【作者】 李玲；

【导师】 常克；

【作者基本信息】 成都中医药大学 ， 中医儿科学， 2018， 硕士

【副题名】附静肝扶脾汤治疗儿童多动症70例疗效观察

【摘要】 目的:探讨“肝常有余,脾常不足”治疗儿童多动症的理论研究,观察和评价“静肝扶脾汤”治疗儿童多动症脾虚肝旺证的疗效,为儿童多动症的治疗提供安全有效的中医药治疗方法。方法:采用分组对照的研究方法,将符合纳入标准的70例患儿分为试验组和对照组各35例。试验组以“静肝扶脾汤”口服,对照组以盐酸哌甲酯控释片(专注达)口服,均治疗6周。观察并统计分析两组患儿治疗前后的中医证候积分、SNAP-IV评定量表积分改善率和多动指数改善率。结果:(1)两组治疗前后中医证候积分组内比较,治疗后积分均明显低于治疗前,P<0.05,数据差异具有统计学意义,表明两组均能有效改善ADHD脾虚肝旺证的中医证候表现。(2)两组患儿治疗后中医证候积分组间比较,试验组积分低于对照组,P<0.05,数据差异有统计学意义,表明在改善ADHD患儿脾虚肝旺证的证候方面,试验组优于对照组。(3)两组患儿治疗后SNAP-IV评定量表积分和多动指数均低于治疗前,P均<0.05,数据差异均具有统计学意义,表明两组均能有效改善ADHD症状。(4)两组临床疾病疗效比较,试验组总有效率85.3%;对照组总有效率为90.9%。P<0.05,表明对照组的疗效优于治疗组。(5)两组中医证候疗效比较:试验组总有效率达91.2%;对照组总有效率达87.9%,P<0.05,数据差异有统计学意义,表明在改善中医证候疗效方面试验组优于对照组。(6)两组患儿治疗过程中均未发现明显不良反应,安全性评价为1级。结论:从调整肝、脾功能着手治疗儿童多动症,运用静肝扶脾汤治疗儿童多动症有效,并且在改善儿童多动症脾虚肝旺的中医证候方面比西药盐酸哌甲酯控释片(专注达)具有优势,使用安全,对于治疗ADHD具有良好的临床应用价值。更多还原

【Abstract】 Objective:To investigate the theoretical study of hyperactivity disorder in children treated by "Excess of the liver,Spleen deficiency." Observe and evaluate the therapeutic effect of "Jing Gan Fu Pi decoction" on children with hyperactivity disorder with spleen deficiency and liver flourishing syndrome.Providing safe and effective treatment of traditional Chinese medicine for the treatment of children’s hyperactivity disorde.Method:In this study,70 children who met the inclusion criteria were divided into two groups: the experimental group(n = 35)and the control group(n = 35).The experimental group was orally administered "Jing Gan Fu Pi decoction" and the control group was orally administered with Methylphenidate Hydrochloride Prolonged-Release Tablets for a total of 6 weeks.Observation and statistics of TCM syndrome scores、SNAP-IV Rating Scale Improvement Rate and Conner’s Scale Hyperactivity Index Improvement Rate in two groups of children before and after treatment.Results:(1)Comparison of TCM syndrome scores between the two groups before and after treatment showed that the scores after treatment were significantly lower than those before treatment,P<0.05,and the difference was statistically significant.The results show that both groups can effectively improve the TCM syndromes of ADHD with spleen deficiency and liver flourishing syndrome.(2)Comparison of TCM syndrome scores between two groups of patients after treatment.The scores in the experimental group were lower than those in the control group(P<0.05).The difference was statistically significant,indicating that the spleen deficiency and liver flourishing syndrome were improved in children with ADHD.The test group was superior to the control group.(3)The SNAP-IV rating scale scores and hyperkinetic index after treatment in both groups were lower than before treatment,P<0.05,and the data differences were statistically significant,indicating that both groups were effective in improving ADHD symptoms.(4)The total effective rate of the treatment group was 85.3%,while that of the control group was 90.9%,p < 0.05,which indicated that the curative effect of the control group was better than that of the treatment group.(5)Comparison of efficacy of two groups of TCM syndromes: The total effective rate of the experimental group was 91.2%;the total effective rate of the control group was 87.9%,P<0.05,the data had differences,indicating that the experimental group was significantly improved in the efficacy of TCM syndromes.Better than the control group.(6)There were no obvious adverse reactions in the treatment of children in both groups,and the safety evaluation of the patients in the two groups was grade 1.Conclusion: The treatment of ADHD by adjusting liver and spleen function and using Jing Gan Fu Pi decoction is more effective than Methylphenidate Hydrochloride Prolonged-Release Tablets in improving the symptoms and signs of childhood hyperactivity disorder with spleen deficiency and liver flourishing syndrome.It is safe to use and has good clinical application value in the treatment of ADHD.更多还原