【摘要】：目的:小兒腹瀉病為多病原、多因素引起的以大便次數(shù)增多和大便性狀改變?yōu)樘攸c的一組疾病,它是小兒常見疾病之一，是當今世界公共衛(wèi)生領(lǐng)域的重要問題之一。全球每年約150-200萬兒童死于與腹瀉相關(guān)的疾病或是并發(fā)癥，其發(fā)病率僅次于呼吸道感染，居第二位。我國是一個發(fā)展中國家，經(jīng)濟基礎(chǔ)相對薄弱，幅員遼闊，人口眾多，各地差異大，發(fā)展不均衡，經(jīng)過半個世紀的努力，國家在環(huán)境、飲食和水質(zhì)等方面做了大量的工作，但腹瀉依然是我國影響群眾生活生產(chǎn)最普遍的一組疾病。本病往往病程長，反復發(fā)作，纏綿難愈，可導致兒童營養(yǎng)不良、免疫力低下、生長發(fā)育障礙等，嚴重影響兒童的身心健康。西醫(yī)學多采用維持水電解質(zhì)、酸堿平衡等支持療法，對于本病在治療上無特效手段。傳統(tǒng)醫(yī)學在治療小兒腹瀉病方面具有療效確切、副作用小等優(yōu)點，顯示出中醫(yī)藥的優(yōu)勢，取得了較好的臨床療效。中醫(yī)常分為風寒型、傷食型、濕熱型、脾虛型和脾腎陽虛型，其中濕熱型泄瀉為最常見證型，主方葛根芩連湯亦為研究重點。本研究就以鹽酸小蘗堿片作為對照組，客觀評價加味葛根芩連湯治療小兒泄瀉(濕熱證)的臨床療效。 方法:將60例符合標準的患兒隨機分成2組，治療組和對照組各30例。治療組給予加味葛根芩連湯，對照組給予鹽酸小蘗堿片，總療程為3天。采用SPSS13.0統(tǒng)計軟件，建立數(shù)據(jù)庫，計數(shù)資料采用卡方檢驗，計量資料先進行正態(tài)性檢驗和方差齊性檢驗，滿足要求者用t檢驗，未滿足要求者用秩和檢驗。兩組患兒在年齡、性別、主要癥狀積分等方面的比較，無統(tǒng)計學意義，具有可比性。以患兒的大便次數(shù)、大便性狀、腹痛為主要療效指標，對兩組患兒的主要癥狀進行組間比較，對其治療前后總積分進行組間、組內(nèi)比較，綜合評價兩組總有效率、痊愈率。 結(jié)果:經(jīng)過3天的治療，兩組在大便次數(shù)、大便性狀方面比較，無顯著性差異(P0.05)。兩組腹痛癥狀相比較，經(jīng)統(tǒng)計學處理，，差別具有統(tǒng)計學意義(P0.05)，兩組總癥狀積分進行組間比較，無顯著性差異。治療組的總有效率93.3%，對照組總有效率90.0%，兩組的差別無統(tǒng)計學意義(P0.05)。治療組痊愈率為40.0%，對照組為16.7%，兩組差別有統(tǒng)計學意義(P0.05)。 結(jié)論:加味葛根芩連湯治療小兒泄瀉(濕熱證)，能夠改善患兒的腹瀉、腹痛癥狀。與對照組相比較，治療組在改善小兒腹痛方面的療效更顯著。兩組患兒的總有效率無明顯差異，但治療組的痊愈率高于對照組。證明加味葛根芩連湯是治療小兒泄瀉(濕熱證)的有效藥物。
[Abstract]:Objective: diarrhea in children is a group of diseases characterized by the increase of defecation frequency and the change of defecation character. It is one of the common diseases in children and one of the most important problems in the field of public health in the world. About 150-2 million children worldwide die from diarrhoeal diseases or complications every year, ranking second only to respiratory infections. China is a developing country with a relatively weak economic base, a vast territory, a large population, large regional differences and uneven development. After half a century of efforts, the country has done a great deal of work in the areas of environment, diet and water quality. However, diarrhea is still the most common group of diseases affecting the life and production of the masses in our country. The disease often has a long course, repeated attacks, lingering and difficult to heal, which can lead to malnutrition, low immunity, growth and development disorders, and seriously affect the physical and mental health of children. Western medicine is mostly used to maintain water electrolyte, acid-base balance and other support therapy, for this disease in the treatment of no special means. Traditional medicine has the advantages of definite curative effect and little side effect in the treatment of infantile diarrhea disease. It shows the advantage of traditional Chinese medicine and obtains better clinical effect. TCM is often divided into wind-cold type, food injury type, damp-heat type, spleen deficiency type and spleen and kidney Yang deficiency type, in which damp-heat type diarrhea is the most common type, the main prescription Gegen Qinlian decoction is also the focus of research. In this study, berberine hydrochloride tablets were used as control group to objectively evaluate the clinical efficacy of modified Gegen Qinlian decoction in treating children with diarrhea (damp-heat syndrome). Methods: 60 children who met the standard were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). The treatment group was treated with Gegen Qinlian decoction and the control group with berberine hydrochloride tablets for 3 days. Using SPSS13.0 statistical software, the database is established, the counting data is checked by chi-square test, the measurement data is tested by normality test and variance homogeneity test, those who meet the requirements are tested by t test, and those who do not meet the requirements use rank sum test. There was no statistical significance and comparability between the two groups in terms of age, sex, main symptom score and so on. Taking the number of defecation, defecation character and abdominal pain as the main curative index, the main symptoms of the two groups were compared between groups, and the total scores before and after treatment were compared, and the total effective rate and cure rate of the two groups were comprehensively evaluated. Results: after 3 days of treatment, there was no significant difference between the two groups in defecation frequency and defecation traits (P0.05). The symptoms of abdominal pain in the two groups were compared, and the difference was statistically significant (P0.05). There was no significant difference in the total symptom score between the two groups. The total effective rate of the treatment group was 93. 3%, the total effective rate of the control group was 90. 0%, the difference between the two groups was not statistically significant (P0.05). The cure rate of treatment group was 40.0 and that of control group was 16.7.The difference between the two groups was statistically significant (P0.05). Conclusion: modified Gegen Qinlian decoction can improve diarrhea and abdominal pain in children with diarrhea (damp-heat syndrome). Compared with the control group, the treatment group was more effective in improving abdominal pain in children. There was no significant difference in the total effective rate between the two groups, but the cure rate in the treatment group was higher than that in the control group. It is proved that Jiawei Gegen Qinlian decoction is an effective drug for treating diarrhea (damp-heat syndrome) in children.
【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R272

