脏腑点穴配合揿针治疗胃肠结热证小儿肠系膜淋巴结炎的临床效果

Clinical Study of Digital-Acupoint Pressure of Zang-Fu Combined with Needle-Embedding Therapy in the Treatment of Mesenteric Lymphadenitis with Gastrointestinal Heat Retention Syndrome in Children

目的 探讨脏腑点穴配合揿针治疗胃肠结热证小儿肠系膜淋巴结炎(ML)的临床效果。方法 选取2021年5月—2023年5月120例胃肠结热证小儿ML为研究对象,随机分为点穴组、揿针组、联合组,每组40例。3组予以头孢克肟、利巴韦林治疗,在此基础上,点穴组予以脏腑点穴,揿针组予以揿针治疗,联合组予以脏腑点穴联合揿针治疗。统计3组临床疗效,对比治疗前后中医证候积分、腹部彩色多普勒检查参数、白细胞计数、C反应蛋白、免疫球蛋白A、G水平及肠道菌群变化。结果 联合组总有效率为97.50%(39/40),高于点穴组的80.00%(32/40)、揿针组77.50%(31/40)(P<0.05)。治疗后,联合组中医证候主症和次症积分、淋巴结横径及纵径低于点穴组、揿针组(P<0.05);治疗后,联合组白细胞计数、C反应蛋白水平低于点穴组、揿针组(P<0.05);治疗后,联合组免疫球蛋白A、G水平高于点穴组、揿针组(P<0.05);治疗后,联合组乳杆菌、双歧杆菌高于点穴组、揿针组,肠杆菌、大肠埃希菌低于点穴组、揿针组(P<0.05)。点穴组与揿针组上述指标比较差异均无统计学意义(P>0.05)。结论 脏腑点穴配合揿针治疗胃肠结热证小儿ML的效果显著,可改善临床症状,缩小增大淋巴结,抑制炎症反应,提高机体免疫功能,纠正肠道菌群失衡状态。

Objective To investigate the clinical effect of digital-acupoint pressure of Zang-Fu combined with needle-embedding therapy in the treatment of mesenteric lymphadenitis(ML) with gastrointestinal heat retention syndrome in children.Methods From May 2021 to May 2023,120 ML children with gastrointestinal heat retention syndrome were selected as the research subjects,and randomly divided into the digital-acupoint pressure group,the needle-embedding therapy group and the combination group,with 40 cases in each group.The three groups were treated with Cefixime and Ribavirin tablets.On this basis,the digital-acupoint pressure group was treated with digital-acupoint pressure of Zang-Fu,the needle-embedding therapy group was treated with needle-embedding therapy,and the combination group was treated with digital-acupoint pressure of Zang-Fu combined with needle-embedding therapy.The clinical effects of the three groups were analyzed,and the changes of TCM syndrome score,abdominal color Doppler examination parameters,white blood cell(WBC) count,C reactive protein(CRP),immunoglobulin A(IgA),immunoglobulin G(IgG) levels and intestinal flora before and after treatment were compared.Results The total effective rate in combination group was 97.50%(39/40),which was higher than 80.00%(32/40) in digital-acupoint pressure group and 77.50%(31/40) in needle-embedding therapy group(P<0.05).After treatment,the main and secondary syndrome scores,transverse and longitudinal diameter of lymph nodes in combination group were lower than those in digital-acupoint pressure group and needle-embedding therapy group(P<0.05).After treatment,WBC count and CRP level in combination group were lower than those in digital-acupoint pressure group and needle-embedding therapy group(P<0.05).After treatment,the levels of IgA and IgG in combination group were higher than those in digital-acupoint pressure group and needle-embedding therapy group(P<0.05).After treatment,lactobacillus and bifidobacterium in combination group were higher than those in digital-acupoint pressure group and needle-embedding therapy group,and enterobacter and Escherichia coli were lower than those in digital-acupoint pressure group and needle-embedding therapy group(P<0.05).There was no significant difference in the above indexes between the digital-acupoint pressure group and the needle-embedding therapy group(P>0.05).Conclusion Digital-acupoint pressure of Zang-Fu combined with the needle-embedding therapy has a significant effect on the treatment of ML children with gastrointestinal heat retention syndrome,which can improve clinical symptoms,reduce the enlarged lymph nodes,inhibit inflammatory response,improve immune function,and correct the imbalance of intestinal flora.