中西医结合治疗小儿功能性腹痛肝郁气滞证41例临床观察

Clinical observation on 41 cases of functional abdominal pain with depression of the liver-qi and stagnation of qi syndrome in children treated by combined traditional Chinese and Western medicine

目的观察加味柴胡疏肝散联合西药治疗小儿功能性腹痛(FAP)肝郁气滞证的临床疗效。方法选取2015年3月至2017年9月在安吉县人民医院儿科就诊的FAP肝郁气滞证患儿82例,按随机数字表法分为对照组和治疗组,各41例。对照组口服多潘立酮片和山莨菪碱片,治疗组在对照组治疗方法的基础上予加味柴胡疏肝散治疗,2组均治疗4周后统计疗效。结果治疗前2组疼痛评分比较,差异无统计学意义(P>0.05),具有可比性。治疗后2组疼痛评分均较同组治疗前明显降低,经统计学分析,差异有统计学意义(P<0.01),且治疗组降低更显著(P<0.05)。治疗前2组中医证候积分比较,差异无统计学意义(P>0.05),具有可比性。治疗后2组中医证候积分均较同组治疗前明显降低,差异有统计学意义(P<0.01),且治疗组降低更显著(P<0.05)。治疗前2组胃动素(MOT)、胃泌素(GAS)、缩胆囊素(CCK)水平比较,差异均无统计学意义(P>0.05),具有可比性。治疗后2组MOT、GAS、CCK水平均较同组治疗前明显降低,差异有统计学意义(P<0.01),且治疗组降低更显著(P<0.05)。治疗组总不良反应发生率为9.7%,对照组为14.6%,2组比较,差异无统计学意义(P>0.05)。结论加味柴胡疏肝散联合西药治疗FAP肝郁气滞证疗效显著,可明显减轻临床症状,改善胃肠功能,值得临床推广应用。

Objective To observe the clinical efficacy of modified Chaihu Shugan San(加味柴胡舒肝散)combined with Western medicine in the treatment of functional abdominal pain(FAP)with depression of the liver-qi and stagnation of qi syndrome in children.Methods Eighty-two cases of FAP with depression of the liver-qi and stagnation of qi syndrome admitted to department of pediatrics in Anji County the People’s Hospital from March 2015 to September 2017 were chosen and divided into control group and treatment group according to random number table method,with 41 cases in each.The control group was given oral domperidone tablets and anisodamine tablets,while the treatment group was given modified Chaihu Shugan San on the basis of the control group.We kept statistics on clinical efficacy after the 2 groups were both treated for 4 weeks.Results Before treatment,there was no statistically significant difference in pain scores between the two groups(P>0.05),and they were comparable.After treatment,the pain scores of the two groups decreased significantly compared with the same group before treatment,and the difference was statistically significant(P<0.01),moreover,the treatment group decreased more significantly(P<0.05).Before treatment,there was no statistically significant difference in TCM symptom scores between the two groups(P>0.05),and they were comparable.After treatment,the TCM symptom scores of the two groups all decreased significantly compared with the same groups before treatment,and the difference was statistically significant(P<0.01),moreover,the treatment group decreased more significantly(P<0.05).Before treatment,there was no statistically significant difference in the levels of motilin(MOT),gastrin(GAS)and cholecystokinin(CCK)between the two groups(P>0.05),and they were comparable.After treatment,the levels of MOT,GAS and CCK of the two groups decreased significantly compared with the same groups before treatment,and the difference was statistically significant(P<0.01),moreover,the treatment group decreased more significantly(P<0.05).The total adverse reactions rate of the treatment group was 9.7%,that of the control group was 14.6%,and the difference was not statistically significant between the two groups(P>0.05).Conclusion Modified Chaihu Shugan San combined with Western medicine in the treatment of FAP with depression of the liver-qi and stagnation of qi syndrome in children has obtained significant curative effect,can significantly relieve clinical symptoms,and improve gastrointestinal function,which is worthy of clinical promotion and application.