健脾止痒散治疗小儿脾虚湿蕴型湿疹的临床研究

发布时间：2018-06-29 07:23

本文选题：健脾除湿法 + 小儿湿疹　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:探讨以健脾除湿法为理论基础的健脾止痒散治疗脾虚湿蕴型小儿湿疹的临床疗效,并与临床上小儿湿疹的常用治疗方案进行对比分析,进而为中医临床治疗脾虚湿蕴型小儿湿疹提供临床依据。方法:将广西中医药大学第一附属医院皮肤科收治的90例小儿湿疹患者随机分为基础治疗组,健脾止痒散组和参苓白术散组三组,每组各30例。基础治疗组单服氯雷他定,健脾止痒散组在服用氯雷他定的基础上加服健脾止痒散,参苓白术散组在氯雷他定的基础上加服参苓白术散。连续治疗四周,观察对比各组的疗效,并于治疗的14天、28天观察对比各组患者的皮损改善情况、瘙痒症状变化、中医全身症候变化等。结果:(1)治疗14天时,基础治疗组、健脾止痒散组和参苓白术散组三组有效率依次为60.00%、70.00%和66.67%,疗效差异无统计学意义(χ~2=0.689,P=0.709);28天治疗有效率依次为66.67%、93.33%和83.33%,疗效差异有统计学意义(χ~2=7.107,P=0.029)。(2)三组患儿治疗后皮损面积均较治疗前明显好转;治疗14天时,疗效差异无统计学意义(F=2.253,P=0.112);治疗28天时三组间比较差异有统计学意义(F=12.492,P0.001),三组间两两比较,差异亦有统计学意义。(3)三组患儿治疗后EASI评分均较治疗前显著降低;治疗14天时,三组间差异有统计学意义(F=3.732,P=0.028);治疗28天时三组间比较差异有统计学意义(F=9.864,P0.001),三组间两两比较,差异亦有统计学意义。(4)三组患儿治疗后瘙痒程度评分均较治疗前降低;治疗14天时,三组间差异无统计学意义(F=0.023,P=0.983);治疗28天时三组间比较差异有统计学意义(F=9.071,P0.001),三组间两两比较,差异亦有统计学意义。(5)三组患儿治疗后中医症候评分均较治疗前降低;治疗14天时,三组间差异无统计学意义(F=0.023,P=0.983);治疗28天时三组间比较差异有统计学意义(F=9.071,P0.001),三组间两两比较,差异亦有统计学意义。(6)疗程结束后3个月,三组复发率依次为57.14%、7.14%、30.00%,差异有统计学意义(χ~2=6.229,P=0.044),健脾止痒散组复发率低于基础治疗组和参苓白术散组;疗程结束后6个月,三组复发率依次为71.43%、14.29%、50.00%,三组间比较差异亦有统计学意义(χ~2=7.216,P=0.027),健脾止痒散组复发率低于基础治疗组和参苓白术散组。结论:健脾止痒散组患儿皮损情况、瘙痒程度、中医全身症候综合方面改善情况优于其他两组,且其不良反应少,复发率低,具有较好的临床疗效,是临床治疗小儿湿疹的可靠方法,值得临床推广使用。
[Abstract]:Objective: to explore the clinical effect of Jianpi Zhiyao Powder (JZZS) on the treatment of children eczema with spleen deficiency and dampness accumulation, and to compare it with the commonly used treatment scheme of infantile eczema in clinic, which is based on the theory of invigorating spleen and dehumidifying dampness. It provides clinical basis for the treatment of children eczema with spleen deficiency and dampness accumulation. Methods: 90 children with eczema were randomly divided into basic treatment group, Jianpi Zhiyao powder group and Shenling Baizhu powder group, with 30 cases in each group. The basic treatment group was treated with loratadine alone, the Jianpi Zhiyang powder group was treated with loratadine plus Jianpi Zhiyang powder, and the Shenling Baizhu powder group was treated with Loratadine plus Shenling Baizhu powder on the basis of loratadine. After continuous treatment for four weeks, the curative effects of each group were observed and compared, and the improvement of skin lesions, the changes of pruritus symptoms and the changes of systemic symptoms of TCM were observed and compared in 14 days and 28 days of treatment. Results: (1) after 14 days of treatment, the basic treatment group, The effective rates of Jianpi Zhitao San group and Shenling Baizhu Powder group were 60.007% and 66.67%, respectively. There was no significant difference in the curative effect (蠂 ~ (2 +) ~ 0.689 ~ (0.709). The effective rate for 28 days was 93.33% and 83.33%, respectively, and the difference was statistically significant (蠂 ~ (2) 7.107 ~ (1). (_ (0.029). (_ 2). Better than before treatment; At the 14th day of treatment, there was no significant difference in the curative effect between the three groups (F _ (2.253) P _ (0.112), but there was a significant difference between the three groups on the 28th day (F _ (12.492) P _ (0.001), and there was also a significant difference among the three groups. (3) the EASI scores of the three groups were significantly lower than those of before treatment. At the 14th day of treatment, the difference among the three groups was statistically significant (F _ (3.732P) 0.028), the difference between the three groups was statistically significant on the 28th day (F _ (9.864) P _ (0.001), and the difference between the three groups was also statistically significant. (4) the scores of pruritus degree in the three groups were lower than those before treatment. On the 14th day of treatment, there was no significant difference among the three groups (F0. 023 / P0. 983), but on the 28th day after treatment, there was a significant difference between the three groups (F9. 071, P0. 001), and the difference between the three groups was also statistically significant. (5) after treatment, the scores of TCM symptoms in the three groups were lower than those before treatment. On the 14th day of treatment, there was no significant difference among the three groups (F0. 023, P0. 983), but on the 28th day after treatment, there was a significant difference between the three groups (F9. 071, P0. 001), and the difference between the three groups was also statistically significant. (6) three months after the end of the course of treatment, the difference was also statistically significant. The recurrence rate of the three groups was 57.14 and 7.14 respectively, and the difference was statistically significant (蠂 ~ 2 ~ 2 ~ (6. 229) P ~ (0. 044). The recurrence rate of Jianpi Zhiyao San group was lower than that of the basic treatment group and the Shenling Baizhu Powder group, 6 months after the end of the course of treatment, the recurrence rate of the three groups was lower than that of the basic treatment group and the Shenling Baizhu Powder group. The recurrence rate of the three groups was 71.43 and 14.29 respectively. The difference among the three groups was statistically significant (蠂 ~ (2 +) 7.216P ~ (0. 027). The recurrence rate in the Jianpi Zhiyang Powder group was lower than that in the basic treatment group and Shenling Baizhu Powder group. Conclusion: the improvement of skin lesion, the degree of pruritus and the syndromes of traditional Chinese medicine in Jianpi Zhiyao San group is better than that in the other two groups, and its adverse reaction is less, the recurrence rate is low, and it has better clinical curative effect. It is a reliable method for the treatment of eczema in children and is worth popularizing.
【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】：R275.9

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