哮喘缓解期不同中医证型患儿的胃肠动力障碍临床表现和胃电图改变

发布时间：2018-05-17 15:58

本文选题：缓解期哮喘 + 中医分型　；参考：《大连医科大学》2016年硕士论文

【摘要】：目的:探讨哮喘缓解期不同中医证型患儿的胃肠动力障碍临床表现和胃电图改变。方法:入选本课题的60例患儿均来源于2013年10月至2015年2月到空军总医院儿科门诊就诊的4-12岁缓解期哮喘患儿。对所有入组患儿填写病情基线调查表,记录其胃肠动力障碍临床症状,进行胃电图检测,同时进行中医辨证,分为肺虚型、脾虚型、肾虚型,并对其胃电参数进行分析。另选取30例健康儿童为对照组。本实验使用XDJ-S8B型消化道动力检测仪处理系统,分别对两组患儿进行餐前、餐后各8min的胃电图及胃电参数描记,并对各导联餐前、餐后的胃电参数做比较分析。分析的胃电参数包括胃电平均幅值(Vpp)、平均频率(f)、波形反应面积(Ra)、正常慢波百分比(PNSW)、餐后/餐前功率比等。所得数据采用正态性t检验。所得试验数据均应用SPSS17.0统计软件进行统计学分析,P0.05为差异有统计学意义。结果:(1)60例缓解期哮喘患儿均有不同程度的胃肠动力障碍的临床表现,存在纳差者占60.00%(其中肺虚证占45.45%,脾虚证占86.67%,肾虚证占66.67%),嗳气者70.00%(肺虚证占69.70%,脾虚证占80.00%,肾虚证占58.33%),恶心、呕吐者38.88%(肺虚证占33.33%,脾虚证占66.67%,肾虚证占16.67%),66.67%的患儿出现食后腹胀、腹痛(肺虚证占60.61%,脾虚证占86.67%,肾虚证占58.33%),71.67%的患儿存在大便秘结不畅(肺虚证占60.61%,脾虚证占93.33%,肾虚证占75%)。(2)胃体、胃窦导联,缓解期哮喘组的餐后胃电参数Vpp、Ra较餐前均有所升高,差异有统计学意义(P0.05),胃电参数f、PNSW餐前、餐后无明显差异。餐后/餐前功率比1。对照组的胃电参数Vpp、Ra餐后明显比餐前升高,两者差异有显著性(P0.05),胃电参数f、PNSW餐前、餐后无明显差异,餐后/餐前功率比1。(3)胃体、胃窦导联,缓解期哮喘儿童组的餐前胃电参数Vpp、f、Ra均低于对照组,差异有显著性(P0.05),餐前胃电参数PNSW与对照组比较无明显差异。缓解期哮喘组餐后胃电参数Vpp、f、Ra均小于对照组,差异有显著性(P0.05),而餐后胃电参数PNSW两组比较无明显差异。(4)胃体、胃窦导联,缓解期哮喘组各中医证型餐前胃电参数Vpp、f、Ra均无显著性差异,餐后胃电参数Vpp、f、Ra亦均无显著性差异。结论:缓解期哮喘患儿常有不同程度胃肠动力障碍的临床表现,主要表现为纳差、嗳气、食后腹胀、腹痛及大便秘结不畅等,脾虚证患儿表现尤其明显。与健康儿童胃电图相比,缓解期哮喘患儿的胃电活动异常,胃电功率降低,胃电基本节律减慢,胃舒缩功能降低,胃动过缓,胃排空减慢,胃动力不足。但缓解期哮喘各中医辨证分型之间的胃电图比较无显著性差异。
[Abstract]:Objective: To investigate the clinical manifestations and Electrogastrogram changes of gastrointestinal motility disorders in children with different TCM syndrome types during the remission period of asthma. Methods: all 60 children enrolled in this subject were from 4-12 year old children with asthma in outpatient department of Pediatrics of General Hospital of the Air Force PLA from October 2013 to February 2015. The clinical symptoms of gastrointestinal motility disorders were recorded, and the electrogastrogram was detected. At the same time, the TCM syndrome differentiation was divided into lung deficiency type, spleen deficiency type and kidney deficiency type, and the gastric electrical parameters were analyzed. 30 healthy children were selected as the control group. The XDJ-S8B digestive tract dynamic test instrument was used in the experiment. Two groups of children were treated before meals and 8 after meals respectively. The electrogram and electrogram of min were used to make a comparative analysis of the gastric electrical parameters before and after meals. The analysis of the gastric electrical parameters included the average amplitude of the stomach (Vpp), the average frequency (f), the area of the wave response (Ra), the normal slow wave percentage (PNSW), the postprandial / pre meal power ratio, and so on. The data obtained by the normal T test. Statistical analysis was carried out with SPSS17.0 statistical software, and the difference was statistically significant. Results: (1) 60 cases of children with asthma had different degrees of clinical manifestations of gastrointestinal motility disorder, 60% (45.45% of lung deficiency syndrome, 86.67% of spleen deficiency, 66.67% of kidney deficiency syndrome, 66.67% of kidney deficiency syndrome), and 70% (69.70% of asthenia of lung, spleen deficiency). Syndrome accounted for 80%, kidney deficiency syndrome accounted for 58.33%), nausea, vomiting 38.88% (33.33% of asthenia of the lung, 66.67% of spleen deficiency, 16.67% of kidney deficiency), 66.67% of children with abdominal distention, abdominal pain (60.61% of lung deficiency syndrome, 86.67% of spleen deficiency, 58.33% of kidney deficiency syndrome, 58.33% of kidney deficiency syndrome, 58.33%), 71.67% of children with feces (deficiency of lung syndrome, 60.61%, spleen deficiency 93.33%, kidney deficiency) (2) 75%. (2) gastric body, gastric antrum lead, and remission asthma group had higher postprandial gastric electrical parameters Vpp and Ra than before meals. The difference was statistically significant (P0.05). There was no significant difference between the gastric electrical parameters and PNSW before meals. The gastric electrical parameters of the postprandial / pre meal power ratio of the 1. control group were Vpp, Ra after the meal was significantly higher than that before the meal, and the difference was significant (P0.05). The gastric electrical parameters F, PNSW before meal, no obvious difference after meal, after meal / pre meal power ratio 1. (3) stomach body, gastric antrum lead, Vpp, F, Ra of the children with asthma in the remission stage were lower than the control group, the difference was significant (P0.05), the pre meal gastric electrical parameters PNSW was not significantly different from the control group. The postprandial gastric electrical parameters Vpp, F, Ra were smaller in the remission stage asthma group. In the control group, the difference was significant (P0.05), but there was no significant difference in the PNSW two groups after the meal. (4) there was no significant difference between the gastric body, the gastric antrum lead, and the Vpp, F, and Ra of the TCM syndrome types, and there were no significant differences in the postprandial gastric electrical parameters Vpp, F, Ra. The clinical manifestations of dynamic dysphasia were mainly characterized by Na, belching, abdominal distention, abdominal pain and poor constipation, especially in children with spleen deficiency syndrome. Compared with the healthy children's electrogram, the abnormal gastric electrical activity, the decrease of gastric electric power, the decrease of gastric electric base rhythm, the decrease of gastric systolic and contractile function, the slow gastric motility and gastric emptying in the children of the healthy children were compared with the healthy children's electrogram. There was no significant difference in the electrocardiogram between TCM Syndromes of asthma in remission stage.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R272

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