目的 观察化痰补肺通窍方联合啄治疗法对扁桃体腺样体肥大患者的临床疗效.方法 104 例患者随机分为对照组和观察组,每组 52 例,对照组给予糠酸莫米松鼻喷雾剂联合孟鲁司特钠,观察组给予化痰补肺通窍方联合啄治疗法,疗程 8 周.检测临床疗效,临床症状体征评分,扁桃体、腺样体体积,外周血Th17、Treg、Th17/Treg,OSA-20 生活质量评分,不良反应发生率变化.结果 观察组总有效率高于对照组(P<0.05).治疗后,2 组临床症状体征评分、Th17、Th17/Treg、OSA-20 生活质量评分降低(P<0.05),扁桃体、腺样体体积缩小(P<0.05),Treg 升高(P<0.05),以观察组更明显(P<0.05).2 组不良反应发生率比较,差异无统计学意义(P>0.05).结论 化痰补肺通窍方联合啄治疗法可安全有效地改善扁桃体腺样体肥大患者临床症状体征,缩小扁桃体、腺样体体积,降低外周血Th17/Treg细胞水平,提高生活质量.

目的:观察补中助长颗粒联合生活方式干预脾虚型特发性矮身材(idiopathic short stature,ISS)的临床疗效,探讨其对GH-IGF-1轴的影响.方法:将脾虚型ISS患儿63例随机分为空白组(n=20)、观察组(n=22)、对照组(n=21),空白组给予生活方式干预,观察组在空白组基础上口服补中助长颗粒,对照组在空白组基础上口服赖氨肌醇维生素B12口服溶液.比较3组患儿治疗前及治疗6、12个月身高、体质量、骨龄(bone age,BA)与血清生长激素峰值(growth hormone peak,GHP)、胰岛素样生长因子1(insulin-like growth factor-1,IGF-1)水平.结果:治疗6个月,观察组IGF-1高于空白组、对照组,差异有统计学意义(P<0.05);治疗12个月,观察组身高、IGF-1高于空白组、对照组,观察组体质量高于空白组,对照组IGF-1高于空白组,差异有统计学意义(P<0.05);治疗后3组BA、GHP比较差异无统计学意义(P>0.05).结论:补中助长颗粒联合生活方式干预可能通过调节GH-IGF-1轴实现改善ISS患儿脾虚症状,促进身高、体质量增长,刺激IGF-1表达.

介绍韩雪教授运用经方合方治疗小儿反复咳喘的临床经验.韩雪教授认为,小儿反复咳喘属本虚标实之证,以正气虚弱为本,痰瘀互结为标.故以温阳扶正、化痰平喘、祛瘀通络的基本治法贯穿始终.急性发作期多兼有表证,故在温化痰饮、补肾纳气的同时宣肺解表;缓解期因宿痰暗瘀阻于肺络,在调理肺、脾、肾功能的同时合用化痰、散瘀、通络之法.临证常合用的经方有:小青龙汤及其类方、桂枝加厚朴杏子汤、茯苓桂枝白术甘草汤、麻黄附子细辛汤、金匮肾气丸、桂枝茯苓丸.

目的:分析韩雪治疗急性期大叶性肺炎的用药规律.方法:收集2019年3月至2020年2月韩雪在郑州大学附属儿童医院中医科病房诊治的急性期大叶性肺炎患儿的中药处方,应用频数分析、因子分析、聚类分析等方法进行挖掘整理,分析组方用药规律.结果:共收集处方301首,涉及68味中药,其中使用频次＞20次的药物有33味,以解表药、清热药、化痰止咳平喘药为主,核心处方药物为:蜜麻黄、炒苦杏仁、石膏、甘草、芦根、桃仁、薏苡仁、法半夏、桔梗、瓜蒌、黄连、浙贝母、鱼腥草,常用配伍药物有9组.结论:韩雪治疗急性期大叶性肺炎以清热涤痰、化湿开结、活血排脓为基本治则,临证把握病机,随证加减.

介绍韩雪教授从湿、热、瘀论治儿童大叶性肺炎经验.大叶性肺炎可归属于中医学"肺痈"范畴,韩雪教授认为本病的发病基础为湿、热、瘀,胸膈湿热,郁蒸痰涎,痰瘀互结,酿毒成痈,故临症以清热涤痰,化湿开结,活血排脓为基本治法;常用麻杏石甘汤、千金苇茎汤、小陷胸汤、桔梗汤合方,并随症加减.急性期邪气盛时,以祛邪为主,病久正气受损,邪实正虚,在祛邪的同时或益气养阴,或温阳化饮,使正气得复,痰湿得化,瘀毒得清.

