本文選題：健脾除濕法 + 小兒濕疹��； 參考：《廣西中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:探討以健脾除濕法為理論基礎(chǔ)的健脾止癢散治療脾虛濕蘊(yùn)型小兒濕疹的臨床療效,并與臨床上小兒濕疹的常用治療方案進(jìn)行對(duì)比分析,進(jìn)而為中醫(yī)臨床治療脾虛濕蘊(yùn)型小兒濕疹提供臨床依據(jù)。方法:將廣西中醫(yī)藥大學(xué)第一附屬醫(yī)院皮膚科收治的90例小兒濕疹患者隨機(jī)分為基礎(chǔ)治療組,健脾止癢散組和參苓白術(shù)散組三組,每組各30例�；A(chǔ)治療組單服氯雷他定,健脾止癢散組在服用氯雷他定的基礎(chǔ)上加服健脾止癢散,參苓白術(shù)散組在氯雷他定的基礎(chǔ)上加服參苓白術(shù)散。連續(xù)治療四周,觀察對(duì)比各組的療效,并于治療的14天、28天觀察對(duì)比各組患者的皮損改善情況、瘙癢癥狀變化、中醫(yī)全身癥候變化等。結(jié)果:(1)治療14天時(shí),基礎(chǔ)治療組、健脾止癢散組和參苓白術(shù)散組三組有效率依次為60.00%、70.00%和66.67%,療效差異無統(tǒng)計(jì)學(xué)意義(χ~2=0.689,P=0.709);28天治療有效率依次為66.67%、93.33%和83.33%,療效差異有統(tǒng)計(jì)學(xué)意義(χ~2=7.107,P=0.029)。(2)三組患兒治療后皮損面積均較治療前明顯好轉(zhuǎn);治療14天時(shí),療效差異無統(tǒng)計(jì)學(xué)意義(F=2.253,P=0.112);治療28天時(shí)三組間比較差異有統(tǒng)計(jì)學(xué)意義(F=12.492,P0.001),三組間兩兩比較,差異亦有統(tǒng)計(jì)學(xué)意義。(3)三組患兒治療后EASI評(píng)分均較治療前顯著降低;治療14天時(shí),三組間差異有統(tǒng)計(jì)學(xué)意義(F=3.732,P=0.028);治療28天時(shí)三組間比較差異有統(tǒng)計(jì)學(xué)意義(F=9.864,P0.001),三組間兩兩比較,差異亦有統(tǒng)計(jì)學(xué)意義。(4)三組患兒治療后瘙癢程度評(píng)分均較治療前降低;治療14天時(shí),三組間差異無統(tǒng)計(jì)學(xué)意義(F=0.023,P=0.983);治療28天時(shí)三組間比較差異有統(tǒng)計(jì)學(xué)意義(F=9.071,P0.001),三組間兩兩比較,差異亦有統(tǒng)計(jì)學(xué)意義。(5)三組患兒治療后中醫(yī)癥候評(píng)分均較治療前降低;治療14天時(shí),三組間差異無統(tǒng)計(jì)學(xué)意義(F=0.023,P=0.983);治療28天時(shí)三組間比較差異有統(tǒng)計(jì)學(xué)意義(F=9.071,P0.001),三組間兩兩比較,差異亦有統(tǒng)計(jì)學(xué)意義。(6)療程結(jié)束后3個(gè)月,三組復(fù)發(fā)率依次為57.14%、7.14%、30.00%,差異有統(tǒng)計(jì)學(xué)意義(χ~2=6.229,P=0.044),健脾止癢散組復(fù)發(fā)率低于基礎(chǔ)治療組和參苓白術(shù)散組;療程結(jié)束后6個(gè)月,三組復(fù)發(fā)率依次為71.43%、14.29%、50.00%,三組間比較差異亦有統(tǒng)計(jì)學(xué)意義(χ~2=7.216,P=0.027),健脾止癢散組復(fù)發(fā)率低于基礎(chǔ)治療組和參苓白術(shù)散組。結(jié)論:健脾止癢散組患兒皮損情況、瘙癢程度、中醫(yī)全身癥候綜合方面改善情況優(yōu)于其他兩組,且其不良反應(yīng)少,復(fù)發(fā)率低,具有較好的臨床療效,是臨床治療小兒濕疹的可靠方法,值得臨床推廣使用。
[Abstract]:Objective: to explore the clinical effect of Jianpi Zhiyao Powder (JZZS) on the treatment of children eczema with spleen deficiency and dampness accumulation, and to compare it with the commonly used treatment scheme of infantile eczema in clinic, which is based on the theory of invigorating spleen and dehumidifying dampness. It provides clinical basis for the treatment of children eczema with spleen deficiency and dampness accumulation. Methods: 90 children with eczema were randomly divided into basic treatment group, Jianpi Zhiyao powder group and Shenling Baizhu powder group, with 30 cases in each group. The basic treatment group was treated with loratadine alone, the Jianpi Zhiyang powder group was treated with loratadine plus Jianpi Zhiyang powder, and the Shenling Baizhu powder group was treated with Loratadine plus Shenling Baizhu powder on the basis of loratadine. After continuous treatment for four weeks, the curative effects of each group were observed and compared, and the improvement of skin lesions, the changes of pruritus symptoms and the changes of systemic symptoms of TCM were observed and compared in 14 days and 28 days of treatment. Results: (1) after 14 days of treatment, the basic treatment group, The effective rates of Jianpi Zhitao San group and Shenling Baizhu Powder group were 60.007% and 66.67%, respectively. There was no significant