邵瑛教授所创推腹八法治疗小儿伤食热的疗效观察

发布时间：2018-04-20 21:35

本文选题：推腹八法 + 食积　；参考：《广州中医药大学》2016年硕士论文

【摘要】：目的：小儿伤食热是指小儿受饮食所伤,食物停聚在中焦胃脘,积而不化,蕴结而内生热所导致的一系列症状。脾胃虚弱是其发病的根本,饮食过量或误食生冷难以消化之物是其直接原因,而小儿体属纯阳,脾阳运化不利,极易郁而化热。本研究通过临床随机对照试验,观察邵瑛教授所创的推腹八法与常规推拿治疗伤食热的临床疗效差异,通过比较两组病例治疗前体温、第一次治疗后0.5小时、1小时、2小时、6小时、12小时,24小时的体温及推拿前24小时及推拿后24小时内大便次数评估推腹八法的临床有效性及实用性,分析其相对于常规推拿的临床优越性,并以推腹八法为治疗基本方,为形成临床推拿治疗伤食热的新的诊疗规范技术提供依据。方法：本研究采取临床随机对照试验的研究方法,从2014年9月至2015年9月收集广州中医药大学第一附属医院及固生堂国医馆邵瑛教授门诊患者,将其中符合诊断标准及纳入标准的伤食热患者60例作为研究对象,运用随机数字表法,将研究对象分为推腹八法组和常规推拿组,其中推腹八法组30例,常规推拿组30例。其中推腹八法组采用推腹八法：摩腹、分腹阴阳、荡腹、抄腹、拿腹、挪腹、推腹、揉脐和龟尾；常规推拿组采用廖品东主编的《小儿推拿学》：清肺平肝1-3分钟、清胃经1-3分钟、清大肠经1-2分钟、掐揉四横纹10遍、捏挤板门10次、运内八卦1-2分钟、退六腑2-3分钟、推拿取痧、推天柱骨、捏脊3-20遍、腹部操作、推箕门、摩涌泉1分钟。研究过程中,两组均记录观察记录年龄,性别,病程,治疗前体温、第一次治疗后0.5小时、1小时、2小时、6小时、12小时,24小时的体温,并记录推拿前24小时及推拿后24小时内大便次数。结果：纳入本研究的60例病例中,无脱落病例,实际完成病例数推腹八法组30例,常规推拿组30例。基线情况：推腹八法组和常规推拿组均30例病例,两组在治疗前年龄、性别、病程、体温、大便次数差异均无统计学意义(P＞0.05),两组具有可比性。疗效评价方面：推腹八法和常规推拿治疗伤食热均有一定疗效,总有效率分别是93.33%和83.33%。在推拿结束后1小时内,常规推拿组对改善发热症状疗效优于推腹八法组；1小时到2小时期间,两组疗效差异无统计学意义(P＞0.05),表示两组疗效无差别；2小时以后推腹八法组疗效优于常规推拿组，，且远期疗效更稳定(P＜0.05)。在食积改善方面,推腹八法组和常规推拿组均能促进小儿排便,但推腹八法组优于常规推拿组(P＜0.05)。结论：推腹八法和常规推拿治疗伤食热均有一定疗效,近期推拿效果常规推拿组疗效优于推腹八法组,但推腹八法远期疗效更显著、稳定。
[Abstract]:Objective: the heat of food injury in children is a series of symptoms caused by food injury, food accumulation in the stomach, accumulation, accumulation and endogenetic fever. The deficiency of spleen and stomach is the root of the disease, and the direct cause is the excessive diet or the indigestibility of cold, while the body of children is pure yang, the spleen yang is unfavorable, and it is easy to turn heat into heat. In this study, we observed the difference of clinical curative effect between the eight methods of pushing abdomen created by Professor Shao Ying and the routine massage in the treatment of food injury and heat by clinical randomized controlled trial, and compared the body temperature before treatment between the two groups. To evaluate the clinical efficacy and practicability of the eight methods, the body temperature of 0.5 hours, 1 hour, 2 hours, 6 hours, 12 hours and 24 hours after the first treatment, and the number of defecation 24 hours before and within 24 hours after massage, were evaluated. This article analyzes its clinical superiority compared with the conventional massage, and takes the eight methods of pushing abdomen as the basic treatment formula, which provides the basis for forming a new diagnostic and therapeutic standard technique for the treatment of injury-food and heat with clinical massage. Methods: from September 2014 to September 2015, the outpatients from the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine and Professor Shao Ying of Gusheng Tang State Medical Center were collected from September 2014 to September 2015. Among them, 60 patients who met the diagnostic criteria and included in the criteria were selected as the study objects. The subjects were divided into eight pushing abdominal method group and conventional massage group by using random digital table method, including 30 cases in the eight pushing abdominal method group and 30 cases in the routine massage group. The patients were divided into two groups: the control group (n = 30) and the control group (n = 30). Eight methods of pushing abdomen were used in the group of pushing abdomen: rubbing abdomen, dividing abdomen yin and yang, swinging abdomen, copying abdomen, taking abdomen, moving abdomen, pushing abdomen, rubbing navel and tortoise tail; routine massage group used "Pediatric Massage" (edited by Liao Pin-dong): clearing the lung and calming the liver 1-3 minutes, Clear stomach channel 1-3 minutes, clear large intestine 1-2 minutes, pinch and knead four transverse stripes 10 times, squeeze and squeeze plate door 10 times, transport inside the gossip 1-2 minutes, back six Fu organs 2-3 minutes, massage take Guasha, push Tianzhu bone, squeeze ridge 3-20 times, abdominal operation, push the door, Mo Yongquan 1 minute. During the course of the study, the two groups recorded the age, sex, course of disease, body temperature before treatment, and the body temperature of 0.5 hour, 1 hour, 2 hour, 6 hour, 12 hour and 24 hour after the first treatment. The number of defecation was recorded 24 hours before massage and 24 hours after massage. Results: among the 60 cases included in this study, there were no abscission cases, 30 cases in the eight methods group and 30 cases in the routine massage group. Baseline data: there were 30 cases in the eight methods of pushing abdomen group and 30 cases in the routine massage group. There was no significant difference in age, sex, course of disease, body temperature and defecation frequency between the two groups before treatment (P > 0.05), which was comparable between the two groups. The total effective rates were 93.33% and 83.33%, respectively. Within 1 hour after massage, the curative effect of the routine massage group on improving fever symptoms was better than that of the eight-method massage group in the period of 1 hour to 2 hours. There was no significant difference in curative effect between the two groups (P > 0.05), which indicated that the curative effect of the two groups was better than that of the routine massage group after 2 hours, and the long-term curative effect was more stable than that of the conventional massage group (P < 0.05). In the improvement of food production, both the eight methods of pushing abdomen group and the routine massage group could promote the defecation of children, but the group of eight methods of pushing abdomen and abdomen was superior to the group of routine massage (P < 0.05). Conclusion: both the eight methods of pushing abdomen and the routine massage have certain curative effect. The curative effect of the traditional massage group is better than that of the traditional massage group in the near future, but the long-term curative effect of the eight methods of pushing abdomen and abdomen is more obvious and stable.
【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】：2016
【分类号】：R249;R272

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