we treated children with spleen asthenia and diarrhea with modified decoction to transfer spleen and remove dampness. The changes of serum IgA,IgG,IgM, fecal SIgA content before and after treatment were observed. From the aspect of humoral immunology, the mechanism of treating diarrhea due to spleen deficiency in children was discussed. Methods: 1. The contents of serum IgA,IgG,IgM and fecal SIgA were detected in 20 healthy infants. 60 children who met the diagnostic criteria were divided into observation group and control group by a simple randomized controlled trial. The observation group was treated with modified decoction for removing spleen and dampness, the control group was treated with smecta, the two groups were given necessary symptomatic treatment and liquid therapy according to the condition of the disease, the course of treatment was 5 days. 3. The changes of serum IgA,IgG,IgM and fecal SIgA levels before and after treatment were observed in 60 children. Results: 1. Compared with the healthy control group, the serum IgM,IgA and fecal SIgA decreased in the children with spleen deficiency diarrhea (P0.05), but the serum IgG did not change (P0.05). 2. Serum IgM,IgA and stool SIgA increased after treatment in the observation group (P0.05), while serum IgG did not change (P0.05). SIgA returned to the level of healthy control group, IgM, IgA is still lower than the healthy control group (P0.05) 3. In the control group, the fecal SIgA decreased (P0.05), while the serum IgG,IgA,IgM did not change (P0.05). The total effective rate of the observation group was 83.33%, which was better than that of the control group (56.67%) (P0.05). After treatment the total score of syndromes was lower than that of control group (P0.05) especially in improving the number of stool abdominal distension appetite loss than the control group on the three syndromes and no adverse reactions. Conclusion: the modified decoction can improve the symptoms such as defecation times, abdominal distension, appetite decline, and the effect is safe. The decrease of humoral immune function in children with spleen deficiency and diarrhea was manifested by the decrease of serum IgA,IgM and fecal SIgA content. The treatment of this disease may be by improving the humoral immune function of the children.
【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
本文编号：2415480
[Abstract]:Objective: diarrhea is a common disease in children, in which spleen deficiency and diarrhea have a long course of disease, symptoms have been delayed and repeated, accompanied by abdominal distension, anorexia, fatigue, body wasting and other syndromes, which have great influence on the growth and development of children, and bring physiology to the children and their parents. Psychological and economic burdens. The teacher's group summarized the clinical experience for many years and concluded that "spleen deficiency and dampness victory" was the main pathogenesis of infantile diarrhea and the treatment of infantile diarrhea by "transferring spleen and removing dampness" had achieved good results. In this study, we treated children with spleen asthenia and diarrhea with modified decoction to transfer spleen and remove dampness. The changes of serum IgA,IgG,IgM, fecal SIgA content before and after treatment were observed. From the aspect of humoral immunology, the mechanism of treating diarrhea due to spleen deficiency in children was discussed. Methods: 1. The contents of serum IgA,IgG,IgM and fecal SIgA were detected in 20 healthy infants. 60 children who met the diagnostic criteria were divided into observation group and control group by a simple randomized controlled trial. The observation group was treated with modified decoction for removing spleen and dampness, the control group was treated with smecta, the two groups were given necessary symptomatic treatment and liquid therapy according to the condition of the disease, the course of treatment was 5 days. 3. The changes of serum IgA,IgG,IgM and fecal SIgA levels before and after treatment were observed in 60 children. Results: 1. Compared with the healthy control group, the serum IgM,IgA and fecal SIgA decreased in the children with spleen deficiency diarrhea (P0.05), but the serum IgG did not change (P0.05). 2. Serum IgM,IgA and stool SIgA increased after treatment in the observation group (P0.05), while serum IgG did not change (P0.05). SIgA returned to the level of healthy control group, IgM, IgA is still lower than the healthy control group (P0.05) 3. In the control group, the fecal SIgA decreased (P0.05), while the serum IgG,IgA,IgM did not change (P0.05). The total effective rate of the observation group was 83.33%, which was better than that of the control group (56.67%) (P0.05). After treatment the total score of syndromes was lower than that of control group (P0.05) especially in improving the number of stool abdominal distension appetite loss than the control group on the three syndromes and no adverse reactions. Conclusion: the modified decoction can improve the symptoms such as defecation times, abdominal distension, appetite decline, and the effect is safe. The decrease of humoral immune function in children with spleen deficiency and diarrhea was manifested by the decrease of serum IgA,IgM and fecal SIgA content. The treatment of this disease may be by improving the humoral immune function of the children.
【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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