辨证选穴推拿治疗小儿厌食症的规范化研究
发布时间：2018-08-12 14:19
【摘要】：研究目的：通过观察辨证选穴推拿捏脊疗法对厌食症患儿的症状、治疗前后血红蛋白含量、血锌含量及尿D-木糖吸收率的影响,验证其临床疗效,并与传统推拿捏脊疗法进行比较,评价辨证选穴推拿捏脊治疗小儿厌食症有效性,从而为制定规范、统一的推拿捏脊辨治厌食的方案提供临床依据。 研究方法：将2009年5月至2010年8月就诊于北京中医药大学东方医院儿科、首都医科大学附属北京中医医院儿科、中国中医科学院西苑医院儿科门诊的165例厌食症患儿随机分为两组,对照组采用传统推拿捏脊疗法治疗,治疗组在此基础上进行辨证选穴推拿。 研究结果：治疗前,治疗组与对照组中医证候总分、单项症状评分、血锌含量、血红蛋白含量、尿D-木糖排泄率比较均无统计学意义(P0.05)。治疗后,治疗组与对照组疗前、疗后在血红蛋白含量、血锌含量及尿D-木糖排泄率方面均有统计学差异(P0.05、P0.01),且两组组间疗后比较,治疗组尿D-木糖排泄率优于对照组(P0.05)；在单项症状方面,治疗组与对照组在食量减少、大便不调、性情或精神、面色少华及咬齿磨牙等方面,均有统计学意义(P0.05、P0.01),两组间疗后比较,在食量减少、性情烦躁哭闹及咬齿磨牙等症状方面,有显著性统计学意义(P0.01)；在腹胀及口渴喜饮方面,两组治疗前后均无统计学意义(P0.05)；在临床疗效方面,治疗组临床疗效与对照组比较无统计学意义(P0.05)；在中医证候疗效方面,治疗组中医证候疗效与对照组比较有统计学意义(P0.05)。将治疗组的患儿分为1.5-3岁,3-7岁,7-12岁三个年龄段,结果显示三组在临床疗效方面有显著统计学意义(P0.01)；将治疗组患儿按病情程度分为轻度、中度、重度三组,结果显示三组在临床疗效方面有显著统计学意义(P0.01)；治疗组中按四个证型比较,结果显示四个证型在临床疗效方面无统计学意义(P0.05)。 研究结论： ①传统推拿疗法与辨证选穴推拿疗法均能够明显改善厌食症小儿的食量减少、大便不调、性情烦躁哭闹、面色少华、咬齿磨牙等症状,且在食量减少、性情烦躁哭闹及咬齿磨牙等症状方面,辨证选穴推拿疗法优于传统推拿疗法；在腹胀及口渴喜饮方面,传统推拿疗法与辨证选穴推拿疗法均对厌食症患儿改善不明显。辨证选穴推拿疗法改善中医证候疗效方面优于传统推拿疗法。在临床疗效方面,传统推拿疗法与辨证选穴推拿疗法疗效相当。因此,治疗小儿厌食症,辨证选穴推拿疗法从整体上来说优于传统推拿疗法。 ②辨证选穴推拿疗法及传统推拿疗法治疗厌食症患儿,均可提高患儿血红蛋白含量及血锌含量。 ③辨证选穴推拿疗法及传统推拿疗法治疗厌食症患儿,均可明显提高患儿尿D-木糖排泄率。且辨证选穴推拿疗法优于传统推拿疗法。 ④年龄及病情程度对辨证选穴推拿疗法治疗小儿厌食症有影响,年龄小于7周岁治疗效果较好：病情程度越轻,治疗效果越好；辨证选穴推拿疗法对脾胃气虚、脾胃阴虚、脾胃不和及脾虚肝旺四个证型均有疗效,对脾胃气虚型治疗效果更好。
[Abstract]:Objective: To observe the effect of massage and chiropractic therapy on anorexia children, hemoglobin content, blood zinc content and urine D-xylose absorption rate before and after treatment, verify its clinical efficacy, and compare it with traditional massage and chiropractic therapy, and evaluate the effectiveness of massage and chiropractic therapy on anorexia children. According to the norms, a unified massage and chiropractic for the treatment of anorexia is provided.
Methods: 165 anorexia children were randomly divided into two groups from May 2009 to August 2010. The control group was treated with traditional massage and chiropractic therapy. The treatment group was on the basis of this. Acupuncture and massage were carried out according to syndrome differentiation.
Results: There was no significant difference in the total score of TCM syndromes, single symptom score, blood zinc content, hemoglobin content and urinary D-xylose excretion rate between the treatment group and the control group before and after treatment (P 0.05). (P 0.05, P 0.01), and after treatment between the two groups, the urinary D-xylose excretion rate of the treatment group was better than that of the control group (P 0.05); in the single symptoms, the treatment group and the control group in food loss, incoordination of stool, temperament or spirit, facial color and grinding teeth, etc., there were significant differences (P 0.05, P 0.01), after treatment between the two groups, in the amount of food reduced, sex, etc. (P 0.05, P 0.01). The symptoms of restlessness, crying and gnashing teeth and molars had significant statistical significance (P 0.01); in abdominal distention and thirst, there was no statistical significance between the two groups before and after treatment (P 0.05); in the clinical efficacy, there was no statistical significance between the treatment group and the control group (P 0.05); in the efficacy of TCM syndrome, TCM syndrome in the treatment group was not statistically significant (P 0.05). The treatment group was divided into three groups: 1.5-3 years old, 3-7 years old, 7-12 years old. The results showed that there was significant statistical significance in the clinical efficacy of the three groups (P 0.01); The treatment group was divided into mild, moderate and severe groups according to the degree of illness, the results showed that the three groups in clinical efficacy. There was significant statistical significance (P 0.01); in the treatment group, according to the four syndrome types, the results showed that there was no statistical significance in the clinical efficacy of the four syndrome types (P 0.05).
