泻黄散加味联合排便训练在小儿便秘中的应用

Application of Modified Xiehuang Powder(泻黄散加味)Combined with Defecation Training in Children Constipation

目的分析泻黄散加味联合排便训练在小儿便秘中的应用效果。方法选取2019年7—2023年4月河北省沧州中西医结合医院收治的便秘患儿100例,随机数字表法将其分为对照组(50例)和研究组(50例)。对照组采用双歧杆菌三联活菌治疗,研究组采用泻黄散加味联合排便训练治疗,两组均治疗2个疗程(7 d为1个疗程),并于治疗后随访1个月。比较两组临床相关指标。结果治疗后,研究组总有效率高于对照组;研究组首次排便时间及腹胀、食欲不振、恶心呕吐、便溏消化等症状改善时间更短;治疗后与治疗前比较,两组主症积分、次症总积分、中医证候总积分、血清生长抑制素(somatostatin,SS)水平降低,两组间治疗后比较,研究组更低;治疗后与治疗前比较,两组血清胃泌素(gastrin,GAS)、胃动素(motilin,MLT)、P物质(substance P,SP)水平升高,两组间治疗后比较,研究组更高;治疗期间研究组不良反应总发生率更低,随访期间研究组复发率更低(P<0.05)。结论泻黄散加味联合排便训练应用于小儿便秘中有助于缓解患儿的临床症状,调节胃肠道激素表达,提高临床疗效,且安全性高,不易复发。

Objective To analyze the application effect of Modified Xiehuang Powder(泻黄散加味)combined with defecation training in children with constipation.Methods A total of 100 cases of constipation in Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine.Hebei were selected from July 2019 to April 2023,and they were divided into the control group(50 cases)and the research group(50 cases).The grouping method was random number table method.The control group was treated with bifidobacterium triple viable bacteria,while the research group was treated with Modified Xiehuang Powder combined with defecation training.Both groups were treated for 2 courses(7 days was one course)and were followed up for 1 month after treatment.The clinical related indexes were compared between the two groups.Results After treatment,the total effective rate of the research group was higher than that of the control group.The first defecation time and the improvement time of symptoms such as abdominal distension,loss of appetite,nausea and vomiting and loose stool digestion of the research group were shorter.After treatment,compared with those before treatment,the main symptom score,the total score of secondary symptoms,the total score of TCM syndromes and the serum somatostatin(SS)level of the two groups decreased,and the indexes of the research group were lower than those of the control group.After treatment,compared with those before treatment,the serum levels of gastrin(GAS),motilin(MLT)and substance P(SP)of the two groups increased,and the levels of the research group were higher than those of the control group.The total incidence of adverse reactions of the research group was lower(compared with the treatment period between the two groups),and the recurrence rate of the research group was lower(compared with the follow-up period between the two groups)(P<0.05).Conclusion Modified Xiehuang Powder combined with defecation training is helpful to relieve the clinical symptoms of children with constipation,regulate gastrointestinal hormone expression and improve the clinical efficacy,and it is safe and is not prone to recurrence.