本文選題：小兒過敏性紫癜 + 瘀熱傷絡(luò)型��； 參考：《廣州中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:通過觀察三草化斑湯(自擬組方)對小兒單純型過敏性紫癜(瘀熱傷絡(luò)型)患兒的治療,客觀評價(jià)其臨床療效、癥狀改善、安全性及預(yù)防復(fù)發(fā)等情況。方法:采用隨機(jī)、對照臨床試驗(yàn),對符合納入標(biāo)準(zhǔn)的60例符合單純型過敏性紫癜患兒隨機(jī)分配進(jìn)入對照組和治療組,每組30例。對照組給予甲氰咪胍注射液合維生素C注射液靜滴,氯苯那敏片口服等治療,治療組給予三草化斑湯及氯苯那敏片口服治療。觀察兩組患兒14天治療前后有效率,癥狀積分及其各個癥狀改善等情況,其中主要癥狀包括(皮膚紫癜的分布范圍、色澤程度、形態(tài)大小、消退時間等)及次要癥狀包括(膚癢、扁桃體、飲食、大小便等),記錄兩組患兒病程長短,并隨訪3個月,觀察兩組患兒復(fù)發(fā)情況,考察三草化斑湯對單純型過敏性紫癜(瘀熱傷絡(luò)型)的治療效果和優(yōu)勢。結(jié)果:(1)兩組療效比較:分別包括疾病臨床療效、中醫(yī)癥候療效。其中患兒疾病臨床療效:治療組治愈18例,有效10例,無效1例,總有效率96.6%;對照組治愈15例,有效9例,無效4例,總有效率85.7%;中醫(yī)癥候療效:治療組治愈16例,顯效8例,有效3例,無效2例,總有效率93.1%;對照組治愈13例,顯效7例,有效3例,無效5例,總有效率82.4%。結(jié)果顯示治療后兩組患兒療效均較顯著,對照組有效率略高于治療組,但經(jīng)統(tǒng)計(jì)學(xué)檢驗(yàn),對照組療效與治療組療效比較無統(tǒng)計(jì)學(xué)意義(P0.05)。(2)癥狀積分比較:兩組患兒治療后癥狀積分均比治療前癥狀積分顯著降低;但治療組癥狀積分與對照組癥狀積分比較無統(tǒng)計(jì)學(xué)意義(P0.05)。(3)各個癥狀改善情況比較:與對照組比較,治療組患兒在改善皮膚紫癜、飲食、大便等癥狀方面明顯優(yōu)于對照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);但在改善瘙癢、咽痛、小便等癥狀方面差異無統(tǒng)計(jì)血意義(P0.05)。(4)病程比較:觀察14天患兒病情變化,治療組患兒病程明顯比對照組患兒病程短,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(5)實(shí)驗(yàn)指標(biāo)比較:具體以觀察患兒血小板、大便、尿常規(guī)為主,兩組患兒治療后血小板值較治療前比較均有明顯降低,但治療組與對照組比較無統(tǒng)計(jì)學(xué)意義(P0.05)。治療前后兩組患兒尿蛋白、尿隱血、大便潛血比較差異亦無統(tǒng)計(jì)學(xué)意義(P0.05)。(6)安全性評價(jià):治療前后觀察有無不良反應(yīng)癥狀,且實(shí)驗(yàn)指標(biāo)(血常規(guī)、二便、生化等檢查)均在安全范圍之內(nèi)。(7)預(yù)后情況比較:治療組患兒皮膚紫癜的復(fù)發(fā)率明顯低于與對照組復(fù)發(fā)率,但兩組比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:本研究結(jié)果表明:三草化斑湯聯(lián)合西藥口服治療小兒單純型過敏性紫癜(瘀熱傷絡(luò)型)療效顯著,在改善皮膚紫癜、飲食、大便等癥狀、縮短病程等方面療效確切,安全可靠,表明以清熱涼血,化瘀通絡(luò)法治療瘀熱傷絡(luò)型過敏性紫癜(單純型)療效肯定。
[Abstract]:Objective: to evaluate the clinical effect, symptom improvement, safety and recurrence of simple Henoch-Schonlein purpura in children. Methods: 60 children with simple Henoch-Schonlein purpura were randomly divided into control group and treatment group with 30 cases in each group. The control group was treated with cimetidine injection combined with vitamin C injection and chlorphenamine tablet. The treatment group was treated with Sancaohuaban decoction and chlorphenamine tablet orally. The effective rate, symptom score and improvement of symptoms were observed in the two groups before and after 14 days treatment. The main symptoms included (the distribution range of skin purpura, the degree of color and color, the size of shape, etc.) The duration of regression and secondary symptoms including skin itch, tonsil, diet, defecation and urination were recorded and followed up for 3 months to observe the recurrence of the two groups. To investigate the therapeutic effect and advantage of Sancao Huaban decoction on simple allergic purpura. Results comparison of the two groups: clinical curative effect of disease, TCM symptom curative effect. Among them, 18 cases were cured, 10 cases were effective, 1 case was ineffective, the total effective rate was 96.6 in the treatment group, 15 cases were cured, 9 cases were effective, 4 cases were ineffective, and the total effective rate was 85.7% in the control group. In the control group, 13 cases were cured, 7 cases were markedly effective, 3 cases were effective, 5 cases were ineffective, and the total effective rate was 82.4%. The results showed that the curative effect of the two groups was significant after treatment, the effective rate of the control group was slightly higher than that of the treatment group, but by statistical test, There was no significant difference between the control group and the treatment group in the symptom score: after treatment, the symptom score of the two groups were significantly lower than that before treatment. However, there was no significant difference in symptom score between the treatment group and the control group (P 0.05. 05. 3) the improvement of symptoms in the treatment group was better than that in the control group in improving the symptoms of skin purpura, diet and stool, compared with the control group. The difference was statistically significant (P 0.05), but there was no significant difference in the improvement of pruritus, pharynx pain, urine and other symptoms (P 0.05). The course of disease in the treatment group was significantly shorter than that in the control group. The difference was statistically significant (P 0.05). Comparison of experimental indexes: platelet, stool and urine routine were mainly observed in the two groups. After treatment, the platelet value of the two groups was significantly lower than that before treatment, but there was no significant difference between the treatment group and the control group (P 0.05). There was no significant difference in urine protein, urine occult blood and fecal occult blood between the two groups before and after treatment. Comparison of prognosis: the recurrence rate of skin purpura in the treatment group was significantly lower than that in the control group, but the difference between the two groups was not statistically significant (P 0.05). Conclusion: the results of this study indicate that Sancaohuaban decoction combined with western medicine is effective in the treatment of simple allergic purpura in children. It is effective in improving the symptoms of skin purpura, diet, defecation, shortening the course of disease and so on. It is safe and reliable, which indicates that the method of clearing away heat and cooling blood and removing blood stasis and dredging collaterals is effective in treating allergic purpura of blood stasis and heat injury collaterals (simple type).
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R272
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本文編號：1819163