Research conclusions:
(1) Both traditional massage therapy and point selection massage therapy based on syndrome differentiation can obviously improve the symptoms of anorexia children, such as reduced food intake, irregular stool, irritable and crying temperament, light complexion, gnashing teeth and molars, and the symptoms of reduced food intake, irritable and crying temperament and gnashing teeth and molars, the point selection massage therapy based on syndrome differentiation is superior to the traditional massage therapy; In the aspect of thirst and liking drink, the traditional massage therapy and the massage therapy of selecting acupoints according to syndrome differentiation have no obvious improvement on anorexia children. The massage therapy is superior to the traditional massage therapy.
The content of hemoglobin and blood zinc in anorexia children can be increased by massage therapy of selecting acupoints according to syndrome differentiation and traditional massage therapy.
(3) Both acupoint selection massage therapy based on syndrome differentiation and traditional massage therapy can obviously improve the urinary D-xylose excretion rate of anorexia children, and point selection massage therapy based on syndrome differentiation is superior to traditional massage therapy.
(4) Age and degree of illness have influence on the treatment of anorexia in children, the treatment effect is better when the age is less than 7 years old: the lighter the illness, the better the treatment effect; the treatment of acupuncture and massage based on syndrome differentiation has effect on spleen-stomach Qi deficiency, spleen-stomach Yin deficiency, spleen-stomach disharmony and spleen-stomach Qi deficiency and liver hyperactivity, and has effect on spleen-stomach Qi deficiency type. Better.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R272
本文编号：2179315
[Abstract]:Objective: To observe the effect of massage and chiropractic therapy on anorexia children, hemoglobin content, blood zinc content and urine D-xylose absorption rate before and after treatment, verify its clinical efficacy, and compare it with traditional massage and chiropractic therapy, and evaluate the effectiveness of massage and chiropractic therapy on anorexia children. According to the norms, a unified massage and chiropractic for the treatment of anorexia is provided.
Methods: 165 anorexia children were randomly divided into two groups from May 2009 to August 2010. The control group was treated with traditional massage and chiropractic therapy. The treatment group was on the basis of this. Acupuncture and massage were carried out according to syndrome differentiation.
Results: There was no significant difference in the total score of TCM syndromes, single symptom score, blood zinc content, hemoglobin content and urinary D-xylose excretion rate between the treatment group and the control group before and after treatment (P 0.05). (P 0.05, P 0.01), and after treatment between the two groups, the urinary D-xylose excretion rate of the treatment group was better than that of the control group (P 0.05); in the single symptoms, the treatment group and the control group in food loss, incoordination of stool, temperament or spirit, facial color and grinding teeth, etc., there were significant differences (P 0.05, P 0.01), after treatment between the two groups, in the amount of food reduced, sex, etc. (P 0.05, P 0.01). The symptoms of restlessness, crying and gnashing teeth and molars had significant statistical significance (P 0.01); in abdominal distention and thirst, there was no statistical significance between the two groups before and after treatment (P 0.05); in the clinical efficacy, there was no statistical significance between the treatment group and the control group (P 0.05); in the efficacy of TCM syndrome, TCM syndrome in the treatment group was not statistically significant (P 0.05). The treatment group was divided into three groups: 1.5-3 years old, 3-7 years old, 7-12 years old. The results showed that there was significant statistical significance in the clinical efficacy of the three groups (P 0.01); The treatment group was divided into mild, moderate and severe groups according to the degree of illness, the results showed that the three groups in clinical efficacy. There was significant statistical significance (P 0.01); in the treatment group, according to the four syndrome types, the results showed that there was no statistical significance in the clinical efficacy of the four syndrome types (P 0.05).
Research conclusions:
(1) Both traditional massage therapy and point selection massage therapy based on syndrome differentiation can obviously improve the symptoms of anorexia children, such as reduced food intake, irregular stool, irritable and crying temperament, light complexion, gnashing teeth and molars, and the symptoms of reduced food intake, irritable and crying temperament and gnashing teeth and molars, the point selection massage therapy based on syndrome differentiation is superior to the traditional massage therapy; In the aspect of thirst and liking drink, the traditional massage therapy and the massage therapy of selecting acupoints according to syndrome differentiation have no obvious improvement on anorexia children. The massage therapy is superior to the traditional massage therapy.
The content of hemoglobin and blood zinc in anorexia children can be increased by massage therapy of selecting acupoints according to syndrome differentiation and traditional massage therapy.
(3) Both acupoint selection massage therapy based on syndrome differentiation and traditional massage therapy can obviously improve the urinary D-xylose excretion rate of anorexia children, and point selection massage therapy based on syndrome differentiation is superior to traditional massage therapy.
(4) Age and degree of illness have influence on the treatment of anorexia in children, the treatment effect is better when the age is less than 7 years old: the lighter the illness, the better the treatment effect; the treatment of acupuncture and massage based on syndrome differentiation has effect on spleen-stomach Qi deficiency, spleen-stomach Yin deficiency, spleen-stomach disharmony and spleen-stomach Qi deficiency and liver hyperactivity, and has effect on spleen-stomach Qi deficiency type. Better.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R272
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