【作者】 吕随治；

【导师】 高树彬；

【作者基本信息】 福建中医学院 ， 中医儿科学， 2009， 硕士

【摘要】 目的:运用调理肺胃法原理,观察调肺运脾汤治疗脾胃气虚型厌食症患儿的临床疗效,探讨调理肺胃法的作用机制,为今后小儿厌食症的临床治疗及辨证分型提供有效的依据。方法:将65例符合脾胃气虚厌食纳入标准的门诊患儿,随机将其纳入试验组33例,对照组32例,进行比较研究,采用分层分段随机、阳性药物平行对照的临床研究设计方法。试验组运用调理肺胃法,予口服调肺运脾汤,药用:苍耳子、辛夷、枳壳、桑白皮、青陈皮、半夏、太子参、炒白术、茯苓、焦三仙、鸡内金、甘草;对照组运用单纯运脾法,予口服异功散加味,药用:太子参、炒白术、茯苓、青陈皮、半夏、焦三仙、鸡内金、甘草。水煎服,每日1剂,每日早晚服用,年幼患儿少量频服,根据患儿的年龄和体重调整中药用量。两组疗程均为4周。治疗前对两组患儿年龄、性别、体重、病情、病程等基础资料进行比较,经统计学处理无显著性差异,说明两组具有可比性。试验结束后进行治疗前后试验组自身及与对照组在疾病疗效和症候疗效的比较。判定调肺运脾汤对小儿厌食症的临床疗效,并从中医传统理论上探讨调理肺胃法的作用机理。结果:从临床观察结果来看,服用调肺运脾汤后患儿的食欲明显好转,食量、体重明显增加,临床症状如面色、神疲、汗出、呕吐、大便不调等均明显改善或消失,说明调肺运脾汤疗效确切。两组的疾病疗效分析:试验组治愈7例,显效18例,愈显率为75.7%,有效6例,总有效率为93.9%;对照组临床痊愈2例,显效7例,愈显率为28.2%,有效17例,总有效率为81.3%,两组在总体疗效上比较有明显差异(P＜0.01)。症候疗效分析:试验组在改善主症食欲、食量上,优于对照组(P＜0.05);改善兼症上,如面色、神疲、汗出、大便症状,试验组较对照组显著(P＜0.05);在增加体重和血红蛋白上试验组明显优于对照组(P＜0.01)。结论:①调肺运脾汤治疗小儿厌食症疗效确切,总体疗效优于异功散。②调肺运脾汤能够明显改善厌食症患儿主症及兼症,明显增加体重及血红蛋白,作用优于异功散.③调肺运脾汤是治疗小儿厌食症的有效方剂,调理肺胃法优于单纯运脾法。本文从理论、临床研究方面进行有益的探索,提出气机失调、脾失健运是小儿厌食症的病机;宣肺通窍、益气健脾为其主要治疗法则。采用肺胃同调治疗小儿厌食症,是中医防治的新思路。更多还原

【Abstract】 Objective:Using recuperation lung and stomach’s law principle,to observe the effect of Tiao-fei-yun-pi-tang on Infantile anorexia(deficiency of spleen and stomach qi),and explore the feasibility by applying the therapy of recuperating lung and stomach,For the clinical treatment of Infantile anorexia and dialectical type provide effective basis.Methods:65 cases measured up to the take-in standard were randomly devided into treatment group and comparison group,namely 33 in the former and 32 in the latter,clinical was adopted in parallel comparison through random,positive drug.Treatment group using recuperation lung and stomach’s law principle,treated with Tiao-fei-yun-pi-tang.The comparison group using pure treating spleen method,treated with Yi-gong-san,with the dosage of both group decided according to age.Two times a day.Four weeks later.Before therapy,age,sex,avoirdupois,course,patient’s condition,and etc,the elementary data should be compared,but it is nothing with statistics.That is said the two groups could be compared.After treatment,it would be graded,counted and analyzed,according to improving of curative effect and syndrome symptom.And so it could be evaluated validity of the medication.Results:From clinical observation,treatment group can improve the symptom of anorexia,the main aspect of curative effect and TCM principle symptom,such as appetite,and secondary symptom such as complexion,drinking water,sweat,defecate,vexed,and etc.Curative effect:For the treatment group:7recovered,18had obvious effect,6 had effect, the total effective rate up to 93.9%.For the comparison group:2 recovered,7 had obvious effect,17 had effect,the total effective rate up to 81.3%.There was statistical difference in overall efficacy between the two groups(P＜0.01).To improve major symptoms of appetite and appetite,treatment group than in control group(P＜0.05);To improve secondary symptoms, If the complexion,drinking water,sweat,defecate,vexed etc,treatment group than in control group(P＜0.05);weight and hemoglobin,treatment group than in control group(P＜0.01).Conclusion:①Tiao-fei-yun-pi-tang is the exact effect of the treatment of infantile anorexia,overall more effective than Yi-gong-san.②Tiao-fei-yun-pi-tang can significantly improve the major and secondary symptoms,a marked increase in body weight and hemoglobin,the role of different reactive than Yi-gong-san.③Tiao-fei-yunpi-tang is effective in treating Infantile anorexia.Recuperation lung and stomach’s law is better than pure treating spleen method.The article carries a beneficial discovery through in TCM theory,clinical research and enriches the approach.To propose Qi disorders and spleen qi lost is the pathogenesis of Infantile anorexia and treating lung、invigorating spleen is main treatment.Recuperation lung and stomach’s law is new ideas in treating Infantile anorexia.更多还原