加减和中散联合头孢克肟颗粒治疗小儿肠系膜淋巴结炎脾虚湿盛证43例临床观察

Clinical observation on the treatment of 43 cases of pediatric mesenteric lymphadenitis with spleen deficiency and dampness excess syndrome using modified Hezhong San(和中散)combined with cefixime granules

目的观察加减和中散联合头孢克肟颗粒治疗小儿肠系膜淋巴结炎脾虚湿盛证的临床疗效。方法选取2021年1月至2022年6月余姚市妇幼保健院儿科收治的85例肠系膜淋巴结炎脾虚湿盛证患儿,采用随机数字表法分为治疗组43例和对照组42例。对照组给予头孢克肟颗粒治疗,治疗组在对照组治疗方法的基础上联合加减和中散治疗。2组均以1周为1个疗程,连续治疗2个疗程后统计临床疗效,比较治疗前后临床症状改善时间、消化功能指标以及淋巴结大小的变化。结果治疗组总有效率为97.67%(42/43),对照组为85.71%(36/42),2组比较,差异有统计学意义(P<0.05)。治疗前2组血清胃泌素、胃动素及D-乳酸水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组上述指标值均显著下降,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组下降更显著(P<0.05)。治疗前2组淋巴结横径与纵径比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组横径、纵径均显著缩小,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组缩小更显著(P<0.05)。结论加减和中散联合头孢克肟颗粒治疗小儿肠系膜淋巴结炎脾虚湿盛证,可显著改善患儿的临床症状、消化功能指标以及肿大的淋巴结,值得临床推广应用。

Objective To observe the clinical efficacy of modified Hezhong San(和中散)combined with cefixime granules in the treatment of spleen deficiency and dampness excess syndrome in children with mesenteric lymphadenitis.Methods 85 children with spleen deficiency and dampness excess syndrome of mesenteric lymphadenitis admitted to the pediatric department of Yuyao Maternal and Child Health Hospital from January 2021 to June 2022 were selected.They were randomly divided into a treatment group of 43 cases and a control group of 42 cases using a random number table method.The control group was treated with cefixime granules,while the treatment group was treated with modified Hezhong San based on the treatment method of the control group.Both groups were treated for one week as a course of treatment,and after two consecutive courses of treatment,the clinical efficacy was statistically analyzed.The improvement time of clinical symptoms,digestive function indicators,and changes in lymph node size before and after treatment were compared.Results The total clinical effective rate of the treatment group was 97.67%(42/43),while that of the control group was 85.71%(36/42).The clinical efficacy of the treatment group was better than that of the control group(P<0.05).There was no statistically significant difference(P>0.05)in serum gastrin,motilin,and D-lactate between the two groups before treatment,indicating comparability.After treatment,the values of two or more indicators significantly decreased in both groups,and the difference was statistically significant(P<0.05)compared to before treatment in the same group,with the treatment group showing a more significant decrease(P<0.05).There was no statistically significant difference(P>0.05)between the transverse and longitudinal diameters of the two groups of lymph nodes before treatment,indicating comparability.After treatment,the transverse and longitudinal diameters of both groups significantly decreased,and the difference was statistically significant(P<0.05)compared to before treatment in the same group,with the treatment group showing a more significant reduction(P<0.05).Conclusion The combination of modified Hezhong San with cefixime granules can significantly improve the clinical symptoms,digestive function indicators,and lymph node enlargement of children with mesenteric lymphadenitis of spleen deficiency and dampness excess syndrome,and is worthy of clinical promotion and application.