本文選題：小兒脾胃樂 + 厭食癥�。� 參考：《湖北中醫(yī)藥大學(xué)》2012年碩士論文

【摘要】：目的：厭食是小兒的常見病、多發(fā)病之一,國內(nèi)專家將其歸屬于消化功能紊亂、功能性消化不良或進(jìn)食障礙之中。目前西醫(yī)治療缺乏針對性,且療效欠佳,而中醫(yī)藥治療注重整體辨證施治,對本病的治療積累了豐富的經(jīng)驗(yàn)。小兒脾胃樂顆粒是安徽省名老中醫(yī)張瓊林主任的臨床經(jīng)驗(yàn)方,本研究是在中醫(yī)基礎(chǔ)理論的指導(dǎo)下運(yùn)用小兒脾胃樂顆粒治療證屬脾失健運(yùn)的厭食患兒,使其脾復(fù)健運(yùn)、胃復(fù)腐熟,從而達(dá)到陰平陽秘,并探討小兒脾胃樂顆粒治療小兒厭食脾失健運(yùn)證的療效及其作用機(jī)制,同時(shí)初步評價(jià)其安全性。 方法：收集臨床西醫(yī)診斷為厭食、中醫(yī)證屬脾失健運(yùn)的患兒36例,年齡在1～7歲之間,隨機(jī)分為治療組18例和對照組18例。治療組給予小兒脾胃樂顆�？诜�,對照組給予安慰劑口服。用量：1～3歲每次0.5袋,3+～7歲每次1袋,一日3次,開水沖服。療程為4周。用藥期間,不得使用助消化、止瀉類西藥及健脾益氣、化食消積中藥。觀察治療前后兩組患兒食欲不振、食量減少、體重、尿D-木糖排泄率、中醫(yī)證候、主癥計(jì)分和與證候計(jì)分和等療效評價(jià)指標(biāo)及生命體征(體溫、脈搏、呼吸、血壓)和常規(guī)生化檢查(血常規(guī)、肝腎功能、糞常規(guī)、尿常規(guī)、心電圖)等安全性評價(jià)指標(biāo)。 結(jié)果：臨床研究顯示,治療組痊愈8例,顯效4例,愈顯率66.66%,對照組痊愈0例,顯效2例,愈顯率為11.76%,結(jié)果表明治療組明顯優(yōu)于對照組。兩組主癥積分和、證候積分和等級之間比較,差異有統(tǒng)計(jì)學(xué)意義(P0.01)。 治療組食量減少,食欲減退,腹脹,體重等情況均較對照組為優(yōu)。食欲減退,食量減少,腹脹,體重等情況與對照組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.01)。 治療全過程中未發(fā)現(xiàn)不良反應(yīng),治療前后肝腎功能比較,肝腎功能各項(xiàng)指標(biāo)未見異常變化,前后比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論：用小兒脾胃樂顆粒治療小兒厭食脾失健運(yùn)證有較好的療效,其服用方便,口感好,患兒易接受,且十分安全。是中醫(yī)辨證施治的一個(gè)典范,值得推廣、應(yīng)用。
[Abstract]:Objective: anorexia is a common disease in children, which is classified by domestic experts as digestive disorders, functional dyspepsia or eating disorders.At present, the western medicine treatment lacks pertinence, and the curative effect is poor, and the traditional Chinese medicine treatment pays attention to the whole syndrome differentiation treatment, has accumulated the rich experience to the treatment of this disease.This study is based on the basic theory of traditional Chinese medicine to treat children with anorexia due to spleen failure, so that the spleen will recover and the stomach will decay.In order to achieve Yin Pingyang constipation, and to explore the treatment of infantile spleen anorexia syndrome and its mechanism of action, at the same time preliminary evaluation of its safety.Methods: a total of 36 children, aged between 1 and 7 years, who were diagnosed as anorexia by western medicine and who were diagnosed as incapacitated by traditional Chinese medicine, were randomly divided into treatment group (n = 18) and control group (n = 18).The treatment group was given the children spleen-Weiling granule orally, and the control group was given placebo.Dosage: 1: 1, 3 years old, 0.5 bags, 3 / 7 years old, 1 bag, 3 times a day, boiled water.The course of treatment was 4 weeks.During the use of drugs, not to use digestive aid, anti-diarrhea type of western medicine and invigorate spleen and qi, traditional Chinese medicine.Before and after treatment, two groups of children were observed, such as loss of appetite, food loss, weight, urine D-xylose excretion rate, TCM syndromes, scores of main symptoms and syndromes, and vital signs (body temperature, pulse, respiration, etc.)Blood pressure) and routine biochemical examination (blood routine, liver and kidney function, fecal routine, urine routine, electrocardiogram) and other safety indicators.Results: the clinical study showed that 8 cases were cured in the treatment group, 4 cases were markedly effective, and the recovery rate was 66.66%. In the control group, 0 cases were cured, 2 cases were obviously effective, and the effective rate was 11.76%. The results showed that the treatment group was obviously superior to the control group.The difference between the two groups was statistically significant (P 0.01).The diet, appetite, abdominal distension and body weight in the treatment group were better than those in the control group.Compared with the control group, there were significant differences in appetite loss, appetite loss, abdominal distension, weight and so on.No adverse reactions were found in the whole course of treatment. There were no abnormal changes in the indexes of liver and kidney function before and after treatment, and there was no significant difference between the two groups before and after treatment (P 0.05).Conclusion: the treatment of infantile anorexia and spleen disabling syndrome with children's spleen stomach granule has better curative effect, its use is convenient, taste is good, the child is easy to accept, and is very safe.It is a model of syndrome differentiation and treatment of TCM, which is worth popularizing and applying.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R272

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