本文關(guān)鍵詞： 煨葛根 穴位敷貼 小兒輪狀病毒腸炎 臨床觀察　出處：《廣州中醫(yī)藥大學(xué)》2012年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：研究背景 小兒輪狀病毒腸炎是由輪狀病毒感染引起的急性自限性疾病,以6月至2歲的小兒發(fā)病率最高,傳播迅速,流行廣泛,常合并有心肌損害,會(huì)造成嬰幼兒不同程度的脫水征,對(duì)嬰幼兒的健康危害較大。目前西醫(yī)治療本病尚無(wú)特效藥物,中醫(yī)藥在治療本病方面具有一定優(yōu)勢(shì)；而穴位貼敷療法治療疾病及調(diào)理體質(zhì)的歷史悠久,且能克服小兒口服藥物的困難,避免肝臟首過(guò)效應(yīng),并通過(guò)穴位的敏感性而發(fā)揮藥物的局部治療作用,收到外治內(nèi)調(diào)之功效。目前穴位貼敷療法的研究多以成方為主,藥量及藥性不能確定,難以做到質(zhì)量控制。筆者所在醫(yī)院在“治未病”理念下廣泛開(kāi)展調(diào)理體質(zhì)及穴位貼敷,并根據(jù)臨床經(jīng)驗(yàn)篩選穴位貼敷的藥物,在臨床實(shí)踐中廣受群眾歡迎。 研究目的 本課題從治療小兒泄瀉的常用藥物葛根著手,通過(guò)觀察在常規(guī)治療的基礎(chǔ)上應(yīng)用煨葛根穴位敷貼輔助治療小兒輪狀病毒腸炎患兒的臨床療效與其安全性初步探討,以期為治療小兒輪狀病毒腸炎提供更好的藥物進(jìn)行穴位貼敷,提高治療小兒輪狀病毒腸炎的療效,減少患兒服藥、打針帶來(lái)的痛苦。 研究方法 采用前瞻性隨機(jī)對(duì)照臨床試驗(yàn)設(shè)計(jì)方法,將2011年1月至2012年1月入住廣州中醫(yī)藥大學(xué)附屬南海婦產(chǎn)兒童醫(yī)院兒內(nèi)科,符合診斷標(biāo)準(zhǔn)及納入標(biāo)準(zhǔn)的小兒輪狀病毒腸炎患兒59例,利用隨機(jī)數(shù)字表隨機(jī)分成煨葛根觀察組、糊精對(duì)照組。兩組均采用液體療法、消化道黏膜保護(hù)劑、對(duì)癥處理等常規(guī)治療,煨葛根觀察組加用煨葛根穴位敷貼神闕穴、雙側(cè)天樞穴及雙側(cè)脾俞穴：糊精對(duì)照組加用與煨葛根等量的糊精制作成的貼敷膏貼神闕穴、雙側(cè)天樞穴及雙側(cè)脾俞穴,一天一次,療程為3天。結(jié)合量表觀察兩組患兒大便次數(shù)及性狀恢復(fù)正常的天數(shù),治療前后大便的次數(shù)、性狀、發(fā)熱、嘔吐、皮膚彈性、肛周皮膚等癥狀及體征及證候積分改善情況,并檢測(cè)兩組患兒的大便輪狀病毒抗原、心肌酶譜等相關(guān)實(shí)驗(yàn)室指標(biāo),建立數(shù)據(jù)庫(kù),使用SPSS13.0進(jìn)行統(tǒng)計(jì)分析。 研究結(jié)果 本試驗(yàn)研究前的一般資料中性別、月齡、入院前病程、證候類(lèi)型、觀察的癥狀體征分級(jí)及證候積分和CK-MB檢測(cè)結(jié)果及其異常率,經(jīng)統(tǒng)計(jì)分析,兩組間均無(wú)顯著性差異,具有可比性。研究結(jié)束后,煨葛根觀察組30例、糊精對(duì)照組29例,兩組療效構(gòu)成分別為：顯效20例、有效9例、無(wú)效1例,顯效2例、有效21例、無(wú)效6例,總有效率96.7%;79.3%,提示煨葛根觀察組在臨床療效優(yōu)于糊精對(duì)照組,p0.05,兩組差異有統(tǒng)計(jì)學(xué)意義；兩組治療后大便次數(shù)及性狀恢復(fù)正常的天數(shù)經(jīng)統(tǒng)計(jì)分析,P(0.05,提示差異具有統(tǒng)計(jì)學(xué)意義,提示煨葛根觀察組大便情況恢復(fù)正常的時(shí)間較糊精對(duì)照組短：兩組輪狀病毒轉(zhuǎn)陰率比較,經(jīng)卡方檢驗(yàn)p0.05,差異具有統(tǒng)計(jì)學(xué)意義,提示煨葛根觀察組在輪狀病毒轉(zhuǎn)陰率上優(yōu)于糊精對(duì)照組：通過(guò)兩組治療前后CK-MB值及異常率的比較,p均0.05,差異均具有統(tǒng)計(jì)學(xué)意義,提示煨葛根觀察組在輔助治療心肌受損方面上優(yōu)于糊精對(duì)照組：治療后兩組癥候積分減少率經(jīng)統(tǒng)計(jì)學(xué)分析比較,p0.05,差異具有統(tǒng)計(jì)學(xué)意義,提示煨葛根觀察組在證候積分改善上較糊精對(duì)照組有優(yōu)勢(shì)；經(jīng)觀察,無(wú)安全性指標(biāo)異常及不良反應(yīng)。 研究結(jié)論 煨葛根穴位貼敷能提高治療小兒輪狀病毒腸炎的臨床療效,縮短小兒輪狀病毒腸炎的大便情況恢復(fù)正常的時(shí)間,促進(jìn)大便輪狀病毒抗原轉(zhuǎn)陰,促進(jìn)心肌損害的改善,促進(jìn)病情恢復(fù),無(wú)不良反應(yīng)。
[Abstract]:Research background
Children with rotavirus enteritis is caused by rotavirus infection caused by acute self limiting disease, from June to 2, the highest rate of pediatric onset, rapid spread and widely popular, often associated with myocardial damage, can cause dehydration in different degrees of infant syndrome, health hazard of infants is large. The traditional Chinese medicine treatment of this disease there is no effective drugs, traditional Chinese medicine has certain advantages in the treatment of the disease; and acupoint therapy in the treatment of diseases and physical conditioning has a long history, and can overcome the difficulties of oral drug, avoid the liver first pass effect, and the acupoint sensitivity play a role in local treatment of drugs, efficacy in the treatment received at present. The research of acupoint sticking therapy by Decoction, and drug resistance can not be determined, it is difficult to achieve quality control. The hospital widely carried out in the "disease" under the concept of physical conditioning and acupoint Application, and according to clinical experience screening acupoint application of drug, in clinical practice widely popular with the masses.
research objective
This topic from the commonly used drugs for the treatment of infantile diarrhea to investigate clinical curative effect of puerarin, with adjuvant treatment of pediatric rotavirus enteritis by observing weigegen Acupoint Application on the basis of routine treatment and safety, in order for the treatment of infantile rotavirus enteritis provided for better drugs to improve the curative effect of acupoint application. The treatment of rotavirus enteritis, reduce the pain of patients taking injections.
