针刺四缝穴对脾胃气虚型小儿厌食症血清瘦素的影响
发布时间：2018-10-12 14:06
【摘要】：目的 小儿厌食症(advance of infantile)是指小儿较长时间食欲不振或食欲减退,见食不贪,甚则拒食,进食量减少,是一种慢性消化功能紊乱综合征,是儿科常见病、多发病,1-6岁小儿多见,城市儿童发病率较高。若病程迁延不愈者,可使气血化生乏源,抗病能力下降,罹患他症,可导致小儿营养不良、贫血佝偻病及免疫力低下,出现反复呼吸道感染,对儿童生长发育、营养状态和智力发展也有不同程度的影响。目前西医治疗效果不太理想,而中医治疗小儿厌食症具有疗效佳、不良反应少等优势。近年来现代医学对血清瘦素与厌食症相关性进行了相关的研究,瘦素是脂肪细胞分泌的一种蛋白激素,对食欲和能量代谢具有重要的调节作用,瘦素作用于下丘脑使POMC系统合成增加,引起一系列的生理反应,使食欲下降,耗能增加及交感神经兴奋性增加,而当瘦素水平下降时,瘦素作用于下丘脑使神经肽Y合成,分泌增加,通过Y5受体,机体产生相应的反应,即食欲增加,副交感功能增加,耗能降低,体温降低,从而恢复脂肪容量。从古至今针刺四缝穴对治疗小儿厌食症有较好的疗效,观察针刺四缝穴对儿童厌食症血清瘦素的影响,探讨运用该方法治疗小儿厌食症的有效性与血清瘦素水平变化的相关性,从而为其在临床上的推广应用奠定理论基础。 方法 本试验对符合条件的研究对象分为两组：治疗组(针刺四缝穴),对照组(正常儿童),按拟定的方案进行研究,其中治疗组(针刺四缝穴)15例,对照组(正常儿童)15例,观察针刺四缝穴对患儿食欲、食量及治疗组治疗前、后的瘦素水平与正常儿童瘦素水平比较,进行统计分析,进而初步探讨该方法治疗小儿厌食症有效性的作用机制。 成果 ①针刺四缝穴治疗脾胃气虚型小儿厌食症总有效率为86.7%。治疗组治疗前、后主要症状总积分比较,治疗前与治疗后食量、食欲积分比较差异有统计学意义(P0.05)： ②治疗组治疗前血清瘦素水平与正常小儿血清瘦素水平相比(同性别)均有统计学意义(女：P0.01),(男：P0.05)； ③治疗组治疗后血清瘦素水平与正常小儿血清瘦素水平相比(同性别)均无统计学意义(女：P0.01),(男：P0.05)； ④治疗组治疗前、后血清瘦素水平相比(同性别)均有统计学意义(女：P0.05),(男：P0.01)。 结论 瘦素作为一种主要由脂肪细胞分泌,具有重要生物活性的多肤类激素,在调节食欲及能量代谢过程中发挥着重要作用。针刺四缝穴能显著改善患儿食欲、食量等主要症状,使体内瘦素的水平发生变化,使其接近正常儿童血清瘦素水平,从而起到控制食欲及能量消耗的作用,改善厌食症状。
[Abstract]:Objective (advance of infantile) is a chronic dyspeptic syndrome and is a common disease in pediatrics, which refers to children's anorexia or anorexia for a long time, which is not greedy, even refuses to eat, and reduces the amount of food consumed, so it is a kind of chronic digestive dysfunction syndrome, and it is a common disease in pediatrics. Children aged 1-6 years are more common, urban children have a higher incidence. If the course of the disease is prolonged, it can cause the deficiency of qi and blood, the decrease of disease resistance, and the development of other diseases, which may lead to malnutrition in children, anemia, rickets and low immunity, recurrent respiratory tract infection, and the growth and development of children. Nutritional status and intellectual development also have varying degrees of influence. At present, the effect of western medicine is not ideal, and Chinese medicine has the advantages of good curative effect and less adverse reactions in treating anorexia in children. In recent years, the relationship between serum leptin and anorexia has been studied in modern medicine. Leptin is a protein hormone secreted by adipocytes, which plays an important role in regulating appetite and energy metabolism. Leptin acting on the hypothalamus increased the synthesis of POMC system, caused a series of physiological responses, decreased appetite, increased energy consumption and increased sympathetic excitability. When leptin level decreased, leptin induced neuropeptide Y synthesis in hypothalamus. Through Y5 receptor, the body produces corresponding responses, that is, increased appetite, increased parasympathetic function, lower energy consumption and lower body temperature, thus restoring fat capacity. The effect of acupuncture on children's anorexia was observed, and the relationship between the effect of acupuncture on serum leptin and the changes of serum leptin level in children with anorexia was discussed, so as to observe the effect of acupuncture on children's anorexia, and to explore the relationship between the effect of acupuncture on children's anorexia and the changes of serum leptin levels. So as to lay a theoretical foundation for its clinical application. Methods the subjects in this study were divided into two groups: treatment group (acupuncture at Sijiao point) and control group (normal children). In the control group (normal children), 15 cases were treated with acupuncture on appetite, food quantity and leptin level before and after treatment, and the leptin level was compared with that of normal children. Furthermore, the mechanism of the efficacy of this method in the treatment of infantile anorexia was discussed. Results 1 the total effective rate of acupuncture at Siliang point was 86.7 in treating children anorexia of spleen and stomach qi deficiency. Before and after treatment, the total scores of major symptoms in the treatment group were compared, and the amount of food consumed before and after treatment, The difference of appetite score was statistically significant (P0.05): 2Serum leptin level in treatment group was significantly higher than that in normal children (same sex) (female: P0.01), (male: P0.05); 3There was no significant difference in serum leptin levels between the treatment group and the normal children (same sex) after treatment (female: P0.01), (: P0.05); After the serum leptin level compared with (the same sex) have statistical significance (female: P0.05), (male: P0.01). Conclusion leptin, a polypeptide hormone secreted mainly by adipocytes and having important biological activity, plays an important role in the regulation of appetite and energy metabolism. Acupuncture at Sijiao point can significantly improve the main symptoms such as appetite, food intake and so on, make the level of leptin in the body change, make it close to the level of serum leptin in normal children, thus play the role of controlling appetite and energy consumption, and improve anorexia symptoms.
