四君子汤加味在改善脾虚肝旺型厌食症患儿食欲食量中的应用
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摘要
目的探讨分析四君子汤加味在改善脾虚肝旺型厌食症患儿食欲食量中的应用。方法选取2015年1-2017年12月来我院门诊就诊的厌食症患儿300例,按随机平行分组法将所有患儿分为对照组和观察组,各150例。对照组采用常规西药治疗,包括硫酸锌糖浆、乳酸菌素片等。观察组在对照组的基础上加用中药四君子汤加味口服。2组患者的疗程均为4周,比较治疗前后2组患者的促人生长激素腺释放肽、瘦素水平以及临床疗效。结果观察组患儿的愈显率94.67%明显高于对照组患儿70.00%,差异有统计学意义(P <0.01)。治疗4周后,2组患儿食欲不振、性躁易怒、大便不调、乏力气短等中医证候积分明显低于治疗前(P <0.05或P <0.01),且观察组优于对照组(P <0.01);2组患儿瘦素水平较治疗前明显降低,促人生长激素腺释放肽水平较治疗前明显升高,差异有统计学意义(P <0.01),且观察组优于对照组(P <0.01)。结论对脾虚肝旺型小儿厌食症应用四君子汤加味能够降低瘦素水平,提高促人生长激素腺释放肽水平,有效改善小儿食欲食量。
Objective To investigate application of Sijunzi decoction in improving the appetite in children with spleen deficiency and liver prosperity. Methods 300 children with anorexia treated in our hospital from January 2015 to December 2017 were randomly divided into control group and observation group with 150 cases in each group. The control group was treated with conventional western medicine, such as zinc sulfate syrup, lactic acid bacteriocin tablets. Observation group was treated by Sijunzi decoction on the basis control group medicine. Two groups of patients were treated for 4 weeks. The levels of human growth hormone releasing peptide, leptin and clinical efficacy were compared between the two groups before and after treatment. Results The curative eff ect rate of the observation group was 94.67%, which was significantly higher than that of the control group(70.00%)(P < 0.01). After four weeks of treatment, the scores of TCM syndromes such as loss of appetite, irritability, restlessness, defecation and asthenia in both groups were significantly lower than those before treatment(P < 0. 05 or P < 0.01), and the observation group was superior to the control group(P < 0.01). The level of leptin in the two groups was significantly lower than that before treatment, and the level of promoting human growth hormone releasing peptide was significantly higher than that before treatment(P < 0.01), and the observation group was superior to the control group(P < 0.01). Conclusion The application of Sijunzi decoction to infantile anorexia due to spleen deficiency and liver prosperity can reduce leptin level, increase the level of human growth hormone releasing peptide, and eff ectively improve appetite of children.
Objective To investigate application of Sijunzi decoction in improving the appetite in children with spleen deficiency and liver prosperity. Methods 300 children with anorexia treated in our hospital from January 2015 to December 2017 were randomly divided into control group and observation group with 150 cases in each group. The control group was treated with conventional western medicine, such as zinc sulfate syrup, lactic acid bacteriocin tablets. Observation group was treated by Sijunzi decoction on the basis control group medicine. Two groups of patients were treated for 4 weeks. The levels of human growth hormone releasing peptide, leptin and clinical efficacy were compared between the two groups before and after treatment. Results The curative eff ect rate of the observation group was 94.67%, which was significantly higher than that of the control group(70.00%)(P < 0.01). After four weeks of treatment, the scores of TCM syndromes such as loss of appetite, irritability, restlessness, defecation and asthenia in both groups were significantly lower than those before treatment(P < 0. 05 or P < 0.01), and the observation group was superior to the control group(P < 0.01). The level of leptin in the two groups was significantly lower than that before treatment, and the level of promoting human growth hormone releasing peptide was significantly higher than that before treatment(P < 0.01), and the observation group was superior to the control group(P < 0.01). Conclusion The application of Sijunzi decoction to infantile anorexia due to spleen deficiency and liver prosperity can reduce leptin level, increase the level of human growth hormone releasing peptide, and eff ectively improve appetite of children.
引文
[1]陈会芳.综合治疗小儿厌食症92例临床观察[J].现代中西医结合杂志, 2012, 21(5):523-524.
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[3]吴强,邵瑛,唐纯志,等.基于“健脾益气”思想运用小儿推拿及中药治疗脾失健运型小儿厌食症的随机多中心临床研究[J].实用医学杂志, 2016, 32(5):834-838.
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[8]张文婷,张雁冰,陈志勇,等.小儿扶脾颗粒联合硫酸锌治疗小儿厌食症疗效观察[J].中国医师杂志, 2015, 17(12):1869-1871.
[9]蔡珊珊,江治霞,张勇.消食健脾合剂联合微生态制剂、葡萄糖酸锌治疗小儿厌食症疗效观察[J].现代中西医结合杂志, 2017, 26(26):2918-2920.
[10]连俊兰,邵征洋,陈颖,等.四逆散加味治疗小儿肝旺脾虚型厌食症40例疗效观察[J].中医儿科杂志, 2013,9(3):18-19.
[11]毕胜,王雪峰.儿童厌食症中医证候文献分析[J].中国中西医结合儿科学, 2014, 6(1):6-7.
[12]谢晓丽.辨证论治小儿厌食症42例[J].陕西中医, 2012,33(4):443-445.
[13]黄冬梅,李江全.中医治疗小儿厌食症[J].长春中医药大学学报, 2 013, 29(6):1038-1040.
[14]宋文朗.四君子汤对脾虚证慢性胃炎患者胃动力的影响[J].安徽医药, 2013, 17(2):298-300.