目的 基于"木火刑金"理论,运用疏肝降气法治疗婴幼儿类百日咳并观察其临床疗效.方法 126例类百日咳患儿随机分为对照组62例、治疗组64例.对照组采用红霉素、硫酸镁静滴和雾化吸入治疗,治疗组在对照组的基础上联合解痉止咳颗粒口服.观察两组患儿主症评分、证候评分改善情况,以评价基于"木火刑金"理论,应用疏肝降气法治疗婴幼儿类百日咳的临床疗效.结果 治疗后主症评分改善情况,治疗组总积分小于对照组(P＜0.05),主要表现为改善痉咳发作频次、痉咳持续时间、呕吐等症状(P＜0.05);治疗后证候评分改善情况,治疗组总积分小于对照组(P＜0.05).结论 基于"木火刑金"理论,运用疏肝降气法治疗婴幼儿类百日咳,可有效改善患儿主症评分、证候评分,缩短疗程,临床疗效显著.

目的:观察从脾肾论治青春期前特发性矮身材(ISS)伴骨龄落后的临床疗效.方法:选取64例青春期前ISS伴骨龄落后患儿,按随机数字表法分为治疗组和对照组,每组32例.对照组给予赖氨肌醇维B12口服溶液治疗,并进行饮食指导、健康教育及生活干预,治疗组在对照组基础上给予健脾温肾中药治疗,2组均治疗12个月.观察2组治疗前后身高、体质量、骨龄、血清胰岛素样生长因子-1(IGF-1)水平的变化,比较2组治疗12个月身高及骨龄增长量.结果:治疗6个月、12个月,2组身高及体质量均较治疗前增长(P<0.05).治疗6个月,2组身高及体质量比较,差异均无统计学意义(P>0.05).治疗12个月,治疗组身高及体质量均比对照组增长更明显(P<0.05).治疗12个月,2组骨龄及IGF-1水平均较治疗前升高(P<0.05);2组骨龄及骨龄增长量比较,差异均无统计学意义(P>0.05);治疗组血清IGF-1水平高于对照组(P<0.05);治疗组身高增长量大于对照组(P<0.05).结论:从脾肾论治青春期前ISS伴骨龄落后,可促进患儿体内IGF-1合成,加速其身高、体质量增长.

目的:探讨抽动障碍儿童风池气池色泽与证型的相关性.方法:选取符合抽动障碍诊断标准的4～12岁儿童进行风池气池色泽的判断和辨证分型,并利用对应分析的方法分析、归纳、总结二者的相关性.结果:179例抽动障碍儿童共分为肝亢风动证、脾虚肝亢证、痰热动风证、风邪犯肺证、阴虚阳亢证5种证型,其风池气池色泽分析结果显示,一是肝亢风动证风池气池色泽以淡青、青紫为主,脾虚肝亢证多表现为青紫、紫暗、色黄,痰热动风证多表现为色红、色赤、色紫,3种证型比较肝亢风动证较脾虚肝亢证色泽浅淡,痰热动风证较脾虚肝亢证色泽鲜亮;二是风邪犯肺证及阴虚阳亢证多无改变或色红,两证色泽颇为相似,均隐而难现、不显于外,但病机不同;三是气池色泽变化较风池更著,且随着疾病的发展、病邪的深入,风池气池色泽呈现浅淡、鲜亮、晦暗的演变规律,反映了病情的轻重和病程的长短.结论:抽动障碍儿童风池气池色泽与证型存在相关性,以期使风池气池望诊诊疗技术推广应用于临床,为儿科望诊提供一种新方法.

目的:探讨抽动障碍(TD)与健康儿童风池气池色泽的客观变化,为风池气池望诊的客观化提供一定的依据.方法:于标准环境中采集TD、健康儿童的面部图像,提取风池气池部位的平均RGB、Lab、HSV参数值,并进行统计分析,探讨TD痰热动风组、脾虚肝亢组和健康儿童组的风池气池特征.结果:痰热动风组、脾虚肝亢组、健康儿童组分别为58、60、60例,其风池、气池部位的R、G、B、L、a、b、H、S、V参数有不同的统计学差异(P＜0.05).结论:3组儿童风池、气池色泽存在差异性,借助RGB、Lab、HSV颜色空间能够描述风池、气池色泽变化,进而证明风池气池色泽变化的客观存在性.

