本文關(guān)鍵詞： 小建中湯加減 小兒腸系膜淋巴結(jié)炎 脾胃虛寒　出處：《黑龍江中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的研究小建中湯加減對(duì)脾胃虛寒型小兒腸系膜淋巴結(jié)炎的近期療效以及遠(yuǎn)期療效。方法本課題的臨床病例均來自于黑龍江中醫(yī)藥大學(xué)附屬第一醫(yī)院兒科門診。隨機(jī)選取前來就診的符合中醫(yī)辨證分型和西醫(yī)診斷標(biāo)準(zhǔn)的患兒62例。采取隨機(jī)分組的方法,對(duì)照組30人,治療組32人。對(duì)照組患兒應(yīng)用頭孢丙烯顆�？诜�10天。治療組給予小建中湯加減溫服,療程為10天。治療期間腹痛嚴(yán)重者加用消旋山莨菪堿片。觀察治療前后患兒癥狀和體征變化情況。采用SPSS 19.0統(tǒng)計(jì)軟件,建立數(shù)據(jù)庫,進(jìn)行數(shù)據(jù)分析。結(jié)果(1)總療效比較:治療組和對(duì)照組總有效率分別為93.8%、73.3%,治療組總療效要明顯優(yōu)于對(duì)照組(p0.05);(2)中醫(yī)證候總積分:治療組療前總積分與療后比較p0.05,說明治療組有效;對(duì)照組療前總積分與療后比較p0.05,說明對(duì)照組有效;治療后治療組與對(duì)照組比較p0.05,具有統(tǒng)計(jì)學(xué)意義,提示治療組效果要優(yōu)于對(duì)照組;(3)治療后主癥比較:治療期間患兒腹痛發(fā)生次數(shù),治療組與對(duì)照組比較,p0.05,治療組改善腹痛對(duì)照組效果更明顯;(4)治療后次癥比較:面色少華、手足不溫、食少納呆、食后腹脹方面,p值均小于0.05,差異顯著,提示治療組優(yōu)于對(duì)照組;(5)兩組患兒腹部超聲結(jié)果比較:治療組治療后腸系膜淋巴結(jié)體積與治療前比較p0.05,治療組治療方案有效;對(duì)照組治療后腸系膜淋巴結(jié)體積與治療前比較p0.05,對(duì)照組治療方案有效;治療組與對(duì)照組相比較p0.01,在改善淋巴結(jié)大小方面明顯優(yōu)于對(duì)照組;(6)兩組患兒腹痛復(fù)發(fā)情況比較:治療后對(duì)臨床治愈隨患兒訪2個(gè)月,治療組隨訪19人,復(fù)發(fā)1人,對(duì)照組隨訪6人,復(fù)發(fā)3人,(p0.05)差異有統(tǒng)計(jì)學(xué)意義,即治療組在減少腹痛復(fù)發(fā)方面具有明顯優(yōu)勢(shì)。結(jié)論(1)小建中湯加減治療小兒腸系膜淋巴結(jié)炎有效。治療組總有效率為93.8%。(2)小建中湯加減在改善患兒腹痛程度、乳食減少、腹脹、便溏便秘等方面均明顯優(yōu)于抗生素。(3)小建中湯加減在改善淋巴結(jié)腫大方面優(yōu)于對(duì)照組。(4)小建中湯加減在減少腸系膜淋巴結(jié)復(fù)發(fā)方面具有明顯優(yōu)勢(shì)。
[Abstract]:Objective to study the short term and long term effect of Xiaojianzhong decoction (XJD) on mesenteric lymphadenitis of children with deficiency of spleen and stomach. Methods all the clinical cases in this study came from the pediatric outpatient clinic of the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine. Randomly selected 62 children who met the criteria of TCM syndrome differentiation and western medicine diagnosis, and adopted the method of random grouping. 30 patients in the control group and 32 in the treatment group. The children in the control group were treated with cefpropene granules for 10 days. The treatment group was given Xiaojianzhong decoction for 10 days. The course of treatment was 10 days. The patients with severe abdominal pain were treated with racemic anisodamine tablets. The changes of symptoms and signs of children before and after treatment were observed. SPSS 19.0 statistical software was used to establish the database. Data analysis. Results: the total effective rate of treatment group and control group were 93.8 and 73.3, respectively. The total curative effect of treatment group was significantly better than that of control group (p0.05). The total integral of TCM syndromes: the total score before and after treatment in the treatment group was p0.05, which indicated that the treatment group was effective; The total score of the control group before and after treatment was p0.05, which showed that the control group was effective, and the treatment group had statistical significance compared with the control group. The results indicated that the effect of the treatment group was better than that of the control group (P < 0.05). After treatment, the frequency of abdominal pain in the treatment group was higher than that in the control group (P 0.05), and the effect in the treatment group was more obvious than that in the control group (P < 0.05). There were significant differences in the values of P < 0.05 in abdominal distension after eating, the difference was significant. The results showed that the volume of mesenteric lymph nodes in the treatment group was better than that in the control group (p0.05). The mesenteric lymph node volume in the control group was higher than that before treatment (p0.05), and the control group was effective. Compared with the control group, the treatment group was significantly better than the control group in improving the size of lymph nodes. (2 months after treatment, 19 patients in the treatment group were followed up and 1 patient had relapsed. In the control group, 6 patients were followed up and 3 patients had recurrence (P 0.05). Conclusion Xiaojianzhong decoction is effective in the treatment of mesenteric lymphadenitis in children. The total effective rate of the treatment group is 93.80.The total effective rate of the treatment group is 93.80.The total effective rate of the treatment group is 93.80.The total effective rate of the treatment group is 93.80.The total effective rate of the treatment group is 93.80.The total effective rate of the treatment group is 93.8%. Loose stools constipation was obviously superior to antibiotics. 3) Xiaojianzhong decoction was superior to control group in improving lymphadenopathy. Xiaojianzhong decoction had obvious advantages in reducing the recurrence of mesenteric lymph nodes.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R272

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