双术汤对肠系膜淋巴结炎患儿临床疗效的观察

发布时间：2018-06-15 22:48

本文选题：双术汤 + 肠系膜淋巴结炎　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:对双术汤治疗小儿肠系膜淋巴结炎的临床疗效进行客观评价,为中医药治疗该病提供新思路新方法。方法:根据纳入标准选择符合的肠系膜淋巴结炎患儿60例,依据中医辨证分型:腹部中寒证,乳食积滞证,胃肠结热证,脾胃虚寒证,气滞血瘀证治疗。用双术汤辨证加减治疗,服药2个疗程,每个疗程30天。应用自身前后对照比较分析,观察临床疗效,通过比较治疗前后五种中医证型的中医证候积分,五种中医证型的中医证候疗效,腹部彩超提示的肠系膜淋巴结的数目和纵横径的变化,比较治疗前后的主要症状体征和次要症状,治疗前后腹部疼痛缓解情况,腹部压痛缓解情况及消失率的对比,对临床疗效进行评价。结果:1.治疗前后五种中医证型的中医证候积分比较,治疗后的积分都比治疗前显著下降,差异具有统计学意义(P0.05)。2.五种中医证型的中医证候疗效比较,差异不具有统计学意义(P0.05)。3.复查腹部彩超显示肿大的肠系膜淋巴结数目与治疗前相比减少;纵、横径与治疗前比较较前缩小,差异具有统计学意义(P0.05)。4.腹痛及压痛与治疗前相比,治疗后患儿腹痛明显减轻,总有效率为96.67%;腹部压痛与治疗前相比,显著减轻,总有效率为98.33%,腹痛及腹部压痛复发率低。通过自身前后对照比较,结果显示双术汤能有效地减轻和消除小儿肠系膜淋巴结炎引起的腹痛,腹胀,食欲不振,嗳气,呕吐等症。治疗期间,未见患儿出现汗出过多、恶心等不良反应,说明双术汤治疗小儿肠系膜淋巴结炎安全性较好。结论:1.双术汤能很好地用于不同中医证型的肠系膜淋巴结炎且临床疗效显著,能很好地改善患儿的临床症状。2.治疗后复查腹部肠系膜淋巴结彩超,与治疗前相比,肿大的肠系膜淋巴结数目减少,纵横径缩小。3.服药期间,未见不良反应,双术汤治疗本病无毒副作用,用药安全,值得临床应用和推广。
[Abstract]:Objective: to evaluate the clinical efficacy of Shuangzhu decoction in the treatment of mesenteric lymphadenitis in children. Methods: according to the inclusive criteria, 60 cases of mesenteric lymphadenitis were selected. According to the differentiation of TCM syndromes: abdominal cold syndrome, milk and food accumulation stagnation syndrome, gastrointestinal knot heat syndrome, spleen and stomach deficiency cold syndrome, qi stagnation and blood stasis syndrome were treated. Add and subtract treatment with Shuangzhu decoction, take medicine for 2 courses, 30 days for each course. The clinical curative effect was observed by comparing and analyzing before and after the treatment. By comparing the TCM syndromes integral of five TCM syndromes before and after treatment, the TCM syndromes of five TCM syndromes were compared and the curative effects of TCM syndromes of five TCM syndrome types were compared. The changes of the number and transverse diameter of mesenteric lymph nodes, the main symptoms, signs and secondary symptoms before and after treatment, the relief of abdominal pain, the relief of abdominal tenderness and the rate of disappearance of abdominal tenderness were compared before and after treatment. To evaluate the clinical effect. The result is 1: 1. The scores of five TCM syndromes before and after treatment were significantly lower than those before and after treatment, and the difference was statistically significant (P 0.05). 2. There was no significant difference in the curative effect of five TCM syndromes. The number of enlarged mesenteric lymph nodes was lower than that before treatment, and the longitudinal and transverse diameter was smaller than that before treatment, and the difference was statistically significant (P 0.05). The abdominal pain and tenderness were significantly alleviated after treatment, the total effective rate was 96.67, and the abdominal tenderness was significantly alleviated, the total effective rate was 98.33, and the recurrence rate of abdominal pain and tenderness was lower. The results showed that Shuangzhu decoction could effectively relieve abdominal pain, abdominal distension, anorexia, belching and vomiting caused by mesenteric lymphadenitis in children. During the treatment, there were no adverse reactions such as excessive sweating and nausea in children, which indicated that Shuangzhoutang was safe in treating mesenteric lymphadenitis in children. Conclusion 1. Shuangzhu decoction can be used in different TCM syndromes of mesenteric lymphadenitis with remarkable clinical efficacy and can improve the clinical symptoms of children. 2. After treatment, the number of enlarged mesenteric lymph nodes was reduced and the transverse and longitudinal diameters were decreased. During the period of taking medicine, there was no adverse reaction. Shuangzhu decoction has no side effects and is safe to use, so it is worthy of clinical application and popularization.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R272

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