自拟清胃和中汤治疗小儿HP相关胃脘痛30例临床观察

发布时间：2018-05-12 06:16

本文选题：清胃和中汤 + 小儿胃脘痛　；参考：《长春中医药大学》2016年硕士论文

【摘要】：目的:小儿Hp相关胃脘痛是指在临床上Hp检测呈阳性反应的胃脘痛,导师认为此类胃脘痛多由于小儿脾胃虚弱,运化失畅,积滞中焦,胃气壅滞,脉络受阻,不通则痛而发生本病,考虑到小儿“纯阳之体”,且近年来饮食结构的改变,故“胃中蕴热”型此类病尤为常见。目前临床有效治疗儿科胃痛的中成药种类较少,因此,在总结导师临床用药的经验基础上,自拟清胃和中汤治疗小儿Hp相关胃脘痛(胃中蕴热型)30例,通过观察治疗前后患儿症状体征及实验室检查结果,明确清胃和中汤的疗效,从而减轻患儿痛苦,进行临床推广。方法:选取2014年12月至2015年12月于吉林省中医药科学院第一临床医院儿科二诊就诊,符合纳入标准的30例患儿进行病例观察研究,采取自身对照,以清胃泻热,和中止痛为治疗原则,给予自拟清胃和中汤:黄芩15g,黄连6g,党参10g,苍术6g,金银花10g,连翘10g,莱菔子15g,枳实6g,白芍10g,甘草5g,上药均为免煎制剂(三九免煎颗粒)。用法用量:上诸药各一袋,混合后用100ml开水冲泡,1剂1日,分3次口服,7天为一个疗程,可连续观察三个疗程。停药后或后期巩固期复查HP,后期随访以观察疗效。结果:通过治疗30例病例进行临床观察,其中治愈12例,有效15例,无效3例,总有效率为90%,并且无明显的不良反应。结论:随着人类饮食结构的调整,小儿Hp相关胃脘痛(胃中蕴热型)病证数量日益增多,结合生活及作息习惯,在学龄期儿童尤为常见。从中医辨证角度看,此病证为本虚标实证,多由于小儿脾胃虚弱,运化无力,加之饮食不节,积滞中焦,脉络不通引起,且小儿本为阳热体质,邪气迅速入里化热,引起诸如胃痛、恶心、嗳气、食欲不振、口臭、便秘等一系列症状。治疗上以清胃泻热,和中止痛为治疗原则,从而达到治病除疾的目的。本课题从临床入手,经过导师的悉心指导,运用清胃泻热,和中止痛之品,拟清胃和中汤进行临床疗效观察,符合纳入标准的临床患儿从症状、体征及理化检查方面均有较好的改善,所服用的中药类型及剂量也符合儿科用药安全,基本无副作用,值得临床推广应用。
[Abstract]:Objective : Hp - related abdominal pain in children refers to the abdominal pain which is positive for Hp detection in clinic . It is suggested that this kind of epigastralgia is mainly due to the weakness of the spleen and stomach of the children , the obstruction of transportation , the accumulation of middle jiao , the stagnation of the stomach qi , the obstruction of the vein and the pain , and the occurrence of this disease , taking into account the " pure yang " body of the children A clinical observation was made on 30 cases of children with Hp - related epigastralgia ( stomach ) by observing the symptoms and laboratory tests . Results : With the adjustment of dietary structure , the number of symptoms and symptoms in children with Hp - related abdominal pain ( stomach ) increased , and the total effective rate was 90 % . This disease is characterized by deficiency of spleen and stomach of children , inability to transport , diet , indigestion , constipation and other symptoms . It can be used for treating diseases and eliminating diseases . It is suitable for clinical observation of symptoms , signs and physical and chemical examination .

【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R272

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