目的:观察儿童抽动障碍中医证素分布规律以指导临床辨证。方法:以证素辨证学为基础,采用因子分析的统计学方法对儿童抽动障碍中医证素规律进行初步研究。结果:260例儿童抽动障碍共提取出8个公因子,其中病位证素主要表现为肝、脾胃、肺(表)、肾、心神,病性证素主要为火(热)、阳亢、外风、痰、湿、气虚、阳虚、阴虚等,证素组合以脾虚、肝亢、痰热为主,其次是风邪犯肺。结论:抽动障碍病位证素以肝、脾为主,病性证素多见风、痰、火(热),治宜健脾化痰,平肝熄风。

目的:观察升清降浊制动颗粒对多发性抽动症行为学及脑组织内GABA、Glu、ASP含量影响,探讨升清降浊制动颗粒治疗多发性抽动症的作用机制.方法:将70只雄性SD大鼠随机分为空白对照组、模型组、氟哌啶醇0.2mg/kg组、升清降浊制动颗粒258mg/kg、129mg/kg组5组,每组14只,除空白对照组注射生理盐水,其余各组腹腔注射IDPN 150mg/kg建立TS大鼠模型,药物干预3周后,断头取脑,采用高效液相色谱-四级杆离子阱串联质谱仪检测脑组织内GABA、Glu、ASP的含量.结果:在实验中5只始终未达到造模标准,死亡大鼠6只,最终59只大鼠参与统计分析,治疗后氟哌啶醇0.2mg/kg组、升清降浊颗粒258mg/kg、129mg/kg组,与模型组比较,运动行为及刻板行为明显减少,中央格停留时间缩短、跨格次数显著减少,攀网时间延长,脑组织GABA含量显著升高,Glu、ASP含量显著降低.结论:升清降浊制动颗粒能够改善大鼠运动行为、刻板行为、动物中枢兴奋性及协调性,其作用机制可能是通过调节脑内兴奋性氨基酸Glu、ASP与抑制性氨基酸GABA平衡实现的.

Objective To analyze the possible mechanism and prevention of short stature caused by NFⅠthrough the analysis of a pedigree of neurofibromatosis typeⅠ(NF Ⅰ). Method The clinical data and gene test data of 3 cases of NFⅠwith short stature in a pedigree were retrospectively analyzed. Results The height of two cases of children and their mother were less than 2 standard deviations,all with typical skin changes and varying degrees of skeletal deformity.The bone age of two children lagged behind over 1 year and the level of IGF-1 was lower,with normal thyroid function and no tumor-related abnormalities.Genetic sequencing showed that there was a heterozygous mutation(c.4267 A>G)in mother and 2 children diagnosed with NF Ⅰ. Conclusions NFⅠ,one of the special causes of short stature should be given high priority.It is an autosomal dominant disease,and there is no effective treatment for NFⅠ.Therefore,prenatal diagnosis is the most important prerequisite for preemptive families to prevent NF Ⅰ.

After explored and verified the origin of Er’gan Decoction,professor ZHENG Qizhong’s experience in treating pediatric diseases with Er’gan Decoction,like sweating disease,Tourette’s syndrome,anorexia and anaphylactoid purpura,is introduced in this paper to discuss its syndrome differentiation principle and formula essence,uncover its pathogenesis of qi-yin hurt,deficieny-heat disturbing interior as well as vital qi deficiency with evil-lingering.At last,the principle of treating different diseases with same method has been reflected.4 typical cases are attached for verification.

