加减七味白术散治疗小儿肠系膜淋巴结炎36例

目的 研究加减七味白术散治疗肠系膜淋巴结炎的疗效，初步探讨小儿肠系膜淋巴结炎的中医病因病机及治法。方法 36例患儿均接受加减七味白术散治疗，疗程为3周。治疗前后分别观察患儿的主症（腹痛）积分和次症（面色少华、精神倦怠、乳食减少、食后痞胀、大便改变）积分，采用彩色多普勒超声仪观察患儿腹部淋巴结改变情况，并评价疾病疗效和中医证候疗效。结果 与治疗前比较，患儿治疗后腹痛积分和各次症积分均显著降低（P<0.05）。治疗后患儿腹部淋巴结缩小或消失33例（占91.7%）。按疾病疗效判定标准，治愈28例，好转5例，无效3例，总有效率为91.7%。按中医证候疗效判定标准，治愈3例，显效21例，有效11例，无效1例，总有效率达97.2%。结论 加减七味白术散可缓解脾胃虚寒型肠系膜淋巴结炎患儿的腹痛等临床症状，可使肿大的淋巴结缩小。

Clinical Efficacy of Modified Qiwei Baizhu Powder in Treatment of Mesenteric Lymphadenitis in Children: An Analysis of 36 Cases

Objective To investigate the clinical efficacy of modified Qiwei Baizhu Powder in the treatment of mesenteric lymphadenitis in children, as well as the etiology, pathogenesis, and method of treatment of mesenteric lymphadenitis in children in traditional Chinese medicine (TCM). Methods A total of 36 children were given modified Qiwei Baizhu Powder, and the course of treatment was 3 weeks. The scores of the main symptom (abdominal pain) and minor symptoms (lusterless complexion, fatigue, reduced milk intake, distention and fullness after eating, and change in stools) were observed before and after treatment. Color Doppler ultrasound was performed to observe the changes in abdominal lymph nodes and evaluate disease outcome and the outcome of TCM syndromes. Results The patients showed significant reductions in scores of the main symptom and minor symptoms after treatment (P<0.05). Of all children, 33 (91.7%) experienced shrinkage or disappearance of abdominal lymph nodes. According to the assessment criteria for disease outcome, 28 cases were cured, 5 were improved, and 3 had no response, resulting in an overall response rate of 91.7%. According to the assessment criteria for the outcome of TCM syndromes, 3 were cured, 21 were markedly improved, 11 had certain response, and 1 showed no response, resulting in an overall response rate of 97.2%. Conclusion Modified Qiwei Baizhu Powder can alleviate the clinical symptoms including abdominal pain in children with mesenteric lymphadenitis and deficient cold of spleen and stomach and reduce lymph node enlargement.