本文選題：連樸止痛方 + 濕熱瘀阻　； 參考：《北京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:評(píng)價(jià)連樸止痛方口服治療小兒慢性腸系膜淋巴結(jié)炎相關(guān)性腹痛的臨床療效,為臨床治療再發(fā)性腹痛患兒尋求一種安全、有效、經(jīng)濟(jì)、簡(jiǎn)便的治法。同時(shí),根據(jù)治療前后腸系膜淋巴結(jié)腫大的改善情況,證實(shí)連樸止痛方在改善腸系膜淋巴結(jié)腫大方面的有效性,為小兒腸系膜淋巴結(jié)炎相關(guān)性腹痛的臨床診治提供新思路。方法:本研究共收集2016年1月～2016年12月就診于北京中醫(yī)藥大學(xué)東方醫(yī)院兒科門(mén)診的反復(fù)腹痛患兒,總計(jì)63例,隨機(jī)分為兩組。治療組口服連樸止痛方顆粒,對(duì)照組口服四磨湯口服液合楓蓼腸胃康顆粒。并于治療前、治療后進(jìn)行證候總積分計(jì)算及腹部超聲觀察腸系膜淋巴結(jié)腫大改善情況,進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:①兩組患兒治療前在年齡、性別、病情、病程、主癥次癥、癥候總積分、腹部B超等方面,均無(wú)統(tǒng)計(jì)學(xué)差異,具有可比性。②臨床療效方面:治療組32例,脫落2例,共30例,痊愈15例,顯效5例,有效10例,無(wú)效0例,總有效率100%。對(duì)照組31例,脫落1例,共30例,痊愈0例,顯效0例,有效28例,無(wú)效2例,總有效率93.3%。經(jīng)統(tǒng)計(jì)學(xué)分析P0.05,連樸止痛方組優(yōu)于對(duì)照組。③癥狀改善方面:兩組在改善腹痛程度及持續(xù)時(shí)間、腹脹、大便等方面均有效。在改善腹痛程度和持續(xù)時(shí)間上:組內(nèi)比較,兩組P0.05,治療后與治療前有差異;組間比較:P0.01,治療組明顯優(yōu)于對(duì)照組。在改善腹脹、大便方面:兩組內(nèi)及組間比較,均為P0.05,治療組優(yōu)于對(duì)照組。說(shuō)明:治療組在改善主、次癥方面均優(yōu)于對(duì)照組,在主癥(腹痛程度及持續(xù)時(shí)間)療效方面尤為突出和顯著。④腹部B超(腸系膜淋巴結(jié)大小)改善情況:治療后兩組在改善腸系膜淋巴結(jié)腫大方面均有效。治療組:痊愈22例,有效8例,對(duì)照組痊愈11例,有效19例。但兩組間比較有顯著性差異,證實(shí)連樸止痛方在改善淋巴結(jié)腫大方面優(yōu)于對(duì)照組。結(jié)論:中醫(yī)辨證屬濕熱瘀阻型的反復(fù)腹痛患兒,運(yùn)用連樸止痛方治療,臨床療效肯定。連樸止痛方與中成藥(四磨湯口服液合楓蓼腸胃康顆粒)組比較,療效更好,在改善患兒腹痛程度及持續(xù)時(shí)間、腹脹、大便等主、次癥狀及體征方面作用顯著。而且連樸止痛方組對(duì)于腸系膜淋巴結(jié)腫大的改善情況明顯優(yōu)于對(duì)照組。因此,連樸止痛方治療小兒反復(fù)腹痛療效肯定,且診療期間未出現(xiàn)不良反應(yīng),值得進(jìn)一步研究及應(yīng)用。
[Abstract]:Objective: to evaluate the clinical efficacy of Lianpu Zhitong recipe in treating children with chronic mesenteric lymphadenitis associated with abdominal pain, and to seek a safe, effective, economical and simple method for the treatment of recurrent abdominal pain. At the same time, according to the improvement of mesenteric lymphadenopathy before and after treatment, the effectiveness of Lianpu Zhitong prescription in improving mesenteric lymphadenopathy was confirmed, which provided a new idea for the clinical diagnosis and treatment of mesenteric lymphadenitis associated with abdominal pain in children. Methods: from January 2016 to December 2016, 63 children with recurrent abdominal pain were randomly divided into two groups. The treatment group took Lianpu Zhitong granule, the control group took Simo decoction oral liquid and Fengliu Changweikang granule. Before and after treatment, the total score of syndrome and abdominal ultrasound were observed and the improvement of mesenteric lymph nodes was analyzed statistically. Results there was no significant difference in age, sex, condition, course of disease, main symptom, total symptom score, abdominal B-ultrasound and so on before treatment between the two groups. There was no significant difference between the two groups. The clinical curative effect was comparable. 2 cases in the treatment group, 32 cases in the treatment group, 2 cases in the treatment group, and 2 cases in the treatment group. There were 30 cases, 15 cases were cured, 5 cases were remarkable effect, 10 cases were effective, 0 cases were ineffective, the total effective rate was 100%. In the control group, there were 31 cases with abscission, 30 cases with abscission, 0 cases with cure, 0 cases with remarkable effect, 28 cases with effective effect, 2 cases with no effect, and the total effective rate was 93.3%. By statistical analysis P0.05, Lianpu Zhitong prescription group was better than the control group in improving symptoms: the two groups were effective in improving the degree and duration of abdominal pain, abdominal distention, stool and so on. In improving the degree and duration of abdominal pain, there was a significant difference between the two groups after treatment (P0.05) and between the two groups (P < 0.01), the treatment group was superior to the control group (P < 0.05) in improving the degree and duration of abdominal pain. In improving abdominal distension and defecation, the comparison between the two groups was P0.05. the treatment group was superior to the control group. Conclusion: the treatment group is superior to the control group in improving the primary and secondary symptoms. The main symptoms (degree and duration of abdominal pain) were especially prominent and the improvement of abdominal B ultrasound (size of mesenteric lymph nodes) was significant: both groups were effective in improving the enlargement of mesenteric lymph nodes after treatment. In the treatment group, 22 cases were cured and 8 cases were effective. In the control group, 11 cases were cured and 19 cases were effective. But there was significant difference between the two groups, which proved that Lianpu Zhitong prescription was superior to the control group in improving lymph node enlargement. Conclusion: the clinical effect of Lianpu Zhitong prescription in treating children with repeated abdominal pain of dampness and heat stasis type is confirmed. The effect of Lianpu Zhitong prescription was better than that of traditional Chinese patent medicine (Simo Tang oral liquid combined with Fengliujiangkang granule). It had a significant effect on improving the degree and duration of abdominal pain, abdominal distention, stool and other main, secondary symptoms and signs. The improvement of mesenteric lymphadenopathy in Lianpu Zhitong group was better than that in control group. Therefore, Lianpu Zhitong prescription has definite curative effect on repeated abdominal pain in children, and no adverse reaction occurred during diagnosis and treatment, which is worthy of further study and application.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R272

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