刮痧配合中药治疗小儿“心经积热”型夜啼临床观察

发布时间：2018-03-05 19:29

本文选题：小儿夜啼　切入点：刮痧　出处：《福建中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过观察导师临床运用刮痧疗法治疗小儿"心经积热"型夜啼的临床疗效,分析探讨刮痧配合中药治疗该病的理论依据及具体方法,为治疗心经积热型夜啼患儿提供新的思路和治疗方法。方法:本次研究采用随机对照研究方法,收集厦门市中医院儿科门诊2015年12月-2017年1月符合小儿心经积热型夜啼的患儿60例,随机分为实验组与对照组。实验组30人运用刮痧配合导赤散加减口服治疗,对照组30人运用导赤散加减口服治疗对比,刮痧部位背部取足太阳膀胱经背部循行部分,手部部采取刮拭天河水穴、六腑穴,先沿脊柱旁开1.5寸从大椎至小肠腧循行部位刮试20～30次,刮拭方向从上向下,以皮肤潮红为度,手肘部采取刮拭天河水、六腑,天河水为曲池往腕横纹方向刮拭20次,六腑为肘横纹往腕横纹方向刮拭20次,刮痧程度视患儿承受能力而定,力度轻柔,以皮肤潮红为度,刮痧1周2次。导赤散加减水煎服,每次煎药量约50ml,日一剂,分早晚饭后服用,治疗1个疗程,2周为一疗程,治疗过程中均无脱落病例,治疗前后主症啼哭及各中医次症采用积分观察表,记录主症前后积分变化及中医次症前后总积分变化,并作统计学处理。结果:两组在治疗前一般情况如性别、年龄、病程、主症积分、各次症积分、中医症状总积分、舌象和指纹方面均P0.05,无统计学差异,具有可比性。治疗后:①实验组与对照组的治疗方法均能降低小儿夜啼的症状积分及中医证候总积分,即都能起到治疗效果,但实验组啼哭积分差值的均数(1.77±0.817)对照组啼哭积分差值的均数(0.87±0.507),说明实验组对改善啼哭优于对照组。②实验组在啼哭有效率(90%)、中医症候总积分有效率(100%)分别高于对照组啼哭有效率(63.33%)、中医证候总积分有效率(70%),啼哭有效率P=0.003,中医症候总积分有效率P=0.00,P值均0.05,说明二者比较差异有统计学意义,且实验组在啼哭有效率方面明显高于对照组。结论：应用刮痧配合导赤散加减治疗小儿心经积热型夜啼有效,且优于口服导赤散加减治疗,具有临床价值。刮痧作为传统的中医外治手段,具有绿色、安全、无毒副作用,发挥中医药优势,体现了中医药特色,值得广大儿科工作者进行推广和应用。
[Abstract]:Objective: to observe the clinical curative effect of scrapping therapy on night-cry of "heart meridian and heat" in children, and to analyze the theoretical basis and concrete method of scraping combined with Chinese medicine in treating the disease. Methods: a randomized controlled study was used in this study to provide a new way of thinking and treatment for the treatment of night-crow children with heart meridian accumulation fever. From December 2015 to January 2017, 60 children were randomly divided into two groups: the experimental group and the control group. 30 patients in the experimental group were treated with scraping plus plus or minus oral administration of Daochi Powder. In the control group, 30 patients were treated by oral administration of Daochi Powder, the back of the scraping area was removed from the back of the sun and the bladder meridian along the back, and the hand part was taken to wipe the Tianhe water point and the six fu-organs point. At first, 1. 5 inches along the side of the spine, 1. 5 inches from Dazhui to the small intestine, 20 times, 20 times, 20 times in the direction of wiping from the top to the bottom, with the skin flushed red, the hands at the elbows taking the wiping of the Tianhe water, the six entrails, the Tianhe water for 20 times in the direction of the cross stripes of the wrists. The six Fu organs are cubital striations to the direction of wrist stripes for 20 times. The degree of scraping depends on the bearing capacity of the children. The degree of scraping is gentle, with skin flushing as a degree, scraping twice a week. Daochi San plus water reducing decoction, each time the amount of decoction is about 50 ml, one dose per day, They were taken in the morning and evening after meals, one course of treatment was given for 2 weeks. There were no cases of abscission in the course of treatment. Before and after treatment, the main symptoms cried and every TCM symptom was observed by integral observation table. Results: before and after treatment, the general conditions of the two groups were gender, age, course of disease, main symptom score, each symptom score, TCM symptom total score, There was no statistical difference in tongue image and fingerprint, which was comparable. After treatment, the treatment methods of both experimental group and control group could reduce the symptom score and the total score of TCM syndromes of children with nocturnal crow, that is, they could all play a therapeutic role. But the mean value of crying score difference was 1.77 卤0.817 in the experimental group and 0.87 卤0.507 in the control group, which indicated that the experimental group was superior to the control group in improving the crying rate by 90%, and the total effective rate of TCM symptom score was 100% higher than that in the control group. The effective rate of crying was 63.33%, the total integral rate of TCM syndromes was 70%, the effective rate of crying was 0.003, the total effective rate of TCM symptom score was 0.05, which indicated that the difference between the two groups was statistically significant. The effective rate of crying in the experimental group was significantly higher than that in the control group. Conclusion: the effect of scraping combined with the addition and subtraction of Daochi Powder in treating night-cry of heart meridian accumulation fever type in children is more effective and better than that in oral treatment. Scraping, as a traditional external treatment method of traditional Chinese medicine, has green, safe, no toxic side effects, exerts the advantages of traditional Chinese medicine, embodies the characteristics of traditional Chinese medicine, and is worth popularizing and applying to the vast number of pediatricians.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R272

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