六味地黄汤加减联合针刺治疗小儿外部性脑积水疗效观察
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摘要
目的:探讨六味地黄汤加减联合针刺治疗小儿外部性脑积水的临床疗效。方法:样本选择医院门诊2012年3月—2015年7月收治的小儿外部性脑积水患儿129例,随机分为中药组、针刺组和联合组,每组43例患儿,3组均采用推拿、功能训练等康复训练方法进行综合治疗,其中中药组加用六味地黄汤加减治疗,针刺组加用针刺治疗,联合组加用六味地黄汤加减联合针刺治疗,治疗后评估患儿治疗效果、治疗前后患儿智力发育指数(MDI)、运动发育指数(PDI)、患儿脑电图结果非正常率情况。结果:联合组患儿治疗有效率显著高于中药组和针刺组,差异具均有统计学意义(P<0.05),中药组优于针刺组治疗前,但差异无统计学意义(P>0.05);治疗前3组患儿MDI、PDI指数相当,差异无统计学意义(P>0.05),治疗后3组患儿MDI、PDI指数显著高于组内治疗前水平,联合组患儿MDI、PDI指数改善效果优于中药组和针刺组,差异具均有统计学意义(P<0.05),中药组患儿MDI、PDI指数改善效果优于针刺组,但差异无统计学意义(P>0.05);治疗前3组患儿脑电图结果显示非正常率均较高,差异无统计学意义(P>0.05),治疗后各组患儿非正常率均降低,联合组脑电图结果显示非正常率低于中药组和针刺组,差异具均有统计学意义(P<0.05),中药组脑电图结果显示非正常率高于针刺组,但差异无统计学意义(P>0.05)。结论:在康复训练的基础上,应用六味地黄汤加减联合针刺治疗小儿外部性脑积水能够促进患儿智力发育和运动发育,可以提高临床疗效,值得临床推广使用。
Objective:To explore the clinical effect of Six Ingredients Rehmanniae Decoction on the treatment of children with external hydrocephalus. Methods:Totally 129 cases of children with external hydrocephalus treated in our hospital in July 2012-March 2015 were randomly divided into Chinese medicine group, acupuncture group and combination group. Each group had 43 patients. The three groups were treated with massage, functional training and other rehabilitation training methods. Besides,the Chinese medicine group added Six Ingredients Rehmanniae Decoction;the acupuncture group added acupuncture treatment and the combination group added Six Ingredients Rehmanniae Decoction and acupuncture treatment. After treatment,we assessed the effect, children's mental development index(MDI) and motor development index(PDI), the abnormal rate of children's EEG results. Results: The effective rate in the combination group was significantly higher than that of the traditional Chinese medicine group and the acupuncture group(P<0.05). The traditional Chinese medicine group was superior to the acupuncture group before treatment, but the difference was not statistically significant(P>0.05). The MDI and PDI of the three groups before treatment were similar and the difference was not statistically significant(P>0.05). The DI and PDI were significantly higher than those before treatment in three groups. The improvement effect of MDI and PDI in the children of the combination group was better than that of the traditional Chinese medicine group and the acupuncture group. The difference was statistically significant(P<0.05). The improvement effect of MDI and PDI in the Chinese medicine group was better than that of the acupuncture group, but the difference was not statistically significant(P>0.05). The electrogram results showed that the abnormal rate was higher and the difference was not statistically significant(P>0.05), and the abnormal rates of all the groups were decreased. The EEG results showed that the abnormal rate was lower than that of the traditional Chinese medicine group and the acupuncture group. The difference was statistically significant(P<0.05). The electroencephalogram results showed that the abnormal rate was higher than that of the acupuncture group. There was no significant difference among the groups, but the difference was not significant(P>0.05). Conclusion:On the basis of rehabilitation training, the application of Six Ingredients Rehmanniae Decoction and acupuncture for children with external hydrocephalus can promote intelligence development and motor development of children, and improve the clinical efficacy, which is worthy of clinical promotion and application.
