中醫內服外治法治療肺脾氣虛型腺樣體肥大患兒的臨床研究

佟彤

【摘要】 目的：觀察中醫內服外治法治療肺脾氣虛型腺樣體肥大患兒的臨床療效。方法：選取2015年6月-2016年6月于本院就診的78例患兒，將肺脾氣虛型腺樣體肥大患兒采用隨機數字表法分為治療組和對照組，每組39例。治療組予健脾縮腺湯加減口服配合天竺霧化劑超聲霧化噴鼻治療，對照組予孟魯司特鈉片口服配合丙酸氟替卡松鼻噴霧劑外用噴鼻，均以4周為一個療程，共觀察2個療程。觀察組內治療前后及組間治療前后的總有效率、QSA-18量表積分及腺樣體體積積分的變化。結果：治療4周后，對照組總有效率為69.23%，治療組總有效率為71.79%，兩組比較差異無統計學意義（P>0.05）；QSA-18量表積分及腺樣體體積積分均下降，與本組治療前相比，差異均有統計學意義（P<0.05），但兩組間比較差異無統計學意義（P>0.05）。治療8周后，對照組總有效率為71.79%，治療組為89.74%，比較差異有統計學意義（P<0.05）；且在QSA-18量表積分、腺樣體肥大程度積分的改善程度上，治療組均優于對照組，差異有統計學意義（P<0.05）。結論：中醫內服外治法治療肺脾氣虛型腺樣體肥大患兒作用明顯。

【關鍵詞】 腺樣體肥大； 健脾縮腺湯； 肺脾氣虛

【Abstract】 Objective：To observe the clinical efficacy of Jianpi Suoxian Decoction in the treatment of lung spleen-deficiency type adenoid hypertrophy children.Method：From June 2015 to June 2016，78 children with lung spleen-deficiency type adenoid hypertrophy treated in our hospital were selected，and divided into treatment group and control group according to the random number table method，39 cases in each group.The treatment group were given Jianpi Suoxian Decoction and Tianzhu ultrasonic atomization spray treatment，the control group were treated with Montelukast sodium tablets and Fluticasone propionate nasal spray.4 weeks as a course，both of two groups treated for 2 courses.The total effective rate，QSA-18 scale scores and adenoidectomy volume integral changes of two groups before and after treatment were compared.Result：After 4 weeks treatment，the total effective rate was 69.23% in control group，which of treatment group was 71.79%，the difference was on statistically significant（P>0.05）；QSA-18 scale scores and adenoidectomy volume integral decreased of two groups were decreased than before treatment，the differences were statistically significant（P<0.05），but there was no statistically significant difference between two groups（P>0.05）.After 8 weeks treatment，the total effective rate of control group was 71.79%， which of treatment group was 89.74%，the differences was statistically significant（P<0.05）；QSA-18 cale scores and adenoidectomy volume integral of treatment group were better than those of control group，the difference was statistic significant（P<0.05）.Conclusion： Traditional Chinese Medicine orally and external treatment has obvious efficacy for children with lung spleen-deficiency type adenoid hypertrophy.

【Key words】 Children with adenoid hypertrophy； Jianpi Suoxiuan decoction； Lung spleen-deficiency type

First-authors address：Shenzhen TCM Hospital，Shenzhen 518033，China

doi：10.3969/j.issn.1674-4985.2017.25.018endprint

腺樣體肥大是兒童常見病、多發病，主要臨床表現為鼻塞、睡眠打鼾、張口呼吸、呼吸暫停，同時可以引起鼻竇炎、阻塞性睡眠呼吸暫停低通氣綜合征、分泌性中耳炎等并發癥，病情持續發展可造成患兒生長發育遲緩、頜面畸形、神經行為障礙甚至心血管疾病等結果，已引起了臨床醫生及患兒家長越來越廣泛的關注。中醫古籍中對于兒童腺樣體肥大并無明確的病名記載，現代醫家認為病屬“鼻窒”“頏顙”“痰核”“鼾眠”等范疇，通過中醫辯證治療可有效避免患兒手術之苦，且能防治腺樣體肥大的反復增生、防止患兒免疫功能低下，有著自己獨特的優勢。本院……