本文關(guān)鍵詞： 腹瀉病 脾虛濕盛型 七味白術(shù)散　出處：《北京中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：背景：兒童腹瀉病是由多種病因引起的以大便次數(shù)增多與大便性狀改變?yōu)橹饕Y狀的疾病,是嬰幼兒時期最常見的疾病之一,發(fā)病率在我國排第二位。根據(jù)世界衛(wèi)生組織(WHO)2009年的報告,每年共有150萬兒童死于腹瀉病,在世界范圍內(nèi)也是導(dǎo)致兒童死亡的一大病因。急性腹瀉可出現(xiàn)脫水及電解質(zhì)紊亂,持續(xù)腹瀉可導(dǎo)致消化功能障礙、營養(yǎng)不良、生長發(fā)育落后等。按病程分類,可將兒童腹瀉病分為急性腹瀉、遷延性腹瀉和慢性腹瀉；依照病因,可分為感染性腹瀉和非感染性腹瀉,由于病原體不同,又可將感染性腹瀉分為細(xì)菌感染、病毒感染等。中醫(yī)將該病歸為“泄瀉”范疇,由于小兒脾常不足,感受外邪或內(nèi)傷飲食都易致病。在兒科臨床診療中發(fā)現(xiàn),根據(jù)病因給予中醫(yī)辨證論治療效頗佳,尤其對于兒童常見的脾虛濕盛型腹瀉,中醫(yī)辨證論治不但藥效價廉,而且對于相關(guān)證候的改善效果明顯。綜合大量文獻(xiàn)發(fā)現(xiàn),七味白術(shù)散治療兒童腹瀉病的療效顯著,并優(yōu)于腸黏膜保護劑等部分西藥,而以微生態(tài)調(diào)節(jié)劑作對比的研究尚待探索。目的：本研究以七味白術(shù)散為方,治療兒童脾虛濕盛型腹瀉,并與西藥雙歧桿菌四聯(lián)活菌片作對照,對其治療前后的證候進(jìn)行觀察,初步探索七味白術(shù)散湯劑治療兒童脾虛濕盛型腹瀉的優(yōu)勢所在。方法：本課題為前瞻性研究,研究對象為68例,為2014年6月——2015年9月期間在石景山區(qū)中醫(yī)醫(yī)院兒科門診就診并診斷為脾虛濕盛型腹瀉的患兒,應(yīng)用SPSS17.0軟件隨機分為治療組和對照組各34例,兩組均予飲食指導(dǎo)。治療組予口服七味白術(shù)散湯劑,每日1/3-1劑,對照組予口服雙歧桿菌四聯(lián)活菌片1-3片,每日3次。觀察患兒治療前后的證候并評分。所有資料均采用SPSS17.0進(jìn)行分析,所有計量資料治療組、對照組治療前后比較采用配對t檢驗,組間比較采用獨立樣本t檢驗,計數(shù)資料采用卡方檢驗,等級資料采用秩和檢驗。結(jié)果：1.兩組療效比較：治療組、對照組的總有效率分別為94.1%和91.2%。兩組總有效率差異無統(tǒng)計學(xué)意義(卡方值=0.216,P=0.6420.05);兩組顯效率差異有統(tǒng)計學(xué)意義(卡方值=0.965,P=0.0150.05)。2.治療組治療前后證候評分比較：在大便次數(shù)、大便性狀、腹瀉病程、腹痛、嘔吐、精神、口渴、飲食、小便、面色、肛門各項評分存在差異,有統(tǒng)計學(xué)意義(P0.05)。3.兩組治療后第3天證候評分比較：治療組、對照組治療后第3天腹痛、口渴、飲食、面色各項評分存在差異,有統(tǒng)計學(xué)意義(P0.05)。結(jié)論：1.七味白術(shù)散治療兒童脾虛濕盛型腹瀉療效可靠。2.治療組在部分相關(guān)證候改善方面優(yōu)于對照組。
[Abstract]:Background: diarrhoeal disease in children is one of the most common diseases in infantile age, which is mainly characterized by the increase of defecation frequency and the change of defecation character. According to the 2009 report of the World Health Organization (WHO), 1.5 million children die from diarrhoeal diseases every year, which is also a major cause of death in the world. Acute diarrhea can lead to dehydration and electrolyte disorders. Persistent diarrhea can lead to dyspepsia, malnutrition, stunted growth, etc. According to the course of disease, children's diarrhoeal diseases can be divided into acute diarrhea, persistent diarrhea and chronic diarrhea; according to the etiology, It can be divided into infectious diarrhea and non-infectious diarrhea. Because of the different pathogens, infectious diarrhea can also be divided into bacterial infection, viral infection and so on. In clinical diagnosis and treatment of pediatrics, it was found that it was very effective to treat TCM with syndrome differentiation according to the etiology, especially for the common diarrhea of spleen deficiency and dampness, and the differentiation of symptoms and signs of TCM was not only effective, but also cheap. It was found that Qiwei Baizhu Powder had a remarkable effect on treating diarrhea in children, and was superior to some western medicine such as intestinal mucosal protectant. Objective: in this study, Qiwei Baizhu Powder was used as the prescription to treat the diarrhea of children with spleen deficiency and dampness, and compared with the western medicine Bifidobacterium tetralogicum tablets, the syndromes before and after treatment were observed. Objective: to explore the advantages of Qiwei Baizhu decoction in treating diarrhea with spleen deficiency and dampness in children. From June 2014 to September 2015, children with diarrhea of spleen deficiency and dampness were randomly divided into treatment group (34 cases) and control group (34 cases). The treatment group was given 1 / 3-1 dose of Qiwei Baizhu decoction daily, while the control group was given 1-3 tablets of bifidobacterium tetralogens. All the data were analyzed by SPSS17.0. All the metrological data in treatment group and control group were matched t test before and after treatment, and independent sample t test was used for comparison between groups. The counting data were chi-square test and rank data were rank sum test. Results the curative effect of the two groups was compared: treatment group, The total effective rate of the control group was 94.1% and 91.2, respectively. There was no significant difference in the total effective rate between the two groups (chi-square value was 0.216p, P < 0.6420.05), and the difference between the two groups was statistically significant (chi-square value was 0.965p 0.0150.05n.2.) before and after treatment, the scores of syndromes in the treatment group were as follows: the number of defecation times, the defecation traits, the difference between the two groups were statistically significant. The course of diarrhea, abdominal pain, vomiting, spirit, thirst, diet, urination, facial color, anus scores were different, there were significant differences between the two groups after treatment on the third day after the treatment of syndrome score comparison: treatment group, control group 3 days after treatment abdominal pain, There were significant differences in the scores of thirst, diet and facial color. Conclusion: 1. Qiwei Baizhu Powder is effective and reliable in treating diarrhea of children with spleen deficiency and dampness. 2. The treatment group is superior to the control group in improving some related syndromes.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R272

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