Objective:To study Zheng Qizhong's medication rules of Cinnamon Twig Decoction.Methods:By collecting Zheng Qizhong's prescriptions,logging the data into TCM inheritance auxiliary platform and applying the data mining method of apriori algorithm under association rules,the medication rules of cough,cold due to weak constitution,abdominal pain and allergic rhinitis were analyzed to study Zheng Qizhong's medication rules.Results:Among the outpatient prescriptions,175 prescriptions involved various pediatric diseases and this formula was applied to the following symptoms for over 10 times:cough,cold due to weak constitution,abdominal pain,allergic rhinitis,snoring and sweating.The most commonly applied 10 drugs include Guizhi (Ramulus Cinnamomi),Baishao (Radix Paeoniae Alba),Shengjiang (Rhizoma Zingiberis Recens),Dazao (Fructus Jujubae),Gancao (Radix et Rhizoma Glycyrrhizae),Wumei (Fructus Mume),Zhigancao (Radix et Rhizoma Glycyrrhizae Praeparata),Huangqi (Radix Astragali),Chantui (Periostracum Cicadae) and Wuweizi (Fructus Schisandrae Chinensis),The meridian tropism mainly includes the spleen meridian,lung meridian,stomach meridian,liver meridian and heart meridian.With association rules analysis,the medication rules for cough,cold due to weak constitution,abdominal pain and allergic rhinitis were found out.Conclusion:Professor Zheng Qizhong applies Cinnamon Twig Decoction to various pediatric diseases such as cough,cold due to weak constitution,abdominal pain,allergic rhinitis,snoring and sweating.Taking the Cinnamon Twig Decoction as main prescription,he often adds the herbs of Huangqi (Radix Astragali),Chantui (Periostracum Cicadae) and Wumei (Fructus Schisandrae Chinensis) by following the principles in Treatise on Cold Damage by Zhang Zhongjing,taking yin and yang as the general principle and harmonizing as the chief method,regulating nutrient phase and defensive phase and balancing yin and yang.

Objective: To analyze the regularity of professor Zheng Qizhong,s application of Fengchi Qichi Dianostic Method.Methods: 30 clinical cases of syndrome of endogenous liver wind,cough,diarrhea and anorexia were collected respectively and the data was logged in the Traditional Chinese medicine auxiliary platform,and two syndromes of each diseases were selected.Results: For Syndrome of endogenous liver wind,patients with insufficiency of the spleen and hyperactivity of liver show navy and purple Qichi,while syndrome of phlegm-fire disturbing mind shows red and purple Qichis.For cough,patients with wind-cold syndrome show navy and reddish Qichi,while phlegm-heat syndrome shows red and purple Qichis.For diarrhea,patients with spleen deficiency syndrome show yellow Qichi,while dampness-heat syndrome shows red and yellow Qichi.For anorexia,patients with dysfunction of spleen in transportation show yellow Qichi,while dampness-heat syndrome shows red and purple Qichi.The colour and lustre changes of Fengchi is in accordance with that of the Fengchi in one patient,while the changes of Qichi occurs more frequently and obviously.Conclusion: The colour and lustre changes of Fengchi Qichi in different diseases and syndromes follow some rules,which direct the syndrome differentiation in the diagnosis of many diseases.Inspection method of Fengchi Qichi is one of the characteristics,which compensates for the weakness of pediatric inspection.

Tourette syndrome is a common disease in pediatrics. TCM medicine on TS shows a curative effect; so the experimental study on the mechanism of TCM medicine is increasing year by year. The mechanisms of treating Tourette syndrome with TCM medicine by the various doctors were summarized from the central neurotransmitters.

Objective: To analyze the composing principles of the prescriptions for tic disorders( TD)collected in CNKI and CSPD through Traditional Chinese Medicine( TCM) Inheritance Support System( TCMISS),in order to provide a reference for clinical treatment of TD. Method: The prescriptions used for TD in CNKI and CSPD from 1998 to 2015 were collected to build a database through TCMISS to make an analysis by association rules and complex system entropy clustering. Then the composing principles of the prescriptions for TD were analyzed. Result: Based on the analysis of 232 cases,the most frequently used drugs included Uncariae Ramulus Cum Uncis,Paeoniae Radix Alba,Bombyx Batryticatus,Glycyrrhizae Radix et Rhizoma and Gastrodiae Rhizoma. And most of these drugs entered the channel of liver. By analyzing the association rules,16 core prescriptions were found,and seven new prescriptions were obtained through the cluster analysis. Conclusion: In the treatment of TD with TCM, invigorating the spleen, calming the liver, reducing phlegm and stopping endogenous wind are the major rules,and recuperating lung is the key. The TCMISS is of great help for the research of TCM prescriptions for TD.

The academic thought,yang mastering yin raised by professor JIANG Yuren in 1985,was concluded and elaborated from its establishment,clinical application and experience,and then 4 cases were attached for verifying efficacy of yang-warming therapy in pediatric diseases.And this thought,yang mastering yin rasied by professor JIANG Yuren,which lays the theoretic foundation of applying yang-warming therapy in pediatric diseases caused by yang deficiency,was proposed explicitly in this paper.And there is of great value in the popularization and application of yang-warming therapy to avoid too cool and cold medication in clinical pediatrics.