本文選題：清熱解毒 + 利咽消腫�。� 參考：《南京中醫(yī)藥大學(xué)》2013年碩士論文

【摘要】：目的：1評價清熱解毒、利咽消腫法治療小兒急性化膿性扁桃體炎國內(nèi)臨床研究文獻(xiàn)的質(zhì)量。2評價清熱解毒、利咽消腫法聯(lián)合西藥治療小兒急性化膿性扁桃體炎臨床優(yōu)勢及可行性,為臨床治療小兒急性化膿性扁桃體炎提供有效的治療方法及診療思路。 方法：1通過計算機檢索2000年1月—2012年12月國內(nèi)公開發(fā)表的以清熱解毒、利咽消腫法為主治療小兒急性化膿性扁桃體炎的國內(nèi)臨床研究文獻(xiàn),按照納入和排除標(biāo)準(zhǔn)進行篩選,對納入的文獻(xiàn)作質(zhì)量評價。2收集60例確診為急性化膿性扁桃體炎肺胃熱盛證的患兒,隨機分為治療組、對照組各30例,對照組予頭孢硫脒、喜炎平靜滴治療；治療組予頭孢硫脒、喜炎平靜滴治療并加用具有清熱解毒、利咽消腫作用的中藥湯劑口服,5天一個療程,兩組均輔以西醫(yī)對癥處理。 結(jié)果：1檢索到相關(guān)文獻(xiàn)231篇,最終納入評價的文獻(xiàn)77篇。文獻(xiàn)質(zhì)量評價顯示納入研究文獻(xiàn)的臨床研究設(shè)計存在一系列問題。納入文獻(xiàn)經(jīng)Meta分析顯示,清熱解毒,利咽消腫法治療小兒急性化膿性扁桃體炎與西醫(yī)治療對比,異質(zhì)性檢驗分析P=0.0030.10,所納入文獻(xiàn)存在異質(zhì)性,采用隨機效應(yīng)模式,結(jié)果示：OR=2.84,95%CI為[1.54,5.24],合并效應(yīng)量Z=3.34,P=0.00080.05,差異具有統(tǒng)計學(xué)意義。清熱解毒,利咽消腫法聯(lián)合西藥治療小兒急性化膿性扁桃體炎與西藥治療相比較,異質(zhì)性檢驗分析P=1.000.10,所納入文獻(xiàn)不存在異質(zhì)性,采用固定效應(yīng)模式分析,結(jié)果示：0R=6.19,95%,CI為[4.99,7.68],合并效應(yīng)量Z=16.56,P0.00001,提示清熱解毒、利咽消腫法或清熱解毒、利咽消腫法聯(lián)合西藥治療小兒急性化膿性扁桃體炎與西藥治療相比總有效率更具有優(yōu)勢,治療組優(yōu)于對照組。2兩組治療前后在主要癥狀及次要癥狀方面改善情況組內(nèi)比較,差異有統(tǒng)計學(xué)意義(P0.05)。治療后兩組組間比較,在改善主要癥狀方面,差異有統(tǒng)計學(xué)意義(P0.05)；在改善咳嗽、大便、發(fā)熱、口渴等次要癥狀方面比較,差異有統(tǒng)計學(xué)意義(P0.05),治療組優(yōu)于對照組,在改善煩躁不安、舌象方面比較,治療組與對照組無明顯差異(P0.05)。兩組治療后主癥積分、次癥積分、總積分及綜合療效比較比較,差異有統(tǒng)計學(xué)意義(P0.05),治療組優(yōu)于對照組。 結(jié)論：1對清熱解毒、利咽消腫法或清熱解毒、利咽消腫法聯(lián)合西藥治療小兒急性化膿性扁桃體炎的臨床隨機對照試驗文獻(xiàn)進行質(zhì)量評價,文獻(xiàn)質(zhì)量評價顯示普遍較低,且在試驗設(shè)計等方面存在問題,影響結(jié)論可靠性。Meta分析結(jié)果提示總有效率試驗組較對照組確有優(yōu)勢。2臨床研究顯示清熱解毒、利咽消腫法聯(lián)合西藥治療小兒急性化膿性扁桃體炎是可行的,有效的方法,在改善咽痛、扁桃體腫大充血、扁桃體化膿、發(fā)熱、咳嗽、口渴、大便等癥狀體征及綜合療效方面,治療組均優(yōu)于對照組。
[Abstract]:Objective to evaluate the quality of the domestic clinical research literature on the treatment of acute suppurative tonsillitis in children by the methods of removing heat and detoxifying toxin, and to evaluate the quality of the literature on clearing heat and detoxifying toxin. The clinical advantages and feasibility of the treatment of acute suppurative tonsillitis in children with Liyan Xiaoyong method combined with western medicine provide an effective treatment method and diagnosis and treatment thought for clinical treatment of acute suppurative tonsillitis in children. Methods from January 2000 to December 2012, the Chinese clinical literature on the treatment of acute suppurative tonsillitis in children was searched by using the method of clearing heat and detoxifying toxin and detoxifying the pharynx, and was screened according to the criteria of inclusion and exclusion. 60 children with acute suppurative tonsillitis were randomly divided into treatment group (n = 30) and control group (n = 30). The treatment group was treated with cefathiramidine, Heyan tranquil drop and combined with traditional Chinese medicine decoction with antipyretic and detoxifying effect, and the two groups were treated with western medicine for a period of 5 days. Results 231 related articles were retrieved by: 1 and 77 articles were included in the evaluation. Literature quality evaluation shows that there are a series of problems in clinical research