[15]高永珍,武瑞珍,陈永利.四君子汤在中医内科疾病脾胃气虚证中的应用[J].中国民族民间医药, 2013, 22(5):52.
[16]吕苑.四君子汤的药理研究和临床应用[J].中医研究,2012, 25(1):76-78.
[17]冯骥.四君子汤在中医内科疾病脾胃气虚证中的应用[J].中医临床研究, 2014, 6(2):46-47.
[18]李琳.四君子汤对肠梗阻解除后肠黏膜屏障功能影响的实验研究[J].天津中医药, 2015(6):356-358.
[19]邓文祥,李亮,吴华英,等.四君子汤对FCIR大鼠大脑皮质神经保护作用的实验研究[J].湖南中医药大学学报,2016, 36(11):9-12.
[20]陈洁生.四君子汤联合肠内营养支持促进胃癌术后恢复临床研究[J].吉林中医药, 2013, 33(4):383-385.
[21]纪云飞,王瑞君,李晓波.复方四君子汤的化学成分和药理作用研究进展[J].中草药, 2016, 47(5):837-843.
[22]周虹.四君子汤加味对厌食症患儿血清促人生长激素腺释放肽与瘦素水平的影响[J].现代中西医结合杂志,2015, 24(35):3908-3910.
[23]周俊亮,潘奔前,叶伟成.四君子汤加减治疗肝旺脾虚型小儿厌食症24例[J].湖南中医杂志, 2012, 28(3):62-63.
[24]黄静,邓静.自拟健脾和胃汤治疗小儿脾胃虚弱型厌食症的临床研究[J].重庆医学, 2016, 45(17):2409-2410.
[2] WATANABE H. A Comprehensive Care System for Children with Anorexia Nervosain Pediatric Practice[J].Seishin Shinkeigaku Zasshi, 2015, 117(5):333-340.
[3]吴强,邵瑛,唐纯志,等.基于“健脾益气”思想运用小儿推拿及中药治疗脾失健运型小儿厌食症的随机多中心临床研究[J].实用医学杂志, 2016, 32(5):834-838.
[4]孙宁,姚莹莹.加味逍遥散治疗肝郁脾虚型厌食症儿童临床观察[J].浙江临床医学, 2015, 17(10):1778-1779.
[5]张朝霞,王恩杰,孔令霞.自拟厌食方结合针刺四缝穴治疗小儿脾虚型厌食症150例[J].吉林中医药, 2012, 32(10):1056-1057.
[6] STHENEUR C, BERGERON SJ, FRAPPIER JY, et al. Renal injury in pediatric anorexia nervosa:a retrospective study[J].Eat Weight Disord, 2017(5):1-5.
[7]李湘辉.中西医结合治疗小儿厌食症疗效观察[J].现代中西医结合杂志, 2012, 21(14):1525-1526.
[8]张文婷,张雁冰,陈志勇,等.小儿扶脾颗粒联合硫酸锌治疗小儿厌食症疗效观察[J].中国医师杂志, 2015, 17(12):1869-1871.
[9]蔡珊珊,江治霞,张勇.消食健脾合剂联合微生态制剂、葡萄糖酸锌治疗小儿厌食症疗效观察[J].现代中西医结合杂志, 2017, 26(26):2918-2920.
[10]连俊兰,邵征洋,陈颖,等.四逆散加味治疗小儿肝旺脾虚型厌食症40例疗效观察[J].中医儿科杂志, 2013,9(3):18-19.
[11]毕胜,王雪峰.儿童厌食症中医证候文献分析[J].中国中西医结合儿科学, 2014, 6(1):6-7.
[12]谢晓丽.辨证论治小儿厌食症42例[J].陕西中医, 2012,33(4):443-445.
[13]黄冬梅,李江全.中医治疗小儿厌食症[J].长春中医药大学学报, 2 013, 29(6):1038-1040.
[14]宋文朗.四君子汤对脾虚证慢性胃炎患者胃动力的影响[J].安徽医药, 2013, 17(2):298-300.
[15]高永珍,武瑞珍,陈永利.四君子汤在中医内科疾病脾胃气虚证中的应用[J].中国民族民间医药, 2013, 22(5):52.
[16]吕苑.四君子汤的药理研究和临床应用[J].中医研究,2012, 25(1):76-78.
[17]冯骥.四君子汤在中医内科疾病脾胃气虚证中的应用[J].中医临床研究, 2014, 6(2):46-47.
[18]李琳.四君子汤对肠梗阻解除后肠黏膜屏障功能影响的实验研究[J].天津中医药, 2015(6):356-358.
[19]邓文祥,李亮,吴华英,等.四君子汤对FCIR大鼠大脑皮质神经保护作用的实验研究[J].湖南中医药大学学报,2016, 36(11):9-12.
[20]陈洁生.四君子汤联合肠内营养支持促进胃癌术后恢复临床研究[J].吉林中医药, 2013, 33(4):383-385.
[21]纪云飞,王瑞君,李晓波.复方四君子汤的化学成分和药理作用研究进展[J].中草药, 2016, 47(5):837-843.
[22]周虹.四君子汤加味对厌食症患儿血清促人生长激素腺释放肽与瘦素水平的影响[J].现代中西医结合杂志,2015, 24(35):3908-3910.
[23]周俊亮,潘奔前,叶伟成.四君子汤加减治疗肝旺脾虚型小儿厌食症24例[J].湖南中医杂志, 2012, 28(3):62-63.
[24]黄静,邓静.自拟健脾和胃汤治疗小儿脾胃虚弱型厌食症的临床研究[J].重庆医学, 2016, 45(17):2409-2410.