运脾方联合刺四缝治疗小儿厌食脾失健运证的临床观察

发布时间：2018-07-07 20:18

本文选题：小儿 + 厌食　；参考：《南京中医药大学》2016年硕士论文

【摘要】：目的：1评价近二十年运脾法治疗小儿厌食的国内临床研究文献的质量。2评价运脾方联合刺四缝治疗小儿厌食脾失健运证的临床疗效、优势及可行性,为小儿厌食的治疗提供有效地指导。方法：1检索从1995年1月至2015年12月期间国内公开发表的以运脾法治疗小儿厌食的临床研究的中文文献,依据文献选择的纳入和排除标准对文献进行筛选,然后对纳入的文献进行质量评价。2收集60例属于小儿厌食脾失健运证的患儿,按随机数字表法分为治疗组、对照组,每组各30例,治疗组给予运脾方联合刺四缝的治疗,对照组给予双歧杆菌四联活菌片(思连康)的治疗,7天为1个疗程,连续治疗4个疗程,对患儿的症状进行量化评分,记录治疗前后各症状积分变化并对结果进行统计学处理。结果：1纳入评价的文献有23篇,文献质量均较低。纳入文献的Meta分析显示,运脾法治疗小儿厌食与西医治疗对比,异质性检验分析P=0.950.1,不具有异质性,采用固定效应模式,结果示:OR=6.71,95%CI为[5.27,8.55],合并效应量Z=15.40,P0.00001,差异有统计学意义。运脾法内治法治疗小儿厌食与西药治疗相比较,异质性检验分析P=0.860.1,不具有异质性,采用固定效应模式,结果示:OR=6.22,95%CI为[4.59,8.41],合并效应量Z=11.85,P0.00001,提示运脾法内治法治疗小儿厌食比西药治疗更具有优势。运脾法外治法治疗小儿厌食与西医治疗比较,异质性检验分析P=0.870.1,不具有异质性,采用固定效应模式,结果示:OR=7.68,95%CI[5.12,11.53]合并效应量Z=9.84,P0.00001,差异有统计学意义,运脾法外治小儿厌食疗效优于西医治疗。2治疗组的痊愈、显效、好转、无效人数分别是18例、9例、2例、1例,对照组分别是10例、10例、7例、3例；经检验,治疗组的综合疗效优于对照组(P0.05)。在改善主症(食欲、食量)方面,两组无明显差异(P0.05)；在改善面色、暖气、恶心呕吐、腹胀、舌象、脉象或指纹等次症方面,治疗组优于对照组(P0.05)。结论：1对运脾法治疗小儿厌食的临床随机对照试验的中文文献进行了质量评价,纳入的文献质量普遍较低,在试验设计、统计学处理等方面存在诸多问题,影响结论可靠性。Meta分析的结果显示,采用运脾法治疗小儿厌食的疗效确切。2临床研究显示,运脾方联合刺四缝治疗小儿厌食脾失健运证,与双歧杆菌四联活菌片对照组相比,在改善面色、嗳气、恶心呕吐、腹胀、舌象、脉象或指纹等次症及综合疗效方面效果更佳。
[Abstract]:Objective to evaluate the quality of domestic literature on the treatment of infantile anorexia by transposition of spleen in the past twenty years. To provide effective guidance for the treatment of anorexia in children. Methods from January 1995 to December 2015, the Chinese literature on the clinical study of treating anorexia in children with the method of spleen transport was retrieved and screened according to the criteria of inclusion and exclusion of the selected literature. Then 60 cases of children with anorexia spleen incapacitation syndrome were collected and randomly divided into treatment group, control group, 30 cases in each group, and the treatment group was treated with Yunpi prescription combined with acupuncture of four seams, and the treatment group was divided into two groups: the control group (n = 30), and the control group (n = 30). The control group was given bifidobacterium tetralogy tablet (Silenkang) for 7 days as a course of treatment and 4 consecutive courses of treatment. The symptoms of the children were scored quantitatively and the changes of symptom scores before and after treatment were recorded and the results were statistically processed. Results 23 articles were included in the evaluation, and the quality of literature was low. Meta-analysis included in the literature showed that compared with western medicine treatment, the heterogeneity test analysis (P0.950.1) was not heterogeneity, and the fixed effect model was adopted. The results showed that the ratio of the combined effect was 5.278.55, and the combined effect was ZH15.40g P0.00001, the difference was statistically significant. Compared with the western medicine treatment, the heterogeneity test and analysis showed that there was no heterogeneity in the treatment of infantile anorexia, and the fixed effect model was adopted. The results showed that the CI was [4.59 卤8.41], and the combined effect was ZH11.85 (P0.00001), which suggested that the internal treatment of spleen transport was more advantageous than western medicine in the treatment of anorexia in children. Compared with western medicine, the treatment of anorexia in children by the method of transferring spleen and treating with external treatment showed that the heterogeneity test analysis was 0.870.1, not heterogeneity, and the fixed effect model was adopted. The results showed that the combined effect quantity of the combined effect was Zang 9.84 (P 0.00001), and the results showed that there was a significant difference in the combined effect between the two groups (P < 0.05), and the difference was significant (P < 0.05), and the difference was statistically significant (P < 0.05). The curative effect of treating anorexia in children was better than that in the treatment group of western medicine (group .2). The number of patients who were cured, improved, improved and ineffective were 18 cases, 9 cases, 2 cases, and 1 case, respectively, and the control group were 10 cases, 10 cases, 7 cases, 3 cases. The comprehensive curative effect of the treatment group was better than that of the control group (P0.05). In improving the main symptoms (appetite, food consumption), there was no significant difference between the two groups (P0.05); in the improvement of facial color, heating, nausea and vomiting, abdominal distension, tongue, pulse or fingerprint, the treatment group was better than the control group (P0.05). Conclusion the quality evaluation of the Chinese literature in the randomized controlled trial on the treatment of infantile anorexia with the spleen transport method was carried out. The quality of the literature included in the study was generally low, and there were many problems in the design of the experiment and the statistical treatment. Conclusion the results of reliability. Meta-analysis showed that the curative effect of treating anorexia in children by the method of spleen transfer was exact .2 the clinical study showed that the combination of Yunpi recipe and acupuncture of Sijiao in the treatment of children's anorexia and spleen failure was compared with that of the control group of Bifidobacterium combined with live bacteria tablets. It is better in improving facial color, belching, nausea and vomiting, abdominal distension, tongue appearance, pulse or fingerprint, and comprehensive curative effect.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R272

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