清热除湿散治疗小儿湿疹（湿热浸淫证）的临床观察

发布时间：2018-10-29 19:02

【摘要】：目的:通过观察清热除湿散治疗小儿湿疹(湿热浸淫证)的临床总有效率,包括靶皮损程度、瘙痒程度及相关中医证候的情况,评价中医的内外合治法用于临床实践,治疗小儿湿疹的临床疗效。方法:选取符合标准的3-9岁90例小儿湿疹患者为研究对象,按就诊先后顺序,将符合选取条件的病例采用随机分组的方法,分为每组30例,即治疗组、对照组1和对照组2,共3组。分别给予:中药外洗加中药散剂清热除湿散口服治疗、中药外洗加中成药龙胆泻肝颗粒口服治疗、单纯中药外洗治疗。记录性别、年龄、病程、主症(靶皮损程度、瘙痒程度)及兼症(中医证候)等一般情况。三组患者均采取以1周为1个疗程,治疗2个疗程后进行疗效评价。观察症状积分改善情况,并于治疗前和治疗后进行详细记录。治疗2个疗程后进行疗效判断,采用SPSS20.0软件处理分析数据。结果:1.治疗组、对照组1和对照组2三组患者在性别、年龄、病程等情况的构成比比较上均无显著性差异(P0.05),具有可比性,可以进行本次临床研究。2.主症积分(靶皮损程度、瘙痒程度):治疗2个疗程后,三组患儿的靶皮损程度、瘙痒程度积分均有显著差异(P0.05),表明治疗组主症积分改善优于对照组1,对照组1优于对照组2。3.兼症积分(中医证候):治疗2个疗程后,三组患儿中医证候积分均有显著差异(P0.05),表明治疗组中医证候积分改善优于对照组1,对照组1优于对照组2。4.此次共完成90例湿疹患儿的临床观察,治疗组采用清热解毒止痒外洗方加中药散剂清热除湿散冲服治疗,在治疗2个疗程后,治疗组总有效率为86.67%,对照组1为70.00%,对照组2为33.33%。三组有效率有差异,表明治疗组(中药外洗加中药散剂)优于对照组1(中药外洗加中成药),对照组1优于对照组2(单纯外洗方治疗)。治疗组患儿,临床痊愈 9 例(30%)、显效 11 例(36.67%)、有效 6 例(20%)、无效 4 例(13.33%),总有效率86.67%;对照组1采用清热解毒止痒外洗方加中成药龙胆泻肝颗粒冲服治疗,临床痊愈3例(10%)、显效6例(20%)、有效12例(40%)、无效9例(30%),总有效率70%;对照组2单纯使用清热解毒止痒外洗方治疗患儿,临床痊愈1例(3.33%)、显效0例(0%)、有效9例(30%)、无效20例(66.67%),总有效率33.33%,三组患者疗效比较存在显著性差异(P0.05)。结论:1.清热除湿散治疗小儿湿疹(湿热浸淫证)具有显著疗效.2.清热除湿散治疗小儿湿疹(湿热浸淫证)未见明显毒副作用,是安全可靠的临床疗法。
[Abstract]:Objective: to observe the total effective rate of clearing away heat and removing dampness powder in treating children eczema, including the degree of target skin damage, the degree of pruritus and related TCM syndromes, and to evaluate the clinical practice of internal and external treatment of TCM. Treatment of eczema in children. Methods: 90 cases of eczema patients aged 3-9 years were selected as the study objects. According to the order of visit, the selected cases were randomly divided into each group (30 cases), that is, treatment group (30 cases). Control group 1 and control group 2, total 3 groups. Respectively: Chinese medicine external washing plus traditional Chinese medicine powder Qingre dehumidification oral treatment, traditional Chinese medicine external washing plus Chinese patent medicine Gentian Xiegan granule oral treatment, simple Chinese medicine external washing treatment. Gender, age, course of disease, main symptoms (target lesions, pruritus) and concurrent symptoms (TCM syndrome) were recorded. All the three groups were treated with 1 week as a course of treatment and evaluated after 2 courses of treatment. Observe the improvement of symptom score and record it before and after treatment. After 2 courses of treatment, the curative effect was judged and the data were analyzed by SPSS20.0 software. The result is 1: 1. Treatment group, control group 1 and control group 2 patients in sex, age, course of disease and other conditions in the composition of comparison no significant difference (P0.05), comparable, can be carried out this clinical study. 2. The main symptom score (target lesion degree, pruritus degree): after two courses of treatment, there were significant differences in the target skin lesion degree and the pruritus degree integral between the three groups (P0.05), which indicated that the improvement of the main symptom score in the treatment group was better than that in the control group (1). Control group 1 was better than control group 2. 3. Syndrome integral (TCM syndrome): after 2 courses of treatment, the three groups of children with TCM syndrome score were significantly different (P0.05), indicating that the treatment group TCM syndrome integral improvement is better than the control group 1, control group 1 is better than the control group 2.4. A total of 90 cases of children with eczema were observed in this study. The treatment group was treated by clearing heat, detoxifying, relieving itching and external washing prescription plus traditional Chinese medicine powder, clearing away heat and removing dampness. After two courses of treatment, the total effective rate of the treatment group was 86.67. Control group 1 was 70.00g and control group 2 33.33. The effective rate of the three groups was different, which indicated that the treatment group (Chinese medicine external washing plus Chinese medicine powder) was better than the control group 1 (traditional Chinese medicine external washing plus Chinese patent medicine), the control group 1 was superior to the control group 2 (simple external washing prescription treatment). In the treatment group, 9 cases (30%) were clinically cured, 11 cases (36.67%) were markedly effective, 6 cases (20%) were effective, 4 cases (13.33%) were ineffective. The total effective rate was 86.67%. The control group (1) was treated with Qingrejiedu antipruritic external washing prescription plus Longdan Xiegan granule, the traditional Chinese patent medicine. 3 cases were cured (10%), 6 cases were effective (20%), 12 cases were effective (40%), 9 cases were ineffective (30%). The total effective rate was 70%. In control group 2, 1 case (3.33%) was cured, 0 cases (0%) had remarkable effect, 9 cases (30%) were effective, 20 cases (66.67%) were ineffective, the total effective rate was 33.33%, and only one case (3.33%) was cured, 9 cases (30%) were effective, 20 cases (66.67%) were ineffective, and the total effective rate was 33.33%. There was significant difference among the three groups (P0.05). Conclusion: 1. Clearing heat and removing dampness powder has remarkable curative effect in treating children eczema (damp heat immersion syndrome). 2. Clearing heat and removing dampness powder is a safe and reliable clinical therapy for the treatment of children eczema.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R275.9

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