胡思源教授运用藿连保和汤治疗小儿积滞食积化热证病例分析  

Case study of professor HU Siyuan's use of Huolian Baohe Tang(藿连保和汤)in the treatment of pediatric stagnation disease with food accumulation heat syndrome

作　　者：李亚军 蔡秋晗 张旭[1,2] 吴钰仪 钟成梁 LI Yajun;CAI Qiuhan;ZHANG Xu;WU Yuyi;ZHONG Chengliang(Clinical Trials Center,The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin,300381,China;National Acupuncture and Moxibustion Clinical Medical Research Center of Traditional Chinese Medicine,Tianjin,300381,China)

机构地区：[1]天津中医药大学第一附属医院临床试验中心,天津300381 [2]国家中医针灸临床医学研究中心,天津300381

出　　处：《中医儿科杂志》2024年第4期44-48,共5页Journal of Pediatrics of Traditional Chinese Medicine

基　　金：国家科技重大专项(民口)课题——儿童中药新药临床评价技术示范性平台建设项目(2020ZX09201-008)。

摘　　要：目的观察胡思源教授运用藿连保和汤治疗小儿积滞食积化热证的中医证候疗效和主要症状改善情况。方法采用回顾性病例系列研究的方法,共收集病例42例,以藿连保和汤为基础方治疗,1周为1个疗程,1个疗程后统计中医证候改善情况和主要症状消失情况。结果治疗1个疗程后,中医证候愈显率FAS、PPS分析显示分别为51.3%(20/39),62.5%(20/32)。全分析数据集(FAS)分析中无效的9例,包括随访症状无改善或加重,中医证候积分下降率<30%2例,失访病例4例,未按时服药3例。符合方案数据集(PPS)分析中无效的2例仅包括随访症状无改善或加重,中医证候积分下降率<30%。各年龄段亚组的中医证候愈显率FAS、PPS分析显示,<1岁年龄段均为0,1~3岁年龄段分别为75.0%(3/4)、75.0%(3/4),4~7岁年龄段分别为52.9%(9/17)、64.2%(9/14),8~12岁年龄段分别为57.1%(8/14)、66.7%(8/12)。中医证候总积分的中位数治疗前为14(14),治疗后为4(3),经统计学分析,差异有统计学意义(P<0.05)。主要症状消失率FAS、PPS分析显示,不思乳食均消失15例,消失率分别为38.5%(15/39)、46.9%(15/32);脘腹胀满均消失21例,消失率分别为53.8%(21/39)、65.6%(21/32)。观察期间无不良事件及不良反应发生。结论胡教授运用藿连保和汤治疗小儿积滞食积化热证,能够有效改善患儿中医证候及主要症状,且脘腹胀满的疗效优于不思乳食,PPS分析与FAS分析结果一致。建议今后可以设计前瞻性病例系列研究、随机对照试验等进行深入研究,以期为中药新药开发提供临床思路。Objective To observe the therapeutic effect of professor HU Siyuan's use of Huolian Baohe Tang(藿连保和汤)on traditional Chinese medicine syndromes and the improvement of main symptoms in the treatment of pediatric stagnation disease(food accumulation heat syndrome).Methods A retrospective case series study was used to collect a total of 42 cases,treated with Huolian Baohe Tang as the basic formula.One course of treatment lasted for one week,and after one course,the recovery rate of traditional Chinese medicine syndrome and the recovery rate of traditional Chinese medicine syndrome in each subgroup of age group were statistically analyzed.After one course of treatment,the recovery rates of traditional Chinese medicine syndromes were 51.3%(20/39)and 62.5%(20/32),respectively.9 cases in FAS analysis were ineffective,including 2 cases with no improvement or worsening of follow-up symptoms and a decrease rate of less than 30%in traditional Chinese medicine syndrome scores;Four cases were lost to follow-up.Three cases fails to take medicine on time.The two ineffective cases in PPS analysis only included no improvement or aggravation of follow-up symptoms,and the decrease rate of traditional Chinese medicine syndrome score was less than 30%.FAS and PPS analysis showed that the recovery rates of traditional Chinese medicine syndromes in different age groups were 0.0%(0.0%)in the<1 year old age group,75.0%(3/4)and 75.0%(3/4)in the 1-3 year old age group,52.9%(9/17)and 64.2%(9/14)in the 4-7 year old age group,and 57.1%(8/14)and 66.7%(8/12)in the 8-12 year old age group,respectively.The median score of traditional Chinese medicine syndrome was 14(14)before treatment and 4(3)after treatment.After statistical analysis,the difference was statistically significant(P<0.05).FAS and PPS analysis showed that 15 cases of non lactation disappeared,with disappearance rates of 38.5%(15/39)and 46.9%(15/32)respectively;21 cases of abdominal distension disappeared,with disappearance rates of 53.8%(21/39)and 65.6%(21/32),respectively

关 键 词：积滞 小儿 食积化热证 藿连保和汤 病例分析 胡思源 

分 类 号：R272.6[医药卫生—中医儿科学]