【摘要】：目的:應用加味清營湯聯(lián)合常規(guī)西醫(yī)療法治療氣營兩燔型的川崎病,記錄患兒治療前后檢驗指標以及臨床癥狀,并與單純西醫(yī)治療組相對照,觀察中西醫(yī)結(jié)合治療川崎病的臨床療效及安全性,研究治療川崎病的中西醫(yī)結(jié)合優(yōu)勢,為中西醫(yī)結(jié)合治療川崎病提供臨床依據(jù)及參考,從而優(yōu)化川崎病的治療方案。方法:選取符合中西醫(yī)診斷標準及納入標準的6個月至14歲氣營兩燔型的川崎病患兒60例,采用簡單隨機化方法分成兩組,其中治療組30例,對照組30例。兩組在急性期(發(fā)熱的第5～9天)均予靜脈人免疫球蛋白2g/(kg · d)靜滴,10～12小時輸入。阿司匹林60mg/(kg·d),分3次口服,熱退后減量為5mg/(kg·d),1次頓服,共服用7天。治療組同時配合加味清營湯口服,治療7天。采集兩組患兒治療前后檢驗指標:白細胞、C反應蛋白、血沉、血小板及治療前后主要癥狀癥候積分、發(fā)熱時間。將所有數(shù)據(jù)錄入計算機,應用SPSS21.0統(tǒng)計軟件進行統(tǒng)計學分析,比較兩組患兒采用不同治療方案后主要癥狀癥候積分、發(fā)熱時間及實驗室數(shù)據(jù),以P0.05為差異有統(tǒng)計學意義,以P0.01為有顯著差異。結(jié)果:1.臨床癥狀比較:治療后兩組主要癥狀癥候總積分與治療前比較P0.01,差異有統(tǒng)計學意義,即治療后兩組主要癥狀均有明顯改善。治療后治療組目赤、咽紅、皮疹及四肢硬腫癥候積分與對照組比較P0.05,差異有統(tǒng)計學意義,即治療組在改善目赤、咽紅、皮疹及四肢硬腫方面優(yōu)于對照組。治療組發(fā)熱時間與對照組比較P0.05,差異有統(tǒng)計學意義,即治療組在減少發(fā)熱時間上比對照組有優(yōu)勢。2.檢驗指標比較:治療后兩組白細胞、C反應蛋白、血沉、血小板均有改善作用,且治療組明顯優(yōu)于對照組(P0.01)。3.臨床療效評價比較:治療組總有效率為93.33%;對照組總有效率為70.00%,在臨床療效上治療組優(yōu)于對照組(P0.05)。結(jié)論:加味清營湯聯(lián)合常規(guī)西醫(yī)療法治療氣營兩燔型的川崎病患兒,可降低炎癥指標及血小板計數(shù),改善主要臨床癥狀,總療效優(yōu)于對照組。
[Abstract]:Objective: to use Jiawei Qingying decoction combined with routine western medicine therapy to treat Kawasaki disease of Qiying two burnt type, and to record the test indexes and clinical symptoms before and after treatment, and to compare with the western medicine treatment group alone. To observe the clinical efficacy and safety of integrated traditional Chinese and western medicine in the treatment of Kawasaki disease, to study the advantages of integrated traditional Chinese and western medicine in the treatment of Kawasaki disease, to provide clinical basis and reference for the treatment of Kawasaki disease, and to optimize the treatment scheme of Kawasaki disease. Methods: 60 children with Kawasaki disease aged from 6 months to 14 years old were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). Both groups were given intravenous human immunoglobulin (2g/ (kg d) intravenously at the acute stage (5 ~ 9 days of fever) for 10 ~ 12 hours. Aspirin 60mg/ (kg d), was given orally for 3 times, and 5mg/ (kg d), was taken once for 7 days. The treatment group was treated with Jiawei Qingying decoction for 7 days. WBC, C-reactive protein, erythrocyte sedimentation rate, platelet and the score of main symptoms and symptoms before and after treatment, febrile time were collected before and after treatment. All the data were entered into the computer, and the statistical analysis was carried out by SPSS21.0 software. The main symptom score, fever time and laboratory data were compared between the two groups after different treatment schemes. The difference was statistically significant with P0.05. There was significant difference in P0.01. The result is 1: 1. Comparison of clinical symptoms: after treatment, the total score of major symptoms in the two groups was significantly improved compared with that before treatment (P 0.01), that is, the main symptoms of the two groups were obviously improved after treatment. After treatment, the score of eye red, pharynx, rash and limb sclerema in the treatment group was significantly higher than that in the control group (P 0.05), that is, the treatment group was superior to the control group in improving the eye red, pharynx, rash and limb sclerema. The febrile time in the treatment group was significantly higher than that in the control group (P 0.05), that is, the treatment group had an advantage over the control group in reducing the febrile time. Comparison of test indexes: after treatment, WBC, C-reactive protein, erythrocyte sedimentation rate and platelet were improved in the two groups, and the treatment group was significantly better than the control group (P0.01). Comparison of clinical efficacy evaluation: the total effective rate of the treatment group was 93.33; the total effective rate of the control group was 70.00. the treatment group was superior to the control group in clinical efficacy (P0.05). Conclusion: Jiawei Qingying decoction combined with routine western medicine therapy for Kawasaki disease of Qiying two burnt type can reduce the inflammatory index and platelet count, improve the main clinical symptoms, the total curative effect is better than the control group.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R725.4

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