散结消腺方内外合治小儿腺样体肥大临床研究  

Clinical Study on Treatment of Adenoid Hypertrophy in Children with Internal and External Application of Sanjie Xiaoxian Formula(散结消腺方)

作　　者：施会山 王从安 王可秀 孔春妍[4] 董成达 郝云萍 阎兆君[1] SHI Huishan;WANG Cong’an;WANG Kexiu;KONG Chunyan;DONG Chengda;HAO Yunping;YAN Zhaojun(Shandong University of Traditional Chinese Medicine,Jinan 250355,China;Hospital of Neck,Shoulder and Back Pain Affiliated to Shandong First Medical University,Jinan 250001,China;Zoucheng Maternal and Child Health Hospital,Zoucheng 273500,China;The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250001,China)

机构地区：[1]山东中医药大学,山东济南250355 [2]山东第一医科大学附属颈肩腰腿痛医院,山东济南250001 [3]邹城市妇幼保健院,山东邹城273500 [4]山东中医药大学第二附属医院,山东济南250001

出　　处：《山东中医杂志》2024年第1期35-40,64,共7页Shandong Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:82004495);山东省中医药科技发展计划项目(编号:2019-0224);山东省自然科学基金项目(编号:ZR2020QH318)。

摘　　要：目的:观察散结消腺方内外合用治疗气滞痰阻型小儿腺样体肥大的临床疗效。方法:将64例腺样体肥大患儿按随机数字表法分为观察组和对照组各32例。予观察组散结消腺方口服并穴位贴敷治疗,予对照组孟鲁斯特纳咀嚼片口服联合糠酸莫米松鼻喷剂喷鼻,两组均治疗4周。比较两组患儿治疗前后中医证候积分、生活质量调查表(OSA-18量表)评分,治疗前和治疗后3个月腺样体厚度与鼻咽气腔前后径比值(A/N),以及临床疗效和治疗后1、2、3个月的复发率。结果:治疗后,观察组患儿各单项症状积分均较治疗前下降(P<0.05或P<0.01),对照组主症之鼻塞、张口呼吸及次症积分均较治疗前降低(P<0.05),观察组主症睡眠憋气、张口呼吸及次症积分均低于对照组(P<0.05);治疗后,观察组主症总分、次症总分,以及对照组次症总分均较治疗前下降(P<0.01),观察组次症总分低于对照组(P<0.05)。治疗后,观察组患儿OSA-18量表各项目评分均较治疗前降低(P<0.05或P<0.01),对照组OSA-18量表中情绪状态评分、日常及其他影响评分较治疗前降低(P<0.05),观察组OSA-18量表中各项目评分均低于对照组(P<0.05)。治疗后,两组患儿A/N值均较治疗前减小(P<0.05),但组间比较,差异无统计学意义(P>0.05)。治疗后,观察组总有效率90.32%,对照组83.33%,两组疗效比较,差异无统计学意义(P>0.05);两组均未发生严重不良反应;治疗后观察组复发率低于对照组(P<0.05)。结论:散结消腺方口服联合穴位贴敷可明显改善儿童腺样体肥大临床症状,减轻腺样体肥大程度,提高疗效和患儿生活质量,且复发率低。Objective:To observe the clinical effect of internal and external application of Sanjie Xiaoxian Formula(散结消腺方)in the treatment of adenoid hypertrophy(AH)in children with qi stagnation and phlegm obstruction.Methods:A total of 64 children with AH were divided into the observation group and the control group by random number table method,with 32 cases in each group.The observation group was treated with oral administration of Sanjie Xiaoxian Formula and acupoint application,while the control group was treated with monrusna chewable tablet combined with Mometasone furoate nasal spray.Both groups were treated for 4 weeks.Traditional Chinese medicine syndrome score,quality of life questionnaire(OSA-18 scale)score before and after treatment,ratio of adenoid thickness to nasopharyngeal cavity diameter(A/N)before and 3 months after treatment,clinical efficacy and recurrence rate 1,2 and 3 months after treatment were compared between the two groups.Results:After treatment,the scores of each single symptom in the observation group were decreased compared with those before treatmen(t P<0.05 or P<0.01),the scores of nasal congestion,open mouth breathing and secondary symptoms in the control group were decreased compared with those before treatment(P<0.05),and the scores of sleep congestion,open mouth breathing and secondary symptoms in the observation group were lower than those in the control group(P<0.05).After treatment,the total score of main disease,total score of secondary disease in the observation group and the total score of secondary disease in the control group were decreased(P<0.01),and the total score of secondary disease in the observation group was lower than that in the control group(P<0.05).After treatment,the scores of all items in the OSA-18 scale in the observation group were lower than those before treatment(P<0.05 or P<0.01).The scores of emotional state,daily and other effects in the OSA-18 scale in the control group were lower than those before treatment(P<0.05).The scores of all items in t

关 键 词：小儿腺样体肥大 散结消腺方 穴位贴敷 气滞痰阻证 内外合用 

分 类 号：R272.6[医药卫生—中医儿科学]