【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】：R246.4
本文编号：2266403
[Abstract]:Objective (advance of infantile) is a chronic dyspeptic syndrome and is a common disease in pediatrics, which refers to children's anorexia or anorexia for a long time, which is not greedy, even refuses to eat, and reduces the amount of food consumed, so it is a kind of chronic digestive dysfunction syndrome, and it is a common disease in pediatrics. Children aged 1-6 years are more common, urban children have a higher incidence. If the course of the disease is prolonged, it can cause the deficiency of qi and blood, the decrease of disease resistance, and the development of other diseases, which may lead to malnutrition in children, anemia, rickets and low immunity, recurrent respiratory tract infection, and the growth and development of children. Nutritional status and intellectual development also have varying degrees of influence. At present, the effect of western medicine is not ideal, and Chinese medicine has the advantages of good curative effect and less adverse reactions in treating anorexia in children. In recent years, the relationship between serum leptin and anorexia has been studied in modern medicine. Leptin is a protein hormone secreted by adipocytes, which plays an important role in regulating appetite and energy metabolism. Leptin acting on the hypothalamus increased the synthesis of POMC system, caused a series of physiological responses, decreased appetite, increased energy consumption and increased sympathetic excitability. When leptin level decreased, leptin induced neuropeptide Y synthesis in hypothalamus. Through Y5 receptor, the body produces corresponding responses, that is, increased appetite, increased parasympathetic function, lower energy consumption and lower body temperature, thus restoring fat capacity. The effect of acupuncture on children's anorexia was observed, and the relationship between the effect of acupuncture on serum leptin and the changes of serum leptin level in children with anorexia was discussed, so as to observe the effect of acupuncture on children's anorexia, and to explore the relationship between the effect of acupuncture on children's anorexia and the changes of serum leptin levels. So as to lay a theoretical foundation for its clinical application. Methods the subjects in this study were divided into two groups: treatment group (acupuncture at Sijiao point) and control group (normal children). In the control group (normal children), 15 cases were treated with acupuncture on appetite, food quantity and leptin level before and after treatment, and the leptin level was compared with that of normal children. Furthermore, the mechanism of the efficacy of this method in the treatment of infantile anorexia was discussed. Results 1 the total effective rate of acupuncture at Siliang point was 86.7 in treating children anorexia of spleen and stomach qi deficiency. Before and after treatment, the total scores of major symptoms in the treatment group were compared, and the amount of food consumed before and after treatment, The difference of appetite score was statistically significant (P0.05): 2Serum leptin level in treatment group was significantly higher than that in normal children (same sex) (female: P0.01), (male: P0.05); 3There was no significant difference in serum leptin levels between the treatment group and the normal children (same sex) after treatment (female: P0.01), (: P0.05); After the serum leptin level compared with (the same sex) have statistical significance (female: P0.05), (male: P0.01). Conclusion leptin, a polypeptide hormone secreted mainly by adipocytes and having important biological activity, plays an important role in the regulation of appetite and energy metabolism. Acupuncture at Sijiao point can significantly improve the main symptoms such as appetite, food intake and so on, make the level of leptin in the body change, make it close to the level of serum leptin in normal children, thus play the role of controlling appetite and energy consumption, and improve anorexia symptoms.
【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】：R246.4
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