肠痈消炎汤灌肠治疗胃肠结热型小儿肠系膜淋巴结炎35例

Clinical effect of enema with Changyong Xiaoyan decoction in treatment of pediatric mesenteric lymphadenitis with gastrointestinal heat accumulation:An analysis of 35 cases

目的:观察肠痈消炎汤灌肠治疗胃肠结热型小儿肠系膜淋巴结炎的疗效及安全性。方法:选取胃肠结热型小儿肠系膜淋巴结炎患儿70例,将其随机分为治疗组和对照组,每组各35例。对照组给予常规西药治疗,治疗组在对照组基础上加用肠痈消炎汤灌肠治疗,疗程均为5d,随访1个月。比较2组治疗后及随访1个月的综合疗效,腹痛、呕吐、便秘、腹胀等症状消失时间,外周血白细胞(WBC)、超敏C反应蛋白(hs-CRP)恢复正常时间,住院时间,治疗前及随访1个月的肠系膜淋巴结大小。结果:治疗组脱落3例,对照组脱落2例。治疗后总有效率治疗组为81.25%(26/32),对照组为54.55%(18/33),随访1个月总有效率治疗组为90.63%(29/32),对照组为57.58%(19/33),2组比较,差异均有统计学意义(P<0.05)。腹痛、呕吐、便秘、腹胀等症状消失时间,WBC、hs-CPR恢复正常时间及住院时间治疗组均短于对照组(P<0.05);随访1个月治疗组肠系膜淋巴结缩小程度优于对照组(P<0.05)。结论:在西医治疗基础上加用肠痈消炎汤灌肠治疗胃肠结热型小儿肠系膜淋巴结炎,可提高临床疗效,缩短住院时间,促进患儿康复,优于单用西药治疗,值得临床借鉴。

Objective:To investigate the efficacy and safety of enema with Changyong Xiaoyan decoction in the treatment of pediatric mesenteric lymphadenitis with gastrointestinal heat accumulation.Methods:A total of 70 children with pediatric mesenteric lymphadenitis with gastrointestinal heat accumulation were randomly divided into treatment group and control group,with 35 patients in each group.The children in the control group were given conventional Western medicine treatment,and those in the treatment group were given enema with Changyong Xiaoyan decoction in addition to the treatment in the control group.The course of treatment was 5 days for both groups,and all children were followed up for 1 month.The two groups were compared in terms of overall response after treatment and 1-month follow-up,time to the disappearance of related symptoms(abdominal pain,vomiting,constipation,and abdominal distension),time to the normalization of peripheral blood white blood cell count(WBC)and high-sensitivity C-reactive protein(hs-CRP),length of hospital stay,and size of mesenteric lymph node before treatment and after the 1-month follow-up.Results:3 cases in the treatment group dropped out,and 2 cases in the control group dropped out.There was a significant difference in overall response rate between the treatment group and the control group after treatment[81.25%(26/32)vs 54.55%(18/33),P<0.05]and after the 1-month follow-up[90.63%(29/32)vs 57.58%(19/33),P<0.05].Compared with the control group,the treatment group had significantly shorter time to disappearance of related symptoms(abdominal pain,vomiting,constipation,and abdominal distension),time to normalization of peripheral blood WBC and hs-CRP,and length of hospital stay(P<0.05),and after the 1-month follow-up,the treatment group had a significantly greater reduction in the size of mesenteric lymph node than the control group(P<0.05).Conclusion:For pediatric mesenteric lymphadenitis with gastrointestinal heat accumulation,enema with Changyong Xiaoyan decoction in addition to Western medicine treatment can improve clinical outcome,shorten the length of hospital stay,and promote recovery and has a better clinical effect than Western medicine treatment alone,and therefore,it holds promise for clinical application.