自拟通窍宣痹汤治疗小儿慢性腺样体炎气血瘀阻证39例临床观察

Clinical observation on 39 cases of chronic adenoiditis in children with stagnation of qi and blood syndrome treated by self-made Tongqiao Xuanbi Tang(通窍宣痹汤)

目的观察自拟通窍宣痹汤治疗小儿慢性腺样体炎气血瘀阻证的临床疗效。方法选取2019年3月1日至2020年1月20日在黑龙江中医药大学附属第一医院儿科二科门诊就诊的80例慢性腺样体炎气血瘀阻证患儿,按随机数字表法分为治疗组和对照组,各40例。治疗期间治疗组因依从性差脱落1例,对照组因药物过敏脱落3例,最终实际完成76例(治疗组39例,对照组37例)。对照组予孟鲁司特钠咀嚼片口服,布地奈德鼻喷雾剂双侧鼻腔喷入;治疗组予自拟通窍宣痹汤治疗。2组治疗期间,嘱患儿减少户外活动,避风寒,慎起居,清淡饮食,降低感染概率。2组均连续治疗3周后统计疗效。结果对照组总有效率为83.79%(31/37),治疗组为94.87%(37/39),2组比较,差异有统计学意义(P<0.05)。治疗前2组打鼾、鼻后滴漏感、咽部异物感症状积分比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组打鼾、鼻后滴漏感、咽部异物感症状积分明显下降,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组下降更显著(P<0.05)。治疗前2组影像学检查(X线鼻咽侧位片或鼻窦CT)积分比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组影像学检查积分均显著下降,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组下降更显著(P<0.05)。2组治疗前后,血常规、肝肾功能及心电图检查均未见异常。结论自拟通窍宣痹汤治疗小儿慢性腺样体炎气血瘀阻证,能明显改善患儿临床症状,疗效确切,且无明显不良反应,值得临床推广应用。

Objective To observe the clinical efficacy of self-made Tongqiao Xuanbi Tang(通窍宣痹汤)in the treatment of chronic adenoiditis in children with stagnation of qi and blood syndrome.Methods From March 1,2019 to January 20,2020,80 cases of chronic adenoiditis in children with stagnation of qi and blood syndrome consulted in the outpatient service of the second department of pediatrics in The First Affiliated Hospital of Heilongjiang University of Chinese medicine were divided into treatment group and control group according to random number table method,with 40 cases in each group.During treatment,there was 1 drop-out case in the treatment group due to poor compliance and 3 drop-out cases in the control group due to drug allergy,and finally 76 cases were actually completed(39 cases in the treatment group and 37 cases in the control group).The control group was given montelukast sodium chewable tablets orally and sprayed budesonide nasal spray into the bilateral nasal cavity,while the treatment group was given self-made Tongqiao Xuanbi Tang.During the treatment of the 2 groups,the children were advised to reduce outdoor activities,avoid wind-cold,be careful in daily life,have a bland diet,and reduce the risk of infection.After 3 weeks of continuous treatment,we kept statistics about the curative effects of the 2 groups.Results The total effective rate was 83.79%(31/37)in the control group and 94.87%(37/39)in the treatment group,and the difference was statistically significant between the 2 groups(P<0.05).Before treatment,there was no significant difference in the symptom scores of snoring,postnasal drip sensation and foreign body sensation of the pharynx between the 2 groups(P>0.05),indicating comparability;After treatment,the symptom scores of snoring,postnasal drip sensation and foreign body sensation of the pharynx in the 2 groups decreased significantly,and the differences were statistically significant than those of the same group before treatment(P<0.05),moreover,the decrease in the treatment group was more significant(P<0.05).Before treatment,there were no significant differences in the scores of imaging examination(X-ray lateral nasopharynx film or CT scanning of the nasal sinuses)between the 2 groups(P>0.05),indicating comparability;After treatment,the imaging examination scores of the 2 groups decreased significantly,and the differences were statistically significant than those in the same group before treatment(P<0.05),moreover,the decrease was more significant in the treatment group(P<0.05).Before and after treatment,there were no abnormalities in blood routine examination,liver and kidney function examination and ECG examination in the 2 groups.Conclusion It can markedly alleviate the clinical symptoms of children patients,with definite curative effects and no marked adverse reactions to use self-made Tongqiao Xuanbi Tang in the treatment of chronic adenoiditis in children with stagnation of qi and blood syndrome,which is worthy of clinical promotion and application.