罗氏三香包联合西药治疗小儿肠系膜淋巴结炎的随机对照研究

Randomized Controlled Study on Roche Tri-sachet Combined with Western Medicine in Treatment of Mesenteric Lymphadenitis in Children

目的:观察罗氏三香包联合西药治疗小儿肠系膜淋巴结炎的疗效。方法:将60例确诊为肠系膜淋巴结炎的患儿按随机数字表法分成治疗组和对照组各30例,对照组予以口服益生菌药物酪酸梭菌、肠球菌和糖化菌三联活菌片,5岁及以上200 mg,日3次,5岁以下100 mg,日3次服用,持续治疗4周。治疗组在对照组治疗基础上,再予以外用罗氏三香包(小茴香200 g、干姜30 g、藿香20 g、木香30 g)放置患儿小腹部治疗,每次15~20 min,日2次,持续治疗4周,观察治疗前后两组患儿临床疗效、中医证候积分、症状缓解时间、临床指标[白细胞、C-反应蛋白(CRP)、降钙素原(PCT)]、腹膜后淋巴结横纵径、免疫功能指标免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)、腹痛复发率变化等以及不良反应情况,确定各组疗效。结果:治疗组总有效率96.7%,对照组总有效率83.3%,两组疗效比较,差异有统计学意义(P<0.05),治疗组症状缓解时间更短(P<0.05),腹痛复发率更低(P<0.05)。治疗后,治疗组中医证候积分、临床指标低于对照组(P<0.05),腹膜后淋巴结横纵径更短(P<0.05),免疫功能指标水平更低(P<0.05)。结论:罗氏三香包联合西药治疗小儿肠系膜淋巴结炎能改善临床症状,降低腹痛复发率,疗效显著。

Objective:To observe the effect of Roche tri-sachet combined with western medicine in the treatment of children with mesenteric lymphadenitis.Methods:A total of 60 pediatria patients diagnosed with mesenteric lymphadenitis were divided into the treatment group and the control group according to random number table method,with 30 cases in each group.The control group was given the conventional oral probiotic Clostridium butyricum enterococcus triple viable tablets,200 mg/3 times a day for children over 5 years old and 100 mg/3 times a day for children under 5 years old,the treatment was for 4 weeks.The treatment group was given topical Roche tri-sachet[composition:Xiaohuixiang(Foeniculi Fructus)200 g,Ganjiang(Zingiberis Rhizoma)30 g,Huoxiang(Agache Rugosa)20 g,and Muxiang(Aucklandia Radix)30 g],placed on the lower abdomen of the children for treatment,15~20 min each time,twice a day,the dosage of which was the same as that of the control group,the treatment was for 4 weeks.The clinical efficacy,traditional Chinese medicine(TCM)syndrome score,symptom relief time,clinical indicators(white blood cells,Cardio Pulmonary Resuscitation,Procalcitonin),transverse and longitudinal diameter of retroperitoneal lymph nodes,immune function indicators(IgA,IgM,IgG),abdominal pain recurrence rate changes and adverse reactions were observed in the two groups to determine the efficacy of each group.Results:In the treatment group,the total effective rate was 96.7%;in the control group the total effective rate was 83.3%,the difference was statistically significant(P<0.05).In the treatment group,the symptom remission time was shorter(P<0.05),and the recurrence rate of abdominal pain was lower(P<0.05).TCM syndrome scores and clinical indexes in the treatment group were lower than those in the control group(P<0.05),transverse and longitudinal diameter of retroperitoneal lymph nodes were shorter(P<0.05),and the immune function indexes were lower(P<0.05).Conclusions:Roche tri-sachet combined with western medicine can relieve the clinical symptoms,reduce the recurrence rate of abdominal pain and have significant curative effec in the treatment of children with mesenteric lymphadenitis.