连朴止痛方治疗小儿慢性肠系膜淋巴结炎相关性腹痛临床研究

发布时间：2018-06-16 19:07

本文选题：连朴止痛方 + 湿热瘀阻　；参考：《北京中医药大学》2017年硕士论文

【摘要】：目的:评价连朴止痛方口服治疗小儿慢性肠系膜淋巴结炎相关性腹痛的临床疗效,为临床治疗再发性腹痛患儿寻求一种安全、有效、经济、简便的治法。同时,根据治疗前后肠系膜淋巴结肿大的改善情况,证实连朴止痛方在改善肠系膜淋巴结肿大方面的有效性,为小儿肠系膜淋巴结炎相关性腹痛的临床诊治提供新思路。方法:本研究共收集2016年1月～2016年12月就诊于北京中医药大学东方医院儿科门诊的反复腹痛患儿,总计63例,随机分为两组。治疗组口服连朴止痛方颗粒,对照组口服四磨汤口服液合枫蓼肠胃康颗粒。并于治疗前、治疗后进行证候总积分计算及腹部超声观察肠系膜淋巴结肿大改善情况,进行统计学分析。结果:①两组患儿治疗前在年龄、性别、病情、病程、主症次症、症候总积分、腹部B超等方面,均无统计学差异,具有可比性。②临床疗效方面:治疗组32例,脱落2例,共30例,痊愈15例,显效5例,有效10例,无效0例,总有效率100%。对照组31例,脱落1例,共30例,痊愈0例,显效0例,有效28例,无效2例,总有效率93.3%。经统计学分析P0.05,连朴止痛方组优于对照组。③症状改善方面:两组在改善腹痛程度及持续时间、腹胀、大便等方面均有效。在改善腹痛程度和持续时间上:组内比较,两组P0.05,治疗后与治疗前有差异;组间比较:P0.01,治疗组明显优于对照组。在改善腹胀、大便方面:两组内及组间比较,均为P0.05,治疗组优于对照组。说明:治疗组在改善主、次症方面均优于对照组,在主症(腹痛程度及持续时间)疗效方面尤为突出和显著。④腹部B超(肠系膜淋巴结大小)改善情况:治疗后两组在改善肠系膜淋巴结肿大方面均有效。治疗组:痊愈22例,有效8例,对照组痊愈11例,有效19例。但两组间比较有显著性差异,证实连朴止痛方在改善淋巴结肿大方面优于对照组。结论:中医辨证属湿热瘀阻型的反复腹痛患儿,运用连朴止痛方治疗,临床疗效肯定。连朴止痛方与中成药(四磨汤口服液合枫蓼肠胃康颗粒)组比较,疗效更好,在改善患儿腹痛程度及持续时间、腹胀、大便等主、次症状及体征方面作用显著。而且连朴止痛方组对于肠系膜淋巴结肿大的改善情况明显优于对照组。因此,连朴止痛方治疗小儿反复腹痛疗效肯定,且诊疗期间未出现不良反应,值得进一步研究及应用。
[Abstract]:Objective: to evaluate the clinical efficacy of Lianpu Zhitong recipe in treating children with chronic mesenteric lymphadenitis associated with abdominal pain, and to seek a safe, effective, economical and simple method for the treatment of recurrent abdominal pain. At the same time, according to the improvement of mesenteric lymphadenopathy before and after treatment, the effectiveness of Lianpu Zhitong prescription in improving mesenteric lymphadenopathy was confirmed, which provided a new idea for the clinical diagnosis and treatment of mesenteric lymphadenitis associated with abdominal pain in children. Methods: from January 2016 to December 2016, 63 children with recurrent abdominal pain were randomly divided into two groups. The treatment group took Lianpu Zhitong granule, the control group took Simo decoction oral liquid and Fengliu Changweikang granule. Before and after treatment, the total score of syndrome and abdominal ultrasound were observed and the improvement of mesenteric lymph nodes was analyzed statistically. Results there was no significant difference in age, sex, condition, course of disease, main symptom, total symptom score, abdominal B-ultrasound and so on before treatment between the two groups. There was no significant difference between the two groups. The clinical curative effect was comparable. 2 cases in the treatment group, 32 cases in the treatment group, 2 cases in the treatment group, and 2 cases in the treatment group. There were 30 cases, 15 cases were cured, 5 cases were remarkable effect, 10 cases were effective, 0 cases were ineffective, the total effective rate was 100%. In the control group, there were 31 cases with abscission, 30 cases with abscission, 0 cases with cure, 0 cases with remarkable effect, 28 cases with effective effect, 2 cases with no effect, and the total effective rate was 93.3%. By statistical analysis P0.05, Lianpu Zhitong prescription group was better than the control group in improving symptoms: the two groups were effective in improving the degree and duration of abdominal pain, abdominal distention, stool and so on. In improving the degree and duration of abdominal pain, there was a significant difference between the two groups after treatment (P0.05) and between the two groups (P < 0.01), the treatment group was superior to the control group (P < 0.05) in improving the degree and duration of abdominal pain. In improving abdominal distension and defecation, the comparison between the two groups was P0.05. the treatment group was superior to the control group. Conclusion: the treatment group is superior to the control group in improving the primary and secondary symptoms. The main symptoms (degree and duration of abdominal pain) were especially prominent and the improvement of abdominal B ultrasound (size of mesenteric lymph nodes) was significant: both groups were effective in improving the enlargement of mesenteric lymph nodes after treatment. In the treatment group, 22 cases were cured and 8 cases were effective. In the control group, 11 cases were cured and 19 cases were effective. But there was significant difference between the two groups, which proved that Lianpu Zhitong prescription was superior to the control group in improving lymph node enlargement. Conclusion: the clinical effect of Lianpu Zhitong prescription in treating children with repeated abdominal pain of dampness and heat stasis type is confirmed. The effect of Lianpu Zhitong prescription was better than that of traditional Chinese patent medicine (Simo Tang oral liquid combined with Fengliujiangkang granule). It had a significant effect on improving the degree and duration of abdominal pain, abdominal distention, stool and other main, secondary symptoms and signs. The improvement of mesenteric lymphadenopathy in Lianpu Zhitong group was better than that in control group. Therefore, Lianpu Zhitong prescription has definite curative effect on repeated abdominal pain in children, and no adverse reaction occurred during diagnosis and treatment, which is worthy of further study and application.
【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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