difference in the curative effect (蠂 ~ (2 +) ~ 0.689 ~ (0.709). The effective rate for 28 days was 93.33% and 83.33%, respectively, and the difference was statistically significant (蠂 ~ (2) 7.107 ~ (1). (_ (0.029). (_ 2). Better than before treatment; At the 14th day of treatment, there was no significant difference in the curative effect between the three groups (F _ (2.253) P _ (0.112), but there was a significant difference between the three groups on the 28th day (F _ (12.492) P _ (0.001), and there was also a significant difference among the three groups. (3) the EASI scores of the three groups were significantly lower than those of before treatment. At the 14th day of treatment, the difference among the three groups was statistically significant (F _ (3.732P) 0.028), the difference between the three groups was statistically significant on the 28th day (F _ (9.864) P _ (0.001), and the difference between the three groups was also statistically significant. (4) the scores of pruritus degree in the three groups were lower than those before treatment. On the 14th day of treatment, there was no significant difference among the three groups (F0. 023 / P0. 983), but on the 28th day after treatment, there was a significant difference between the three groups (F9. 071, P0. 001), and the difference between the three groups was also statistically significant. (5) after treatment, the scores of TCM symptoms in the three groups were lower than those before treatment. On the 14th day of treatment, there was no significant difference among the three groups (F0. 023, P0. 983), but on the 28th day after treatment, there was a significant difference between the three groups (F9. 071, P0. 001), and the difference between the three groups was also statistically significant. (6) three months after the end of the course of treatment, the difference was also statistically significant. The recurrence rate of the three groups was 57.14 and 7.14 respectively, and the difference was statistically significant (蠂 ~ 2 ~ 2 ~ (6. 229) P ~ (0. 044). The recurrence rate of Jianpi Zhiyao San group was lower than that of the basic treatment group and the Shenling Baizhu Powder group, 6 months after the end of the course of treatment, the recurrence rate of the three groups was lower than that of the basic treatment group and the Shenling Baizhu Powder group. The recurrence rate of the three groups was 71.43 and 14.29 respectively. The difference among the three groups was statistically significant (蠂 ~ (2 +) 7.216P ~ (0. 027). The recurrence rate in the Jianpi Zhiyang Powder group was lower than that in the basic treatment group and Shenling Baizhu Powder group. Conclusion: the improvement of skin lesion, the degree of pruritus and the syndromes of traditional Chinese medicine in Jianpi Zhiyao San group is better than that in the other two groups, and its adverse reaction is less, the recurrence rate is low, and it has better clinical curative effect. It is a reliable method for the treatment of eczema in children and is worth popularizing.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R275.9

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