design. Meta-analysis showed that the treatment of acute suppurative tonsillitis in children with antipyretic and detoxifying method was compared with that of western medicine, and heterogeneity test analysis (P < 0.0030.10) showed that there was heterogeneity in the literature, and the random effect model was used in the treatment of children with acute suppurative tonsillitis. The results showed that the CI was 1.54 / 5.24, and the combined effect was 0.00080.05. The difference was statistically significant. Compared with western medicine treatment of acute suppurative tonsillitis in children, Heterogeneity test was used to analyze the heterogeneity (P0.00.10), and there was no heterogeneity in the literature, so the fixed effect model was used. The results showed that the CI was [4.997.68], and the combined effect was ZH16.56 (P0.00001). The results indicated that the total effective rate of the treatment of acute suppurative tonsillitis in children was more effective than that of western medicine in the treatment of acute suppurative tonsillitis in children, such as clearing away heat and detoxifying toxin, detoxicating pharynx or clearing away heat and detoxifying toxin, and combining western medicine with Liyan's detumescence method in the treatment of acute suppurative tonsillitis in children. The treatment group was better than the control group before and after treatment in the main symptoms and secondary symptoms improvement in the group, the difference was statistically significant (P0.05). After treatment, the difference between the two groups in improving the main symptoms was statistically significant (P0.05); in improving cough, stool, fever, thirst and other secondary symptoms, the difference was statistically significant (P0.05), the treatment group was better than the control group, There was no significant difference between the treatment group and the control group in improving agitation and tongue image (P0.05). The difference between the two groups after treatment was statistically significant (P0.05), and the treatment group was superior to the control group. Conclusion the quality evaluation of the clinical randomized controlled trials on the treatment of acute suppurative tonsillitis in children with the methods of clearing heat and detoxification, detoxification of pharynx, detoxification of heat and swelling, combined with western medicine, showed that the quality evaluation of literature was generally low. The results of Meta-analysis showed that the total effective rate of the trial group was better than that of the control group. It is feasible and effective to treat acute suppurative tonsillitis in children with Liyan Xiaoyong method combined with western medicine. It is effective in improving symptoms, signs and comprehensive curative effects of pharynx, tonsil swelling and congestion, tonsil purulent, fever, cough, thirst, stool, etc. The treatment group was superior to the control group.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R272

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