research method
A prospective randomized controlled clinical trial design method, the affiliated Nanhai maternity and children's Hospital from January 2011 to January 2012 in Guangzhou University of Chinese Medicine, and meet the diagnostic criteria of pediatric rotavirus enteritis in 59 cases using the standard, were randomly divided into observation group weigegen dextrin, control group. Two groups were treated with fluid therapy, digestion intestinal mucosa protective agent, symptomatic treatment and routine treatment, the observation group added with weigegen weigegen acupoint Shenque, spleen and bilateral Tianshu Yu Xue: the control group was treated with dextrin with weigegen amounts of dextrin into the sticking plaster Tianshu Shenque, spleen and bilateral Yu Xue, a one day, 3 days for a course. Combined with the scale of days observation frequency and characters of two groups of children defecate normal, the number of stool before and after the treatment of fever, vomiting, traits, skin elasticity, perianal skin And other symptoms and signs and syndrome integral improvement, and detection of stool rotavirus antigen, myocardial enzymes and other related laboratory indicators in two groups, establish database, use SPSS13.0 for statistical analysis.
Research results
Gender, general details of the study in the months before admission, the course of disease, syndrome type, classification and syndrome symptom scores and the test results of CK-MB observation and abnormal rate, through statistical analysis, there was no significant difference between the two groups were comparable. After the end of the study, 30 patients with weigegen the observation group, dextrin 29 cases in the control group, two groups were formed: 20 cases markedly effective 9 cases, invalid 1 cases, 2 cases were cured, 21 cases effective, 6 cases ineffective, the total efficiency of 96.7%; 79.3%, prompting weigegen in the observation group, the clinical curative effect of dextrin in control group, there were P0.05 significant differences between the two groups; two days after treatment in stool returned to normal after statistical analysis, P (0.05, suggested that the difference was statistically significant, suggesting that the observation group weigegen stool recovery time than the control group: two short dextrin rotavirus negative rate compared by chi square test P0 .05, the difference was statistically significant, suggesting that weigegen in the observation group was better than that of rotavirus negative rate on the dextrin control group: through comparison and the abnormal rate of the CK-MB value of the two groups before and after treatment, P was 0.05, the difference was statistically significant, suggesting that weigegen observed in the adjuvant treatment of heart muscle damage is superior to the control group of dextrin after treatment, symptom scores of two groups reduced rate by statistical analysis and comparison, P0.05, the difference was statistically significant, suggesting that weigegen syndrome in the observation group than the control group the scores of dextrin have advantages; it was observed that no abnormal safety indicators and adverse reactions.
research conclusion
Acupoint application of roasted Pueraria lobata can improve the clinical efficacy of rotavirus enteritis in children, shorten the stool condition of children with rotavirus enteritis, return to normal time, promote the conversion of stool rotavirus antigen, promote the improvement of myocardial damage, and promote the recovery of the disease without adverse reactions.

【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類(lèi)號(hào)】：R272

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