扶正止哮汤对哮喘缓解期患儿肠动力的影响

发布时间：2018-04-24 06:00

本文选题：肠动力 + 儿童　；参考：《北京中医药大学》2017年硕士论文

【摘要】：目的:探讨哮喘缓解期患儿肠动力障碍症状及肠电图参数的改变情况,比较哮喘缓解期患儿各中医证型之间肠动力障碍症状及肠电图参数有无差异,进一步探讨扶正止哮方对哮喘缓解期患儿肠动力的影响。方法:入选本课题的60例患儿均来源于2014年11月至2016年12月到空军总医院儿科门诊就诊的4-14岁缓解期哮喘患儿。对所有入组患儿填写病情基线调查表,记录其中医症候积分,同时进行中医辨证分型,分为肺虚型、脾虚型、肾虚型,并进行肠电图检测。另选取30例健康儿童为对照组,进行肠电图检测。采用随机单盲对照试验,将60例哮喘缓解期患儿随机分为中药组40例和对照组20例,中药组给予扶正止哮方加孟鲁司特钠口服,对照组给予孟鲁司特钠口服,治疗疗程为3个月,记录两组患儿治疗1个月、治疗2个月、治疗3个月的中医症候积分和治疗3个月后肠电图参数。所得试验数据均应用SPSS21.0统计软件进行统计学分析,P0.05为差异有统计学意义。结果:①60例缓解期哮喘患儿中,其中56例患儿存在一种或同时存在多种肠动力障碍症状,其中45.000%的患儿存在腹痛,43.33%的患儿出现腹胀,61.67%的患儿存在大便干结症状,46.67%的患儿存大便频率异常。②哮喘组患儿肠电图升结肠导联和降结肠导联其平均幅值和平均频率较正常对照组儿童均显著降低,差异有统计学意义(P0.05)。③60例哮喘缓解期患儿中,其中脾虚证40例,肺虚证17例,肾虚证3例,因肾虚证患儿病例数较少,故在此仅比较脾虚证与肺虚证患儿肠动力障碍症状积分及肠电图参数。肺虚型17例,29.41%的患儿出现腹痛,29.41%的患儿存在腹胀,47.05%的患儿存在大便干结、大便费力症状,29.41%的患儿存大便频率异常。脾虚型患儿共40例,52.05%的患儿出现腹痛,47.50%的患儿存在腹胀,67.50%的患儿存在大便干结、大便费力症状,55.00%的患儿存大便频率异常。脾虚证患儿肠动力障碍症状积分较肺虚证患儿有升高趋势,差异无统计学意义(p0.05)。脾虚证患儿各导联平均频率较肺虚证患儿无明显差异。脾虚证患儿各导联平均幅值较肺虚证患儿有下降趋势,差异无统计学意义(P0.05)。④中药组患儿40例,共36例完成临床试验。对照组患儿20例,共18例完成临床试验。中药组患儿在治疗1个月后全身症状总积分即有所下降,3个月时明显下降,与治疗前及对照组均有明显差异,差异有统计学意义(P0.05)。而对照组患儿全身症状总积分治疗前后无明显变化(P0.05)。⑤中药组患儿在治疗3个月后肠动力障碍症状积分较前均明显下降,与治疗前及对照组患儿比较均有显著差异,差异有统计学意义(P0.05)。对照组患儿肠动力障碍症状积分较治疗前无明显变化(P0.05)。⑥中药组患儿在治疗3个月后升结肠导联平均幅值明显升高,与治疗前及对照组比较均有显著差异,差异有统计学意义(P0.05),平均频率亦较前升高,但与治疗前及对照组比较差异无统计学意义(P0.05);降结肠导联平均幅值及平均频率在治疗3个月后均明显升高,与治疗前及对照组比较有显著差异,差异有统计学意义(P0.05)。对照组患儿在治疗3个月后各导联平均幅值及平均频率较治疗前均无明显变化(P0.05)。结论:缓解期哮喘患儿多数有不同程度肠动力障碍的临床表现,主要表现为腹胀、腹痛、大便干结及大便频率异常。与健康儿童肠电图相比,缓解期哮喘患儿的餐后肠电活动异常,肠电功率降低,肠电基本节律减慢,肠推进性运用较少,肠动过缓,肠动力不足。哮喘与肠动力之间有一定关系,二者互为因果。哮喘缓解期脾虚证患儿肠动力障碍程度较肺虚证患儿可能更加明显。扶正止哮方能有效的改善哮喘期患儿的全身症状,能改善哮喘缓解期患儿肠动力不足症状,增加其餐后肠电功率和节律,促进肠推进性运动,增加肠动力。扶正止哮方可能通过作用于某些胃肠激素,增加肠动力,预防哮喘发作。
[Abstract]:Objective: To investigate the changes of intestinal motility disorders and electrogram parameters in children with asthma at remission stage, and to compare the differences of intestinal motility and electrogram parameters between the TCM Syndromes of asthma remission period, and further explore the effect of Fuzheng Zhi Zhi Fang on the intestinal motility in children with asthma in remission stage. Methods: 60 children enrolled in this subject All of the 4-14 year old children with asthma in the outpatient department of Pediatrics of General Hospital of the Air Force PLA from November 2014 to December 2016 were selected to fill in the baseline questionnaire of all the children and record the TCM syndrome scores. Meanwhile, the syndrome differentiation of traditional Chinese medicine was divided into lung deficiency type, spleen deficiency type, kidney deficiency type, and 30 cases of healthy children were selected. 60 cases of asthma remission period were randomly divided into 40 cases of traditional Chinese medicine and 20 cases of control group. The Chinese medicine group was given Fuzheng Zhi Xiao Fang plus montelukast sodium, and the control group was given montelukast sodium orally, the treatment course was 3 months, and two groups of children were treated for 1 months and 2 were treated for 2. In the month, the TCM syndrome score of 3 months and the parameters of the Enterogram after 3 months of treatment were treated. The results of the experimental data were statistically analyzed with SPSS21.0 software, and the difference was statistically significant. Results: (1) among the 60 children with remission asthma, 56 of them had one or more intestinal motility disorders, of which 45 were 45. % of the children had abdominal pain, 43.33% of the children had abdominal distention, 61.67% of the children had stool symptoms, and 46.67% of the children had abnormal frequency of stool. The average amplitude and average frequency of the ascending colon and descending colon in the asthmatic group were significantly lower than those in the normal control group (P0.05). (3) 60 cases. Among the children with asthma, there were 40 cases of spleen deficiency syndrome, 17 cases of asthenia of lung and 3 cases of kidney deficiency syndrome, and the number of children with kidney deficiency was less. Therefore, there were only 17 cases of intestinal motility disorders in children with spleen deficiency syndrome and lung deficiency syndrome, 17 cases of lung deficiency type, 29.41% of children with abdominal pain, 29.41% of children with abdominal distention, 47.05% of the children had stool. 