刺络拔罐治疗小儿急性扁桃体炎临床疗效观察

Clinical effects of acupuncture and cupping therapy on acute tonsillitis in children

目的 探讨刺络拔罐治疗小儿急性扁桃体炎的临床疗效。方法 选取2019年3月—2020年9月在北京中医药大学第三附属医院就诊的急性扁桃体炎患儿102例作为研究对象,采取前瞻性、平行开放对照的研究方法,随机分为对照组和观察组,每组51例。对照组仅给予对症治疗,观察组在对症治疗的基础上加用大椎穴刺络拔罐及双手少商穴刺络放血治疗,如果观察组治疗后2 d仍有发热,再次给予上述中医外治1次。观察热退时间、咽痛好转时间、咽部充血改善时间、扁桃体肿大好转时间、扁桃体脓点消失时间等,进行证候评分;总结2组治疗的有效率;并比较治疗前及治疗5 d白细胞计数(WBC)、中性粒细胞比率(N%)、C反应蛋白(CRP)数值;治疗后2周随访复发情况。结果 观察组总有效率为98.04%(分子/分母),高于对照组的90.20%(分子/分母),但差异没有统计学意义(P>0.05)。观察组热退时间、咽痛好转时间、咽部充血改善时间均较对照组缩短,差异均有统计学意义(P<0.05)。观察组扁桃体肿大好转时间及扁桃体脓点消失时间较对照组也有一定程度的缩短,但差异没有统计学意义(P>0.05)。治疗后,2组WBC、N%、CRP的水平较治疗前均有降低趋势(P<0.05),其中观察组CRP水平明显低于对照组,差异具有统计学意义(P<0.05)。治疗后2周随访,观察组复发率明显低于对照组(P<0.05)。结论 刺络拔罐方法治疗小儿急性扁桃体炎较常规治法在改善临床症状、体征,缩短病程,减轻急性炎症反应及预防短期复发等方面具有一定疗效。

Objective To investigate the clinical effect of acupuncture and cupping therapy on acute tonsillitis in children.Methods A total of 102 children with acute tonsillitis who were admitted to the Third Affiliated Hospital of Beijing University of Chinese Medicine from March 2019 to September 2020 were recruited as the subjects. A prospective, parallel open control study was conducted and they were randomly divided into the control group and the observation group(n=51). The control group was only given symptomatic treatment, while the observation group was treated with acupuncture and cupping on Dazhui(DU 14) and acupuncture and bloodletting on Shaoshang(LU 11) on both hands on the basis of symptomatic treatment. If the subjects in the observation group still reported fever 2 days after treatment, the above-mentioned TCM treatment was given again. The time needed for the fever to go away, for pharyngeal pain to improve, for pharyngeal congestion to improve, for tonsillar enlargement to improve and for tonsillar abscess to disappear was recorded. Syndrome scores were obtained and the effective rates of the two groups were collected. WBC, N% and CRP values before and 5 days after treatment were acquired for comparison. A two-week follow-up was conducted to obtain information about disease recurrence.Results The total effective rate of the observation group was 98.04%, higher than that of the control group(90.20%), but the difference was not statistically significant(P>0.05). The time of fever reduction, improvement of pharyngeal pain and improvement of pharyngeal congestion in the observation group were shorter than those in the control group, and the differences were statistically significant(P<0.05). Compared with that of the control group, the improvement time of tonsil enlargement and the disappearance time of tonsil abscess in the observation group were also shortened, but the difference was not statistically significant(P > 0.05). After treatment, WBC, N% and CRP in the two groups were lower than those before treatment(P < 0.05), and CRP in the observation group was significantly lower than that in the control group(P < 0.05). It was found during the follow-up that, 2 weeks after treatment, the recurrence rate of observation group was significantly lower than that of control group(P < 0.05).Conclusion Compared with conventional therapy, acupuncture and cupping therapy is effective in improving clinical symptoms and signs, shortening the course of disease, alleviating acute inflammatory response and preventing recurrence.