疏风清热、化痰散结法治疗儿童腺样体肥大痰热互结型34例临床观察

Clinical observation on 34 cases of adenoid hypertrophy in children of phlegm heat interaction type treated by the methods of soothing wind and clearing heat and resolving phlegm

目的 观察疏风清热、化痰散结法治疗儿童腺样体肥大(AH)痰热互结型的临床疗效。方法 选取2021年5月至2022年5月在厦门市中医院儿科门诊治疗的腺样体肥大痰热互结型患儿68例,按照随机数字表法分为治疗组和对照组,各34例。对照组予糠酸莫米松鼻喷雾剂喷鼻,治疗组予紫正地黄汤合消瘰丸加减口服,2组均连续治疗4周后统计疗效。结果 治疗组总有效率为88.24%(30/34),对照组为76.47%(26/34),2组比较,差异有统计学意义(P<0.05)。治疗前2组的鼻塞、睡眠打鼾及张口呼吸评分比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上述评分均显著下降,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组降低更显著(P<0.05)。治疗前,2组鼻咽侧位片A/N值比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组的A/N值均较同组治疗前明显降低,差异有统计学意义(P<0.05),且治疗组降低更显著(P<0.05)。结论 疏风清热、化痰散结法治疗儿童AH痰热互结型,能有效改善临床症状,显著降低A/N值,值得临床推广应用。

Objective To observe the clinical efficacy of the methods of soothing wind,clearing heat and resolving phlegm in the treatment of children with adenoid hypertrophy of phlegm heat interaction type.Methods 68 children with adenoid hypertrophy of phlegm heat interaetion type who were treated at the pediatric outpatient department of Xiamen Traditional Chinese Medicine Hospital from May 2021 to May 2022 were selected and divided into a treatment group and a control group in a random number table,with 34 cases in each group.The control group was given mometasone furoate nasal spray,and the treatment group was given Zizheng Dihuang Tang(紫正地黄汤) and modified Xiaoluo Wan(消瘰丸) orally.Both groups had statistical efficacy after 4 weeks of continuous treatment.Results The total effective rate of the treatment group was 88.24%(30/34),while the control group was 76.47%(26/34).There was a statistically significant difference between the two groups(P<0.05).There was no statistically significant difference(P<0.05) in the scores of nasal congestion,sleep snoring,and open mouth breathing between the two groups before treatment,indicating comparability.After treatment,the above scores in both groups significantly decreased,and compared with the same group before treatment,the difference was statistically significant(P<0.05),and the decrease in the treatment group was more significant(P<0.05).Before treatment,there was no statistically significant difference in A/N values between the two groups of nasopharyngeal lateral films(P<0.05),indicating comparability.After treatment,the A/N values of both groups significantly decreased compared to before treatment in the same group,with a statistically significant difference(P<0.05),and the decrease was more significant in the treatment group(P<0.05).Conclusion The method of soothing wind,clearing heat and resolving phlegm can effectively improve clinical symptoms,significantly reduce A/N values,and has a definite therapeutic effect in the treatment of children with AH.It is applicable for clinical popularization.