益肾平肝法治疗婴儿痉挛症15例回顾性分析  

Retrospective analysis of 15 infantile spasms patients treated with the method of tonifying kidney and calming liver

作　　者：马融[1,2] 张喜莲 戎萍[1,2] 陈汉江 杨莉斌[1,2] 付乾芳 MA Rong;ZHANG Xilian;RONG Ping;CHEN Hanjiang;YANG Libin;FU Qianfang(Pediatric Department,The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin,300381,China;National Clinical Research Center for Acupuncture and Moxibustion,Tianjin,300381,China)

机构地区：[1]天津中医药大学第一附属医院儿科,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》2025年第1期42-47,共6页Journal of Pediatrics of Traditional Chinese Medicine

基　　金：国家自然科学面上基金(82174439,81373691,81904251)。

摘　　要：目的回顾性分析中药辅助治疗婴儿痉挛症(IS)的临床疗效。方法选取2020年1月1日至2023年12月31日于天津中医药大学第一附属医院儿童脑病专科门诊确诊的IS病例,整理了28例资料完整的医案,对其中给予中药辅助治疗3个月以上的15例进行统计分析。主要采用以方测证的方法,以平肝益肾、补肾息风为主要治则,所用处方包括泻青丸合导赤散、地黄饮子、肾风汤、百合汤、桂枝加龙骨牡蛎汤、柴胡加龙骨牡蛎汤、涤痰汤。均每2周进行复诊,病情稳定后每4周复诊,12周后进行疗效评价,疗效稳定后可固定处方并长期服用2~3年。结果总有效率为73.33%(11/15),其中无发作者4例,75%≤发作减少<100%4例,50%≤发作减少<75%3例。15例患儿治疗期间均未发现血常规、肝功能、肾功能异常及其他不良反应。结论本研究采用的单中心、小样本的回顾性病例系列研究,初步证实了益肾平肝法对于IS有一定的临床疗效,但证据等级相对低,且没有固定的方药,因此需要进一步优化临床处方,有必要开展大样本、多中心及平行对照的高质量证据支持。Objective To retrospectively analyze the clinical efficacy of traditional Chinese medicine(TCM)as adjuvant therapy in the treatment of infantile spasms(IS).Methods IS cases diagnosed at the Pediatric Cerebrovascular Disease Clinic of The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine between January 1,2020,and December 31,2023,were selected.A total of 28 cases with complete medical records over the past three years were reviewed,and 15 cases that received TCM adjuvant therapy for more than 3 months were statistically analyzed.The method of syndrome differentiation based on prescription was mainly adopted,with calming liver,tonifying kidney,nourishing kidney,and stopping wind as the main treatment responsibilities.The prescriptions used included Xieqing Wan(泻青丸)combined with Daochi San(导赤散),Dihuang Yinzi(地黄饮子),Shenfeng Tang(肾风汤),Baihe Tang(百合汤),Guizhi Jia Longgu Muli Tang(桂枝加龙骨牡蛎汤),Chaihu Jia Longgu Muli Tang(柴胡加龙骨牡蛎汤),and Ditan Tang(涤痰汤).Follow-up visits were conducted every 2 weeks until the condition stabilized,then every 4 weeks thereafter.Efficacy evaluation was conducted at 12 weeks,and the prescription could be fixed and taken for a long term of 2 to 3 years if the efficacy was stable.Results The total effective rate was 73.33%(11/15),including 4 cases with no seizures;4 cases with a seizure reduction of 75%to less than 100%,and 3 cases with a seizure reduction of 50%to less than 75%.No abnormalities in blood routine,liver function,renal function,or other adverse reactions were found in the 15 infants during treatment.Conclusion This study,a retrospective case series with a single center and a small sample size,preliminarily confirms that the method of tonifying kidney and calming liver has certain clinical efficacy in the treatment of IS.However,the level of evidence is relatively low,and there is no fixed prescription.Therefore,further optimization of clinical prescriptions is needed,and it is necessary

关 键 词：婴儿痉挛症 益肾平肝法 回顾性分析 临床观察 

分 类 号：R274.1[医药卫生—中医骨伤科学]