【摘要】：目的:通過中藥加減溫膽湯治療小兒腸系膜淋巴結(jié)炎的臨床療效觀察,比較治療組和對照組患兒治療前后證候總積分,淋巴結(jié)大小及治療后總有效,探討中醫(yī)藥治療小兒腸系膜淋巴結(jié)炎的有效方法。方法:將66例小兒腸系膜淋巴結(jié)炎患兒隨機分為對照組和治療組,各33例,治療組予以中藥加減溫膽湯顆粒劑口服2周,對照組予以頭孢丙烯顆�？诜�1周,而后改為酪酸梭菌活菌片繼續(xù)服用1周。兩組患兒在2周療程結(jié)束后進行臨床療效和中醫(yī)證候總積分的比較,同時復(fù)查腹腔彩超,隨訪復(fù)發(fā)率。結(jié)果:(1)兩組總療效比較:治療組總有效率為90.9%,對照組總有效率為66.7%,兩組差異具有統(tǒng)計學(xué)意義(P㩳0.05)。(2)治療組和對照組均可改善治療前后中醫(yī)證候總積分,兩組治療前后具有統(tǒng)計學(xué)意義(P㩳0.05);兩組治療后差異具有顯著統(tǒng)計學(xué)意義(P㩳0.05),故治療組療效明顯優(yōu)于對照組。(3)兩組患兒治療后主要癥狀體征改善比較:兩組差異具有統(tǒng)計學(xué)意義(P㩳0.05)。(4)兩組患兒治療后次要癥狀體征的消失率比較:咽紅情況、腹脹情況、惡心嘔吐、大小便方面兩組差異具有統(tǒng)計學(xué)意義(P㩳0.05);脈象方面兩組差異無統(tǒng)計學(xué)意義(P㧐0.05)。(5)兩組患兒腹痛改善情況比較:治療組3天和7天腹痛改善情況差異具有統(tǒng)計學(xué)意義(P㩳0.05);對照組3天和7天時腹痛改善情況差異無統(tǒng)計學(xué)意義(P㧐0.05)。(6)兩組患兒腹部彩色多普勒改善情況比較:兩組治療對淋巴結(jié)橫徑和縱徑均有改善,差異具有統(tǒng)計學(xué)意義(P㩳0.05);治療組和對照組治療后橫徑和縱徑差異具有統(tǒng)計學(xué)意義(P㩳0.05)。(7)兩組患兒腹痛復(fù)發(fā)率比較:兩組復(fù)發(fā)率差異無統(tǒng)計學(xué)意義(P㧐0.05)。結(jié)論:(1)治療組總療效明顯優(yōu)于對照組,說明加減溫膽湯治療小兒腸系膜淋巴結(jié)炎具有顯著優(yōu)勢。(2)治療組在降低中醫(yī)證候總積分、改善主要癥狀體征及次要癥狀消失率明顯優(yōu)于對照組。(3)治療組在改善腹痛情況方面,第7天時腹痛改善情況明顯優(yōu)于對照組。(4)兩組患兒腹部彩色多普勒改善情況比較:兩組患兒在治療后淋巴結(jié)橫徑和縱徑均較治療前改善,但治療組在淋巴結(jié)橫徑和縱徑方面改善均明顯優(yōu)于對照組。(5)兩組患兒腹痛復(fù)發(fā)率比較:在治療后隨訪的2月中,治療組和對照組的復(fù)發(fā)率經(jīng)過統(tǒng)計學(xué)分析,差異無統(tǒng)計學(xué)意義,即治療組在復(fù)發(fā)率方面無明顯優(yōu)勢。
[Abstract]:Objective: to observe the clinical effect of traditional Chinese medicine plus Jiangwangtang in treating mesenteric lymphadenitis in children, and to compare the total syndromes integral, lymph node size and total effect after treatment between the treatment group and the control group. To explore the effective method of treating mesenteric lymphadenitis in children with traditional Chinese medicine. Methods: 66 children with mesenteric lymphadenitis were randomly divided into control group (n = 33) and treatment group (n = 33). And then changed to Clostridium caseate live bacteria tablets continue to take for 1 week. The clinical efficacy and the total score of TCM syndromes were compared between the two groups after 2 weeks of treatment. Results: (1) comparison of the total curative effect between the two groups: the total effective rate in the treatment group was 90.9 and the total effective rate in the control group was 66.7. The difference between the two groups was statistically significant (P0. 05). (2) both the treatment group and the control group could improve the total score of TCM syndromes before and after treatment. There was significant difference between the two groups before and after treatment (P0. 05), so the curative effect of the treatment group was obviously better than that of the control group. (3) the main symptoms and signs of the two groups were improved after treatment: the difference between the two groups was uniform. Comparison of the disappearance rate of secondary symptoms and signs between the two groups after treatment: pharynx red condition. Abdominal distension, nausea and vomiting, There were significant differences between the two groups (P0. 05), but there was no significant difference in pulse (P0. 05). (5) between the two groups: the improvement of abdominal pain in the treatment group was statistically significant at 3 days and 7 days (P0. 05), and there was no significant difference between the two groups in the improvement of abdominal pain (P0. 05). There was no significant difference in the improvement of abdominal pain between the two groups at day 3 and day 7 (P0. 05). (6). There was no significant difference in the improvement of abdominal color Doppler between the two groups: the transverse diameter and longitudinal diameter of lymph nodes were improved in both groups. The difference was statistically significant (P0. 05), and the difference of transverse and longitudinal diameter between the treatment group and the control group was statistically significant (P0. 05). (7). There was no significant difference in the recurrence rate of abdominal pain between the two groups (P0. 05). Conclusion: (1) the total curative effect of the treatment group is significantly better than that of the control group, which indicates that the treatment group has significant advantages in treating children with mesenteric lymphadenitis. (2) the treatment group is reducing the total integral of TCM syndromes. The improvement of main symptoms and signs and the disappearance rate of secondary symptoms were significantly better than that of the control group. (3) in the treatment group, the abdominal pain was improved, On the 7th day, the improvement of abdominal pain was better than that of the control group. (4) the improvement of abdominal color Doppler: after treatment, the transverse diameter and longitudinal diameter of lymph nodes in the two groups were improved compared with those before treatment. But the improvement of the transverse and longitudinal diameter of lymph nodes in the treatment group was significantly better than that in the control group. (5) the recurrence rate of abdominal pain in the two groups was compared: the recurrence rate of abdominal pain in the treatment group and the control group was statistically analyzed in 2 months after treatment, and there was no significant difference between the treatment group and the control group. That is, the treatment group in the recurrence rate has no obvious advantage.
【學(xué)位授予單位】：安徽中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R272

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