Objective:To explore the clinical effect of Six Ingredients Rehmanniae Decoction on the treatment of children with external hydrocephalus. Methods:Totally 129 cases of children with external hydrocephalus treated in our hospital in July 2012-March 2015 were randomly divided into Chinese medicine group, acupuncture group and combination group. Each group had 43 patients. The three groups were treated with massage, functional training and other rehabilitation training methods. Besides,the Chinese medicine group added Six Ingredients Rehmanniae Decoction;the acupuncture group added acupuncture treatment and the combination group added Six Ingredients Rehmanniae Decoction and acupuncture treatment. After treatment,we assessed the effect, children's mental development index(MDI) and motor development index(PDI), the abnormal rate of children's EEG results. Results: The effective rate in the combination group was significantly higher than that of the traditional Chinese medicine group and the acupuncture group(P<0.05). The traditional Chinese medicine group was superior to the acupuncture group before treatment, but the difference was not statistically significant(P>0.05). The MDI and PDI of the three groups before treatment were similar and the difference was not statistically significant(P>0.05). The DI and PDI were significantly higher than those before treatment in three groups. The improvement effect of MDI and PDI in the children of the combination group was better than that of the traditional Chinese medicine group and the acupuncture group. The difference was statistically significant(P<0.05). The improvement effect of MDI and PDI in the Chinese medicine group was better than that of the acupuncture group, but the difference was not statistically significant(P>0.05). The electrogram results showed that the abnormal rate was higher and the difference was not statistically significant(P>0.05), and the abnormal rates of all the groups were decreased. The EEG results showed that the abnormal rate was lower than that of the traditional Chinese medicine group and the acupuncture group. The difference was statistically significant(P<0.05). The electroencephalogram results showed that the abnormal rate was higher than that of the acupuncture group. There was no significant difference among the groups, but the difference was not significant(P>0.05). Conclusion:On the basis of rehabilitation training, the application of Six Ingredients Rehmanniae Decoction and acupuncture for children with external hydrocephalus can promote intelligence development and motor development of children, and improve the clinical efficacy, which is worthy of clinical promotion and application.
引文
[1] 杨明慧, 巴音吉力格, 周辉. 婴儿外部性脑积水CT诊断[J]. 医药前沿, 2017, 7(4):199-200.
[2] 范少平. 五苓散水煎剂联合西医常规保守治疗脑外伤后交通性脑积水疗效及对肾功能的影响[J]. 现代中西医结合杂志, 2018,27(4):424-426.
[3] 平启年. 半夏白术天麻汤对外伤后脑积水患者血清碱性蛋白、S100β及p73因子表达的影响[J]. 中医学报, 2017, 32(3):440-443.
[4] 闫恒山,慈丽霞,王冬.五苓散加减治疗特发性正常颅压脑积水术后临床观察[J].四川中医,2016,34(3):138-139.
[5] 孙忠人,徐先伟. 针刺与中药并用治疗脑炎后脑积水47例观察[J].针灸临床杂志,2007,23(4):14-15.
[6] Bayley N. Bayley Scales of Infant Development[J]. Encyclopedia of Infant & Early Childhood Development, 1969, 34(2001):145-156.
[7] 陈姝姝,王多德,王薇.新生儿败血症86例临床分析[J].内蒙古中医药,2010,29(1):86-87.
[8] Lee HC, Chong S, Lee JY, et al. Benign extracerebral fluid collection complicated by subdural hematoma and fluid collection: clinical characteristics and management[J]. Childs Nervous System, 2017, 34(2):1-11.
[9] 平启年.半夏白术天麻汤对外伤后脑积水患者血清碱性蛋白、S100β及p73因子表达的影响[J].中医学报,2017,32(3):440-443.
[10] 黄海军,王勇.针刺结合棍棒操对痉挛性脑瘫患儿下肢运动功能障碍的影响[J].针灸临床杂志,2017,33(11):7-10.
[11] Hussain ZB, Hussain AB, Mitchell P. Extra-axial cerebrospinal fluid spaces in children with benign external hydrocephalus: A case-control study[J]. Neuroradiology Journal, 2017, 30(5):410-417.
[12] Wirth B, Sobey I. An axisymmetric and fully 3D poroelastic model for the evolution of hydrocephalus[J]. Mathematical Medicine & Biology A Journal of the Ima, 2018, 23(4):363-388.
[13] 单云鹏,张成军.外部性脑积水的CT诊断及临床治疗价值观察[J].中国实用医药,2016,11(28):77-78.