【參考文獻】

相關(guān)期刊論文 前10條

1 周子洋，張縉;點灸法治療嬰幼兒腹瀉149例臨床觀察[J];安徽中醫(yī)學院學報;1994年04期

2 張越穎;自擬加味葛根芩連湯治療急性腹瀉的療效觀察[J];中國醫(yī)藥學報;2003年05期

3 安經(jīng)克,曹桂花,李亞男;紅外藥磁貼敷臍治療小兒腹瀉臨床觀察[J];河北醫(yī)科大學學報;2001年06期

4 李蘭;推拿治療小兒腹瀉100例[J];湖北中醫(yī)雜志;2000年03期

5 陳春紅,易靜,申軍;經(jīng)皮給藥治療小兒腹瀉[J];湖北中醫(yī)雜志;2001年12期

6 臘明東，穆學義;自擬葛石黃草湯冶療濕熱泄瀉52例[J];河南中醫(yī)藥學刊;1995年01期

7 王萍;倫宗姬;;中藥灌腸治療小兒秋季腹瀉86例[J];菏澤醫(yī)學�？茖W校學報;2007年03期

8 劉奕;吳力群;王素梅;;辨證分型中藥敷臍治療小兒腹瀉520例療效觀察[J];遼寧中醫(yī)雜志;2007年02期

9 張恒峰;穴位旋磁法治療嬰幼兒腹瀉150例[J];南京中醫(yī)藥大學學報;1997年01期

10 吳洪文;黃連霉液灌腸治療慢性腹瀉50例[J];新中醫(yī);1989年09期

本文編號：2171856