29.41% of children had abnormal stool frequency, 40 cases with spleen deficiency, 52.05% of children with abdominal pain, 47.50% of children with abdominal distention, 67.50% of children with bowel movement, feces and feces, 55% of children with abnormal stool frequency. The score of intestinal motility disorder in children with spleen deficiency syndrome was higher than that of children with deficiency of lung syndrome. There was no significant difference in the high trend (P0.05). The average frequency of each lead in children with spleen deficiency syndrome had no significant difference compared with that of children with lung deficiency syndrome. The average amplitude of each lead in children with spleen deficiency syndrome was lower than that of asthenia syndrome in children (P0.05). (4) 40 cases of children in the Chinese medicine group, a total of 36 cases completed clinical trials. 20 cases in the control group were completed, a total of 18 cases were finished. After 1 months of treatment, the total score of the total body symptoms of the children in the Chinese medicine group decreased and decreased obviously at 3 months. There was a significant difference between the group and the control group (P0.05). There was no significant change in the whole body symptom score of the control group (P0.05). (5) the children in the Chinese medicine group were treated for 3 months after the treatment. The score of the symptoms of dynamic disorder was significantly lower than that before the treatment and the control group. The difference was statistically significant (P0.05). The score of the intestinal motility disorder in the control group was not significantly changed (P0.05). (6) the average amplitude of the ascending colon in the Chinese medicine group was significantly higher after 3 months of treatment and before the treatment. There was significant difference between the control group and the control group, the difference was statistically significant (P0.05), the average frequency was also higher, but there was no significant difference between the pre treatment and the control group (P0.05). The average amplitude and average frequency of the descending colon lead were significantly increased after 3 months of treatment, and there were significant differences compared with those before and in the control group. The mean amplitude and average frequency of the lead in the control group had no significant changes after 3 months of treatment (P0.05). Conclusion: most of the children with asthma in remission period have different degrees of intestinal motility disorders, mainly manifested in abdominal distention, abdominal pain, stool dry knot and abnormal frequency of stool. In children with asthma, the intestinal electrical activity was abnormal, the power of intestinal electricity decreased, the basic rhythm of intestinal electricity slowed, intestinal propulsion was less used, intestinal motility was slow, intestinal motility was insufficient. There was a certain relationship between asthma and intestinal motility, and the two were mutually causality. The degree of intestinal motility disorder in children with spleen deficiency syndrome in the remission period of asthma was more obvious than that of the asthmatic children. Fuzheng Zhi Zhi Xiao Fang can effectively improve the systemic symptoms of children with asthma, improve the symptoms of intestinal motility in children with asthma, increase the electric power and rhythm of the intestinal posterior intestine, promote intestinal propulsive movement and increase the intestinal motility. It may help to increase intestinal motility, increase intestinal motility and prevent asthma attacks.

【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R272

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