[14] 侯宝国,张志兰,孙金华,等.针刺结合化痰解语汤治疗缺血性脑卒中后失语症的临床疗效[J].检验医学与临床,2017,14(11):1545-1546,1549.
[15] 段锦龙,邓博,贾立群.六味地黄丸防治肿瘤的研究进展[J].中华中医药学刊,2017,35(9):2329-2331.
[16] 林旭丰,严梅娣,谢小红,等.中医周期疗法对乳腺增生伴乳痛患者内分泌激素及症状的改善观察[J].中华中医药学刊,2017,35(3):745-748.
[17] 张嘉妮, 李玉星, 杨梦琳,等. 六味地黄汤及“补泻”药对对肾阴虚模型小鼠下丘脑-垂体-性腺轴功能的影响[J]. 中国现代应用药学, 2017, 34(1):25-29.
[18] 赵彩云. 中医针灸治疗脑外伤的效果研究[J]. 黑龙江科学, 2017, 8(23):1-2.
[2] 范少平. 五苓散水煎剂联合西医常规保守治疗脑外伤后交通性脑积水疗效及对肾功能的影响[J]. 现代中西医结合杂志, 2018,27(4):424-426.
[3] 平启年. 半夏白术天麻汤对外伤后脑积水患者血清碱性蛋白、S100β及p73因子表达的影响[J]. 中医学报, 2017, 32(3):440-443.
[4] 闫恒山,慈丽霞,王冬.五苓散加减治疗特发性正常颅压脑积水术后临床观察[J].四川中医,2016,34(3):138-139.
[5] 孙忠人,徐先伟. 针刺与中药并用治疗脑炎后脑积水47例观察[J].针灸临床杂志,2007,23(4):14-15.
[6] Bayley N. Bayley Scales of Infant Development[J]. Encyclopedia of Infant & Early Childhood Development, 1969, 34(2001):145-156.
[7] 陈姝姝,王多德,王薇.新生儿败血症86例临床分析[J].内蒙古中医药,2010,29(1):86-87.
[8] Lee HC, Chong S, Lee JY, et al. Benign extracerebral fluid collection complicated by subdural hematoma and fluid collection: clinical characteristics and management[J]. Childs Nervous System, 2017, 34(2):1-11.
[9] 平启年.半夏白术天麻汤对外伤后脑积水患者血清碱性蛋白、S100β及p73因子表达的影响[J].中医学报,2017,32(3):440-443.
[10] 黄海军,王勇.针刺结合棍棒操对痉挛性脑瘫患儿下肢运动功能障碍的影响[J].针灸临床杂志,2017,33(11):7-10.
[11] Hussain ZB, Hussain AB, Mitchell P. Extra-axial cerebrospinal fluid spaces in children with benign external hydrocephalus: A case-control study[J]. Neuroradiology Journal, 2017, 30(5):410-417.
[12] Wirth B, Sobey I. An axisymmetric and fully 3D poroelastic model for the evolution of hydrocephalus[J]. Mathematical Medicine & Biology A Journal of the Ima, 2018, 23(4):363-388.
[13] 单云鹏,张成军.外部性脑积水的CT诊断及临床治疗价值观察[J].中国实用医药,2016,11(28):77-78.
[14] 侯宝国,张志兰,孙金华,等.针刺结合化痰解语汤治疗缺血性脑卒中后失语症的临床疗效[J].检验医学与临床,2017,14(11):1545-1546,1549.
[15] 段锦龙,邓博,贾立群.六味地黄丸防治肿瘤的研究进展[J].中华中医药学刊,2017,35(9):2329-2331.
[16] 林旭丰,严梅娣,谢小红,等.中医周期疗法对乳腺增生伴乳痛患者内分泌激素及症状的改善观察[J].中华中医药学刊,2017,35(3):745-748.
[17] 张嘉妮, 李玉星, 杨梦琳,等. 六味地黄汤及“补泻”药对对肾阴虚模型小鼠下丘脑-垂体-性腺轴功能的影响[J]. 中国现代应用药学, 2017, 34(1):25-29.
[18] 赵彩云. 中医针灸治疗脑外伤的效果研究[J]. 黑龙江科学, 2017, 8(23):1-2.