综合疗法配合健康宣教一体化治疗小儿厌食症脾失健运证30例临床观察

Clinical observation on 30 cases of anorexia in children with failure of spleen in transportation syndrome treated by comprehensive therapy cooperated with integrated health education

目的观察中药内服外治配合健康宣教一体化治疗小儿厌食症脾失健运证的临床疗效。方法选取2019年1—12月在上海市静安区中心医院董氏中医儿科门诊就诊的厌食症脾失健运证患儿120例,采用随机数字表法分为外治组、内服组、内服外治组和综合治疗组,各30例。外治组针挑四缝穴,内服组口服中药董氏苏脾饮加减,内服外治组治疗方法同外治组和内服组,综合组在内服外治组治疗方法的基础上配合对患儿家长的培训宣教。4组均4周为1个疗程,连续治疗2个疗程并随访2个月后统计临床疗效,比较治疗前后中医证候积分和体质量、血红蛋白(Hb)变化情况。结果外治组、内服组、内服外治组和综合治疗组的总有效率分别为83.3%(25/30)、76.7%(23/30)、90.0%(27/30)、96.7%(29/30),内服外治组和综合治疗组总有效率明显优于外治组和内服组,且综合治疗组疗效最显著,差异均有统计学意义(P<0.05)。治疗前,4组中医主症和次症积分比较,差异无统计学意义(P>0.05),具有可比性;治疗后,与同组治疗前比较,4组上述积分均显著减少(P<0.05),内服外治组和综合治疗组改善程度明显优于外治组和内服组,且综合治疗组改善最显著,差异有统计学意义(P<0.05)。治疗前,4组体质量和Hb水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后,与同组治疗前比较,4组体质量和Hb水平均显著增加(P<0.05),内服外治组和综合治疗组改善程度明显优于外治组和内服组,且综合治疗组改善最显著,差异有统计学意义(P<0.05)。结论中药内服外治配合健康宣教一体化治疗小儿厌食症脾失健运证,可显著改善患儿临床症状,疗效显著,值得临床推广应用。

Objectivee To observe the clinical efficacy of oral administration and external treatment(OAET)of Chinese materia medica(CMM)cooperated with integrated health education for anorexia in children with failure of spleen in transportation syndrome.Methods From January to December in 2019,120 cases of anorexia in children with failure of spleen in transportation syndrome consulted in department of DONG's TCM pediatrics of Shanghai Jing'an District Central Hospital were chosen and divided into external treatment group,oral administration group,OAET group as well as comprehensive treatment group,with 30 cases in each group.The external treatment group was pricked with needle at Sifeng(EX-UE 10),and the oral administration group was given CMM modified DONC's Supi Yin(董氏苏脾饮)orally.The treatment method of the OAET group was the same as that of the external treatment group and the oral administration group.The comprehensive group cooperated with the training and education of the parents of the children on the basis of the trcatmcnt mcthod of the OAET group.All 4 groups took 4 weeks as 1 course of treatment,with 2 courses of continuous treatment and a follow-up of 2 months.The clinical efficacy was assessed,and the changes of TCM syndrome score,body mass and hemoglobin(Hb)before and after treatment among the 4 groups were compared.Results The total effective rates of the external treatment group,the oral administration group,the 0AET group and the comprehensive group were 83.3%(25/30),76.7%(23/30),90.0%(27/30)and 96.7%(29/30),respectively.The total effective rates of the OAET group and the comprehensive group were significantly better than those of the external treatment group and the oral administration group,and the curative effect of the comprehensive group was the most significant,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference among the 4 groups in terms of TCM primary symptoms and minor symptoms(P>0.05),indicating comparability.After treatment,the above scores of the 4 groups significantly reduced as compared with the same group before treatment(P<0.05).The improvement degree of the OAET group and the comprehensive group was significantly beter than that of the external treatment group and the oral administration group,and the improvement of the comprehensive group was the most significant,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in body mass and Hb levels among the 4 groups(P>0.05),indicating comparability.After treatment,the body mass and Hb levels in the 4 groups increased significantly as compared with the same group before treatment(P<0.05).The improvement degree of the OAET group and the comprehensive group was significantly better than that of the external treatment group and the oral administration group,and the comprehensive group improved the most significantly(P<0.05).Conclusion It has satisfactory efficacy,can markedly alleviate the clinical symptoms of children patients to use OAET of CMM cooperated with integrated health education in the treatment of anorexia in children with failure of spleen in transportation syndrome.