捏脊疗法对社区肺脾虚儿童的健康干预研究

发布时间：2018-08-12 16:16

【摘要】：背景：万全的“三有余,四不足”理论明确提出“脾常不足”、“肺常不足”。肺脾不足,是儿童的生理特点,小儿免疫系统、消化系统功能尚未完善,故呼吸及消化系统疾病发病率最高。广东地区气候炎热潮湿,感邪夹湿更易碍脾伤肺,因此儿童肺脾气虚的体质十分常见。肺脾气虚的患儿容易患肺系、脾系疾病,按现代医学分类,属于亚健康状态。根据中医“治未病”理论,肺脾气虚儿童处于“未病”范畴中的病而未发阶段。中医药在“治未病”方面积累了丰富的临床经验,在预防保健、养生康复方面具有独特的、不可替代的优势。儿科门诊“治未病”也积累了一定的经验,但门诊就诊患儿多为急性病,且家长常忽视儿童体质的潜在危险,临床开展“治未病”有一定的难度。而社区医疗作为一个新的医疗模式,为中医“治未病”提供了良好的研究平台,社区儿童保健的细化深入,为儿科“治未病”、“未病先防”等医疗诊治的开展提供了更加方便、有利的条件。社区开展治未病,必将在儿童保健预防领域中发挥巨大的作用。目的：通过采用传统疗法——捏脊,进行社区“治未病”的临床探讨,对肺脾虚体质儿童进行健康干预。将治未病服务范围扩大到社区,探索适用于社区的中医治未病的医疗形式。观察捏脊治疗后肺脾虚儿童中医症候及生长发育的改善情况,客观评价中医传统疗法在“治未病”的作用。方法：采用随机单盲对照研究,以幼儿园班级为单位,进行随机分组,对试验组的肺脾虚儿童进行健康干预及调护,对照组采用空白对照,不进行干预治疗。半年后进行总体疗效评价,并填写不良事件观察表。采用SPSS13.0进行统计分析,计量资料方差齐性者用t检验,方差不齐者用秩和检验,计数资料用卡方检验,等级资料用Riddit分析(或秩和检验)。结果：试验组痊愈显效率明显优于对照组痊愈显效率(P0.05)。治疗后,试验组前后主症积分、次症积分进行自身对比,差异具有统计学意义(P0.01)。治疗后,试验组、对照组主症积分、次症积分进行对比,差异具有统计学意义(P0.01)。试验组治疗后每半年上呼吸道感染次数前后比较,差异具有统计学意义(P0.01)；下呼吸道感染次数、腹泻次数前后比较,差异不具有统计学意义(P0.05)。课题组对20例脾虚患儿进行相关唾液淀粉酶检查,研究显示治疗前、后唾液淀粉酶经统计学分析,二组有显著性差距(P0.05)。结论：治疗组疗效优于对照组。提示捏脊疗法能显著改善患儿肺脾虚的临床证候,能显著提高肺脾虚儿童的唾液淀粉酶水平,能显著减少患儿上呼吸道感染的次数,但未发现捏脊治疗能显著减少下呼吸道感染次数及腹泻次数。
[Abstract]:Background: Wan Quan's "more than three, four deficiency" theory clearly put forward "spleen often insufficiency", "lung often insufficiency". Deficiency of lung and spleen is the physiological characteristic of children. The immune system and digestive system of children are not perfect, so the incidence of respiratory and digestive diseases is the highest. The climate of Guangdong is hot and humid, so the constitution of children's deficiency of lung and spleen qi is very common. Children with deficiency of lung and spleen qi are susceptible to diseases of lung and spleen, which belong to sub-health state according to modern medical classification. According to the theory of "treating disease without disease", children with deficiency of lung and spleen qi are in the stage of disease without disease. Traditional Chinese medicine (TCM) has accumulated rich clinical experience in the field of "cure without disease", and has unique and irreplaceable advantages in prevention and health care and health recovery. The pediatric outpatient clinic has accumulated some experience in treating the disease, but most of the outpatients are acute, and the parents often ignore the potential danger of children's physique, so it is difficult to carry out clinical treatment. As a new mode of medical treatment, community medicine provides a good research platform for the "treatment of disease" in traditional Chinese medicine, the refinement of community health care for children, for pediatrics "treatment of disease," The development of medical diagnosis and treatment, such as prevention before illness, provides more convenient and advantageous conditions. Community treatment will play an important role in the field of child health prevention. Objective: to study the health intervention of children with deficiency of lung and spleen by traditional therapy-chiropractic. To expand the scope of treatment of disease to the community, to explore the community of traditional Chinese medicine treatment of disease-free medical forms. To observe the improvement of TCM symptoms, growth and development of children with deficiency of lung and spleen after chiropractic therapy, and to evaluate objectively the role of traditional Chinese medicine in treating diseases. Methods: a randomized single-blind controlled study was carried out in kindergarten classes. The children with deficiency of lung and spleen in the experimental group were treated with health intervention and nursing intervention. The control group was treated with blank control without intervention. After half a year, the overall curative effect was evaluated, and the adverse event observation form was filled out. The statistical analysis was carried out by SPSS13.0, and the statistical data were analyzed by t test, rank sum test by rank sum test, chi-square test by counting data and Riddit analysis (or rank sum test) by rank data. Results: the effective rate of cure in the test group was significantly better than that in the control group (P 0.05). After treatment, the test group before and after the main symptom score, secondary symptom score comparison, the difference was statistically significant (P0.01). After treatment, the main symptom score and the secondary symptom score were compared between the experimental group and the control group, the difference was statistically significant (P0.01). The experimental group after treatment every six months before and after the number of upper respiratory tract infection, the difference was statistically significant (P0.01); the number of lower respiratory tract infection, diarrhea before and after the comparison, the difference was not statistically significant (P0.05). The study group of 20 cases of spleen deficiency children saliva amylase examination, the study showed that before and after treatment saliva amylase after statistical analysis, there was a significant difference between the two groups (P0.05). Conclusion: the curative effect of treatment group is better than that of control group. It is suggested that chiropractic therapy can significantly improve the clinical symptoms of children with lung and spleen deficiency, increase the level of saliva amylase in children with lung and spleen deficiency, and reduce the frequency of upper respiratory tract infection in children. But it was not found that chiropractic treatment could significantly reduce the frequency of lower respiratory tract infection and diarrhea.
【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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