饮食喂养方式与小儿脾虚证形成的相关研究

发布时间：2018-03-23 13:01

本文选题：儿童　切入点：脾虚证　出处：《广州中医药大学》2012年硕士论文

【摘要】：背景脾虚证是儿科疾病常常伴随的一个中医证型。由于小儿饮食不知自节,寒温不能自调,以及父母溺爱不明,喂养方法欠当,稍微不慎就容易损伤脾胃,因此由脾虚所致疾患在儿科临床颇为多见。祖国医学强调防病于未然,平素注意调理小儿的饮食,保持小儿脾胃的正常功能,是小儿保持健康的重要因素。而随着经济的发展,物质供应的丰富,小儿饮食喂养状况却不容乐观。大量调查研究表明我国婴幼儿普遍存在母乳喂养率低、辅食添加不合理的问题,且小儿挑食偏食等饮食不良现象越来越多,受到越来越广泛的关注。虽然目前关于小儿饮食喂养方式的调查成果甚多,但多注重其与小儿膳食营养结构、生长发育、疾病发生关系等的论述,与小儿脾虚证形成的相关调查则尚显空白。小儿脾常不足,脾胃功能的强弱对于小儿的生长发育、疾病的防治和痊愈具有重要意义。脾虚证的形成是多因素综合作用的结果,而通过饮食喂养方式的调整来预防脾虚证的发生具有临床实用性和可行性。目的探讨饮食喂养方式与小儿脾虚证形成的相关性,为临床脾虚证的发生进行有效饮食干预提供依据,减少疾病的发生。方法通过流行病学病例对照研究方法,选取2011年7月-2012年3月广州市区(广东省中医院儿科保健门诊及广州市怡新幼儿园等幼托机构)符合选择标准的1-7周岁脾虚证儿童98名为病例组,以性别、年龄(相差在6个月以内)匹配同一调查地点的非脾虚儿童102名为对照组,采用自制《小儿饮食喂养方式调查问卷》,调查儿童4月龄内喂养方式、辅食添加情况,最近1年内饮食行为状况及家长喂养方法,应用SPSS17.0统计软件进行单因素及多因素条件Logistic回归分析。结果 1.本次调查的200名儿童中,4月龄内母乳喂养、混合喂养和人工喂养比例分别为41.0%、44.5%、14.5%。开奶时间大部分为分娩后7天内(46.5%),分娩后30分钟内的有27.5%,有74.0%的儿童喝到初乳。添加辅食的时间以4-6个月和6个月以后为多,分别占56.5%和25.0%,有13.5%的儿童在小于4个月时已添加辅食。 2.经常睡前1小时内进食为脾虚证的危险因素,膳食平衡、进餐专注度、食物喜好、适度喂养、喂养满意度、饮食节制为脾虚证的保护因素。其中膳食平衡(OR=0.83)和进餐专注度(OR=0.78)为脾虚证两个独立的保护因素。幼儿在进餐专注度、饮食节制得分上低于学龄前儿童,在食物喜好上得分高于学龄前儿童。结论 1.广州市区母乳喂养及辅食添加情况较理想,但仍需继续提高完全母乳喂养率,改变部分儿童过早添加辅食的现象。 2.小儿脾虚证的发生与儿童不良饮食行为相关,家长需注意改变错误的喂养方法,重视儿童良好饮食习惯的早期建立。
[Abstract]:Background. Spleen deficiency syndrome is often accompanied by a traditional Chinese medicine syndrome type of pediatric diseases. Because children do not know their diet, cold temperature can not be adjusted, as well as parents doting unknown, inadequate feeding methods, a little careless will easily damage the spleen and stomach, Therefore, diseases caused by spleen deficiency are quite common in pediatrics. The traditional Chinese medicine emphasizes the prevention of diseases in the early stages. It is an important factor for children to maintain their health by taking care of the diet of children and maintaining the normal function of the spleen and stomach of children. With the development of economy, With the abundance of material supply, the situation of children's dietary feeding is not optimistic. A large number of investigations show that the infant feeding rate is low, the supplement of supplementary food is unreasonable, and the phenomenon of poor diet, such as picky food and partial food, is becoming more and more common in our country. It has received more and more attention. Although there are many achievements in the investigation on the dietary feeding patterns of children, more attention has been paid to its relationship with the dietary nutrition structure, growth and development of children, and the occurrence of diseases, etc. The investigation on the formation of spleen deficiency syndrome in children is still blank. The deficiency of spleen in children and the strength of spleen and stomach function are of great significance to the growth and development of children, the prevention and cure of diseases, and the formation of spleen deficiency syndrome is the result of multiple factors. It is practical and feasible to prevent spleen deficiency syndrome by the adjustment of dietary feeding method. Purpose. To explore the correlation between dietary feeding style and the formation of spleen deficiency syndrome in children, to provide basis for effective dietary intervention and to reduce the incidence of diseases. Method. Through an epidemiological case-control study, From July 2011 to March 2012, 98 children with spleen deficiency syndrome between 1 and 7 years old were selected as case group, including paediatric health care outpatient of Guangdong Provincial traditional Chinese Medicine Hospital and Guangzhou Yixin Kindergarten. 102 children with non-spleen deficiency matched in the same investigation site were matched in age (within 6 months) as control group. Self-made questionnaire on dietary feeding patterns of children was used to investigate the feeding patterns and supplementary food supplementation of children within 4 months of age. Dietary behavior status and parental feeding methods in the past one year were analyzed by Logistic regression analysis of single and multivariate conditions with SPSS17.0 software. Results. 1. Breastfeeding within 4 months of the 200 children surveyed, The proportion of mixed feeding and artificial feeding were 41.0% and 44.5% respectively. The milk opening time was mostly 46.5% within 7 days after delivery. Within 30 minutes after delivery, 27.5% of the children drank colostrum, 74.0% of the children drank colostrum. The time of supplementary food was 4-6 months and 6 months later. 56.5% and 25.0% of the children were given supplementary food when they were less than 4 months old. 2. Eating regularly within 1 hour before sleep is the risk factor of spleen deficiency syndrome, dietary balance, food concentration, food preference, moderate feeding, feeding satisfaction, Dietary abstinence was the protective factor of spleen deficiency syndrome. Among them, dietary balance and meal focus were two independent protective factors of spleen deficiency syndrome. The score of food preference is higher than that of preschool children. Conclusion. 1. The situation of breast-feeding and supplementary feeding in Guangzhou urban area is satisfactory, but it is necessary to continue to increase the rate of exclusive breastfeeding and to change the phenomenon of some children adding supplementary food prematurely. 2. The occurrence of spleen deficiency syndrome in children is related to children's bad eating behavior. Parents should pay attention to changing the wrong feeding methods and pay attention to the early establishment of children's good eating habits.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R272

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