健脾止泻汤联合推拿治疗小儿腹泻的疗效及对免疫功能的影响
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摘要
目的:探讨中医健脾止泻汤联合推拿治疗小儿腹泻的临床疗效及对免疫功能的影响。方法:120例腹泻患儿,根据治疗方法分为联合组(中医健脾止泻汤联合推拿、西医常规疗法治疗)和对照组(西医常规疗法)各60例,对比两组患儿治疗前后的临床症候积分、临床效果及免疫功能指标。结果:治疗前,两组患儿的IgA、IgG、CD~+_4/CD~+_8值差异不具有统计学意义(P>0.05);治疗后,联合组患儿的IgA、IgG、CD~+_4/CD~+_8值均显著的高于对照组(P<0.05);治疗前,两组患儿的大便次数、大便性状、发热、腹痛、呕吐、口渴、烦躁萎靡评分差异不具有统计学意义(P>0.05);治疗后,联合组患儿的大便次数、大便性状、发热、腹痛、呕吐、口渴、烦躁萎靡评分均显著的低于对照组(P<0.05);联合组患儿的痊愈率66.67%、显效率25.00%、进步率8.33%,对照组痊愈率46.67%、显效率33.33%、进步率18.33%、无效率1.67%,两组比较差异具有统计学意义(P<0.05)。结论:中医健脾止泻汤联合推拿治疗小儿腹泻能改善其免疫水平、临床症状,提高临床疗效。
Objective:To explore the clinical effect of Chinese medicine Jianpi Zhixie Decoction combined Tuina on infantile diarrhea and its influence on the immune function. Methods:Totally 120 cases of children with diarrhea were divided into combined group(Chinese medicine Jianpi Zhixie Decoction combined with Tuina and conventional western medicine therapy) and control group(routine therapy) with 60 cases in each. Two groups were compared clinical symptom score, clinical effect and immune function index therapy before and after. Results:Before treatment, two groups' IgA, IgG and CD~+_4/CD~+_8 value were not statistically significant(P>0.05). After treatment, the combined group's IgA, IgG and CD~+_4/CD~+_8 were significantly higher than that of control group(P<0.05). Before treatment, two groups' stool frequency, stool, fever, abdominal pain, vomiting, thirst and irritability depression score were not statistically significant(P>0.05). After treatment, combined with groups' stool frequency and characters, fever, abdominal pain, vomiting, thirst and irritability depression scores were significantly lower than those of the control group(P<0.05). The combined group's cure rate was 66.67%, significant efficiency 25% and progress rate 8.33%. The control group's cure rate was 46.67%, significant efficiency 33.33%,progress rate 18.33% and the ineffective rate was 1.67%. There were significant differences between the two groups(P<0.05). Conclusion:The combination of Chinese medicine Jianpi Zhixie Decoction and Tuina in the treatment of infantile diarrhea can improve the immune level, clinical symptoms and the clinical effect.
Objective:To explore the clinical effect of Chinese medicine Jianpi Zhixie Decoction combined Tuina on infantile diarrhea and its influence on the immune function. Methods:Totally 120 cases of children with diarrhea were divided into combined group(Chinese medicine Jianpi Zhixie Decoction combined with Tuina and conventional western medicine therapy) and control group(routine therapy) with 60 cases in each. Two groups were compared clinical symptom score, clinical effect and immune function index therapy before and after. Results:Before treatment, two groups' IgA, IgG and CD~+_4/CD~+_8 value were not statistically significant(P>0.05). After treatment, the combined group's IgA, IgG and CD~+_4/CD~+_8 were significantly higher than that of control group(P<0.05). Before treatment, two groups' stool frequency, stool, fever, abdominal pain, vomiting, thirst and irritability depression score were not statistically significant(P>0.05). After treatment, combined with groups' stool frequency and characters, fever, abdominal pain, vomiting, thirst and irritability depression scores were significantly lower than those of the control group(P<0.05). The combined group's cure rate was 66.67%, significant efficiency 25% and progress rate 8.33%. The control group's cure rate was 46.67%, significant efficiency 33.33%,progress rate 18.33% and the ineffective rate was 1.67%. There were significant differences between the two groups(P<0.05). Conclusion:The combination of Chinese medicine Jianpi Zhixie Decoction and Tuina in the treatment of infantile diarrhea can improve the immune level, clinical symptoms and the clinical effect.
引文
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[16] 翟红敏,熊振芳,李圣洁,等.中西医结合治疗小儿腹泻的临床观察[J].湖北中医药大学学报,2016,18(6):79-81.
[17] 王正华.醒脾养儿颗粒配合推拿治疗小儿泄泻脾虚型疗效观察[J].实用中医药杂志,2016,32(12):1157.
