中西医结合治疗儿童湿疹的效果分析

Efficacy of integrated Chinese and Western medicine in the treatment of eczema in children

目的评价以小儿推拿特色疗法为主的儿童湿疹中西医结合治疗方案的效果。方法选取2021年6月至2023年6月来自新兴县人民医院、新兴县中医院门诊收治的80例湿疹患儿作为研究对象进行前瞻性研究,采用简单随机方法分为治疗组和对照组,每组40例。对照组40例中男21例、女19例,年龄(4.38±1.05)岁;治疗组40例中男23例、女17例,年龄(4.43±1.13)岁。对照组治疗措施根据患者病情选择使用,主要包括疾病治疗、基础护理、抗组胺药片、免疫系统调节剂等;治疗组在常规治疗的基础上,联合小儿推拿特色疗法;治疗2周为1个疗程。在治疗1个疗程后评估临床疗效,比较两组特应性皮炎积分指数(SCORAD)评分、儿童皮肤病生活质量指数(CDLQI)评分,在第4周、5周、8周进行随访跟踪长期疗效。采用t检验、χ^(2)检验。结果治疗2周后,对照组总有效率为72.5%(29/40),治疗组为92.5%(37/40),差异有统计学意义(χ^(2)=5.541,P=0.019)。治疗前,对照组的SCORAD评分、CDLQI评分分别为(42.77±12.51)分、(16.93±5.61)分,治疗组分别为(41.20±13.68)分、(15.60±5.82分),差异均无统计学意义(t=0.537、1.036,P=0.593、0.303)。治疗2周后,对照组的SCORAD评分、CDLQI评分分别为(23.25±14.72)分、(11.00±6.96)分,治疗组分别为(13.20±12.71)分、(7.47±6.47)分,同组治疗前后比较差异均有统计学意义(t=9.943、9.596、15.441、10.377,均P<0.001);两组治疗后比较差异均有统计学意义(t=3.268、2.346,P=0.002、0.022)。随访第4周、5周、8周,对照组复发率分别为41.4%(12/29)、51.7%(15/29)、58.6%(17/29),治疗组复发率分别为10.8%(4/37)、16.2%(6/37)、18.9%(7/37),差异均有统计学意义(χ^(2)=8.272、9.448、11.074,均P<0.01)。结论中西医结合治疗儿童湿疹不但近期疗效确切,而且远期疗效稳定,复发率低。

Objective To evaluate the treatment plan of integrative Chinese and Western medicine for eczema in children,which is mainly characterized by pediatric massage.Methods Through the research of evidence-based medical literatures and expert consultations,combined with the characteristic therapy of traditional Chinese medicine(TCM)pediatric massage,a new treatment scheme of integrated Chinese and Western medicine was finally formed.A total of 80 children with eczema admitted to People's Hospital of Xinxing County and Xinxing Hospital of Traditional Chinese Medicine from June 2021 to June 2023 were selected as the research objects for a prospective study,and were divided into a treatment group and a control group by the simple random method,with 40 cases in each group.The control group included 21 boys and 19 girls,aged(4.38±1.05)years.The treatment group included 23 boys and 17 girls,aged(4.43±1.13)years.The treatment measures of the control group were selected according to the patients'condition,including disease treatment,basic nursing,antihistamine tablets,immune system modulators,etc.The treatment group was combined with pediatric massage characteristic therapy on the basis of conventional treatment.The treatment lasted for 2 weeks.The clinical efficacy was evaluated after 1 course of treatment,and the scores of Scoring Atopic Dermatitis(SCORAD)and Children's Dermatology Life Quality Index(CDLQI)were compared between the two groups.The long-term efficacy was followed up at 4,5,and 8 weeks.t test andχ^(2) test were used.Results After 2 weeks of treatment,the total effective rate was 72.5%(29/40)in the control group and 92.5%(37/40)in the treatment group,with a statistically significant difference(χ^(2)=5.541,P=0.019).Before treatment,the scores of SCORAD and CDLQI of the control group were(42.77±12.51)points and(16.93±5.61)points,and those of the treatment group were(41.20±13.68)points and(15.60±5.82)points,without statistically significant differences(t=0.537 and 1.036,P=0.593 and 0.303).After 2 weeks of treatment,the scores of SCORAD and CDLQI of the control group were(23.25±14.72)points and(11.00±6.96)points,those of the treatment group were(13.20±12.71)points and(7.47±6.47)points,and there were statistically significant differences before and after treatment in the same group(t=9.943,9.596,15.441,and 10.377,all P<0.001).There were statistically significant differences between the treatment group and the control group after treatment(t=3.268 and 2.346,P=0.002 and 0.022).At 4,5,and 8 weeks of follow-up,the recurrence rates were 41.4%(12/29),51.7%(15/29),and 58.6%(17/29)in the control group,and 10.8%(4/37),16.2%(6/37),and 18.9%(7/37)in the treatment group,with statistically significant differences(χ^(2)=8.272,9.448,and 11.074,all P<0.01).Conclusion Integrated Chinese and western medicine in the treatment of pediatric eczema not only has a definite short-term effect,but also has a stable long-term effect and a low recurrence rate.