针刺四缝穴联合醒脾消食汤治疗脾失健运型小儿厌食症临床研究

Clinical Study on Acupuncture at Sifeng Point Combined with Xingpi Xiaoshi Tang for Children with Anorexia of Spleen Failing in Transportation Type

目的:观察针刺四缝穴联合醒脾消食汤治疗脾失健运型小儿厌食症的临床疗效及对患儿中医证候评分、血清细胞因子水平的影响。方法:选取72例脾失健运型厌食症患儿作为研究对象,按随机数字表法分为对照组及观察组各36例。对照组采用赖氨肌醇B12口服溶液进行治疗,观察组在对照组基础上采用针刺四缝穴联合醒脾消食汤治疗。2组均治疗1个月。比较2组治疗1个月后的临床疗效,比较2组治疗前、治疗1个月后中医证候积分、生长发育情况及血清细胞因子[血清胃泌素(GAS)、神经肽(NPY)、增食欲素-A (Orexin-A)]水平的变化。结果:治疗1个月后,观察组临床疗效总有效率为94.44%,对照组为77.78%,2组比较,差异有统计学意义(P<0.05)。治疗1个月后,2组中医证候积分中大便不调、自汗、食量减少、食欲减退评分均较治疗前下降,观察组上述4项评分均低于对照组,差异均有统计学意义(P<0.05)。治疗1个月后,2组体质量指数、身高指标值均较治疗前升高,摄食量症状评分均较治疗前下降,差异均有统计学意义(P<0.05);观察组体质量指数、身高指标值均高于对照组,摄食量症状评分低于对照组,差异均有统计学意义(P<0.05)。治疗1个月后,2组血清GAS、NPY、Orexin-A水平均较治疗前升高,观察组血清GAS、NPY、Orexin-A水平均高于对照组,差异均有统计学意义(P<0.05)。结论:针刺四缝穴联合醒脾消食汤治疗脾失健运型小儿厌食症,可有效缓解患儿临床症状,改善患儿胃肠道功能,促进生长发育。

Objective:To observe the clinical effect of acupuncture at Sifeng point(EX-UE10) combined with Xingpi Xiaoshi tang for children with anorexia of spleen failing in transportation type and its effect on Chinese medicine syndrome scores and levels of cytokines in serum. Methods: A total of 72 cases of children with anorexia of spleen failing in transportation type were selected as the study subjects, and divided into the control group and the observation group according to the random number table method,with 36 cases in each group. The control group was treated with Lysine Inosite Vitamin BOral Solution,and the observation group was additionally treated with acupuncture at Sifeng point combined with Xingpi Xiaoshi tang based on the treatment of the control group. Both groups were treated for one month. After one-month treatment,the clinical effects in the two groups were compared. Before treatment and after one-month treatment, the changes in Chinese medicine syndrome scores, growth and development situation and levels of cytokines in serum including gastrin(GAS),neuropeptide Y(NPY) and Orexin-A in the two groups were compared. Results:After one-month treatment,the total effective rate of clinical effect was 94.44% in the observation group and 77.78% in the control group,the difference being significant(P<0.05). After one-month treatment, the Chinese medicine syndrome scores of abnormal defecation and spontaneous sweating, complexion, food intake and appetite in the two groups were decreased when compared with those before treatment, and the above four scores in the observation group were lower than those in the control group,differences being significant(P<0.05). After one-month treatment,the body mass and height in the two groups were increased when compared with those before treatment,and the symptom scores of food intake were decreased,differences being significant(P<0.05);the body mass and height in the observation group were higher than those in the control group,and the symptom score of food intake was lower,differences being significant(P<0.05). After one-month treatment,the levels of GAS,NPY and Orexin-A in serum in the two groups were increased when compared with those before treatment,and the levels of GAS,NPY and Orexin-A in serum in the observation group were higher than those in the control group,differences being significant(P<0.05). Conclusion:Acupuncture at Sifeng point combined with Xingpi Xiaoshi tang for children with anorexia of spleen failing in transportation type can effectively relieve clinical symtpoms,improve gastrointestinal tract function and promote the growth and development.