异功散加味联合多酶片及双歧杆菌三联活菌散治疗儿童厌食症脾胃气虚证的临床疗效

Clinical Efficacy of Modified Yigongsan Combined with Multi-enzyme Tablets and Bifidobacterium Triple Live Powder in Treatment of Infantile Anorexia with Spleen-Stomach Qi Deficiency Syndrome

目的:观察异功散加味联合多酶片及双歧杆菌三联活菌散治疗儿童厌食症脾胃气虚证临床疗效。方法:研究纳入2022年1月至2023年6月河北省中医院收治的儿童厌食症脾胃气虚证患儿112例,根据随机数字表法将其分为对照组与观察组(各56例),对照组患儿采取多酶片及双歧杆菌三联活菌散治疗,观察组患儿在对照组治疗基础上联合异功散加味治疗,研究过程中两组各脱落2例。对比两组患儿临床疗效,治疗前后各组患儿中医证候(主证、次证与舌脉)积分变化,食量恢复正常时间及体质量增加量,治疗前后患儿钙、铁、锌含量变化与血红蛋白及白蛋白水平变化、胃泌素及胃动素、血管活性肠肽、生长抑素等胃肠激素水平变化、神经肽Y、促食欲素及瘦素等血清食欲调节因子水平变化,观察研究过程两组患儿的不良反应发生情况。结果:治疗后对照组患儿的总有效率为85.19%(46/54),观察组总有效率为98.15%(53/54),观察组患儿总有效率明显高于对照组(χ^(2)=5.939,P<0.05)。与对照组儿童比较,观察组儿童食量恢复正常时间更短,体质量增加更多(P<0.05)。与本组治疗前比较,两组患儿中医证候(主证、次证与舌脉)积分均显著下降,钙、铁、锌、血红蛋白、白蛋白、胃泌素、胃动素、神经肽Y、促食欲素水平均提升,血管活性肠肽、生长抑素、瘦素水平均显著下降(P<0.01);与对照组治疗后比较,观察组患儿上述指标改善更显著(P<0.01)。治疗期间两组患儿不良反应发生率相当,差异无统计学意义。结论:异功散加味结合多酶片及双歧杆菌三联活菌散治疗儿童厌食症(脾胃气虚证)临床效果甚佳,患儿治疗后症状改善,食欲及食量均增加,胃肠功能改善,体质量增加,且不良反少,治疗较为安全可靠。

Objective:To observe the clinical efficacy of modified Yigongsan combined with multienzyme tablets and bifidobacterium triple live powder on infantile anorexia with spleen-stomach Qi deficiency syndrome.Method:A total of 112 infantile patients anorexia with spleen-stomach Qi deficiency syndrome treated at Hebei Provincial Hospital of Traditional Chinese Medicine from January 2022 to June 2023 were enrolled and divided into a control group and an observation group,with 56 cases in each group,according to a random number table.Children in the control group were treated with multi-enzyme tablets and Bifidobacterium triple live powder,while those in the observation group were treated with modified Yigongsan in addition to the treatment in the control group.During the study,one case dropped out in the control group and two cases dropped out in the observation group.The clinical efficacy of the two groups of children was compared,including changes in traditional Chinese medicine(TCM)syndrome scores(main symptoms,secondary symptoms,tongue,and pulse),time to restore normal food intake,and increase in body weight.Changes in calcium,iron,zinc levels,hemoglobin,and albumin levels before and after treatment,as well as changes in gastrointestinal hormones such as gastrin and motilin,vasoactive intestinal peptide,somatostatin,neuropeptide Y,orexin,and leptin,were observed.The occurrence of adverse reactions in the two groups of children during the study was also recorded.Result:The total effective rate of children in the control group after treatment was 85.19%(46/54),while that in the observation group was 98.15%(53/54)(χ^(2)=5.939,P<0.05).Compared with the control group,the time for food intake to return to normal in the observation group was shorter,and the increase in body weight was greater(P<0.05).Compared with the results before treatment,the TCM syndrome scores(main symptoms,secondary symptoms,tongue,and pulse)in both groups of children significantly decreased,while the levels of calcium,iron,zinc,hemoglobin,albumin,gastrin,motilin,neuropeptide Y,and orexin increased,and the levels of vasoactive intestinal peptide,somatostatin,and leptin decreased(P<0.01).Compared with the control group after treatment,the improvement in the above indicators in the observation group was more significant(P<0.01).The incidence of adverse reactions in the two groups of children during the treatment period was similar,and the difference was not statistically significant.Conclusion:Modified Yigongsan combined with multi-enzyme tablets and Bifidobacterium triple live powder is highly effective in treating infantile anorexia(spleen-stomach Qi deficiency syndrome).After treatment,symptoms of the children were improved,appetite and food intake increased,gastrointestinal function was improved,body weight increased,and adverse reactions were few,indicating that the treatment was safe and reliable.