[18] 唐雨兰,李铁浪,刘迈兰,等.捏脊疗法治疗脾虚型小儿泄泻的临床疗效观察[J].针灸推拿医学(英文版),2016,14(5):340-346.
[19] 雷建波,王德军,李江山,等.湖湘刘氏小儿推拿“推五经”为主治疗小儿脾虚型泄泻疗效观察[J].按摩与康复医学,2016,2(1):37-40.
[20] 王永莉,薛明,田新峰,等.截泻汤加减对急性腹泻的治疗作用及对细胞免疫功能的影响[J].世界中医药,2017,12(8):1816-1819,1823.
[21] 吴蓉,李国熊,李丽,等.消化性溃疡患者外周血细胞免疫及体液免疫功能变化分析[J].中国全科医学,2016,19(20):2481-2485.
[2] 卢建华,刘晓律.双歧三联活菌片联合蒙脱石散治疗小儿腹泻疗效及对患儿免疫功能的影响[J].临床和实验医学杂志,2015(2):125-127.
[3] 张春宇.推拿联合中药敷脐治疗小儿腹泻64例疗效分析[J].中华全科医学,2015,13(6):964-965,968.
[4] 路桃影,郭兰中,郭伟,等.推拿治疗小儿腹泻临床研究的系统评价[J].中国妇幼保健,2015,30(31):5507-5510.
[5] 胡亚美,江载芳.诸福堂实用儿科学[M].7版.北京:人民卫生出版社,2002:1286.
[6] 郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:125.
[7] Mejia A,Atehortua S,Florez I D,et al.Cost-Effectiveness Analysis of Zinc Supplementation for Treatment of Acute Diarrhea in Children Younger Than 5 Years in Colombia[J].Journal of pediatric gastroenterology and nutrition,2015,60(4):515-520.
[8] 万朝敏,俞蕙,刘钢,等.布拉酵母菌预防婴幼儿抗生素相关性腹泻的多中心随机对照研究[J].中华儿科杂志,2017,55(5):349-354.
[9] 吕一枝,张新军,李志飞,等.赖氨葡锌颗粒联合蒙脱石散和双歧杆菌乳杆菌三联活菌颗粒治疗小儿腹泻的效果[J].中国生化药物杂志,2016,36(12):167-169.
[10] 宋代平,余莉.口服酪酸梭菌活菌片联合小儿速泻停颗粒治疗轮状病毒肠炎疗效观察[J].海南医学,2016,27(24):4042-4044.
[11] 江红.双歧三联活菌片联合蒙脱石散治疗小儿腹泻疗效及对患儿免疫功能的影响[J].临床医学,2016,36(9):14-16.
[12] 陈颖,石明芳,曾嵘,等.双歧杆菌活菌联合蒙脱石散治疗小儿腹泻疗效观察[J].西部医学,2016,28(5):687-690.
[13] 孙建民.中药敷脐治疗小儿腹泻临床研究[J].河南中医,2016,36(2):270-271.
[14] 王全权,宗芳,黄慧敏,等.推拿手法结合神阙灸治疗小儿腹泻疗效观察[J].中国中医急症,2016,25(10):1963-1965.
[15] Nielsen C,Agergaard CN,Jakobsen MA,et al.Infantile Hemophagocytic Lymphohistiocytosis in a Case of Chediak-Higashi Syndrome Caused by a Mutation in the LYST/CHS1 Gene Presenting With Delayed Umbilical Cord Detachment and Diarrhea[J].Journal of pediatric hematology/oncology: Official journal of the American Society of Pediatric Hematology/Oncology,2015,37(2):E73-E79.
[16] 翟红敏,熊振芳,李圣洁,等.中西医结合治疗小儿腹泻的临床观察[J].湖北中医药大学学报,2016,18(6):79-81.
[17] 王正华.醒脾养儿颗粒配合推拿治疗小儿泄泻脾虚型疗效观察[J].实用中医药杂志,2016,32(12):1157.
[18] 唐雨兰,李铁浪,刘迈兰,等.捏脊疗法治疗脾虚型小儿泄泻的临床疗效观察[J].针灸推拿医学(英文版),2016,14(5):340-346.
[19] 雷建波,王德军,李江山,等.湖湘刘氏小儿推拿“推五经”为主治疗小儿脾虚型泄泻疗效观察[J].按摩与康复医学,2016,2(1):37-40.
[20] 王永莉,薛明,田新峰,等.截泻汤加减对急性腹泻的治疗作用及对细胞免疫功能的影响[J].世界中医药,2017,12(8):1816-1819,1823.
[21] 吴蓉,李国熊,李丽,等.消化性溃疡患者外周血细胞免疫及体液免疫功能变化分析[J].中国全科医学,2016,19(20):2481-2485.