益气活血运脾小儿推拿法防治反复呼吸道感染

发布时间：2018-01-12 07:06

本文关键词：益气活血运脾小儿推拿法防治反复呼吸道感染　出处：《北京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本次研究主要基于导师王俊宏教授益气活血运脾法治疗小儿反复呼吸道感染(Recurrent Respiratory Tract Infection,RRTI)的思想,用相应的小儿推拿手法进行疾病干预,并且观察其临床疗效以及气虚血瘀证候的改变,探讨活血推拿手法在小儿反复呼吸道感染中的应用意义。研究方法:选取于2015年12月至2016年11月期间,三里屯街道社区以及东直门医院儿科门诊的反复呼吸道感染患儿,共40例,在缓解期进行益气活血运脾推拿法干预治疗,依据自身前后对照原则进行试验。选穴组方:补脾经、顺运内八卦、搓摩胁肋、啄捏中脘与气海穴、捏脊、总收法,根据患儿年龄增加手法次数和时间。疗程为每周推拿3次,1个月为1疗程,一共3个疗程。每个疗程后进行感染期症状评分和中医气虚血瘀证候治疗前后积分对比。运用SPSS20.0软件进行统计分析,多组数据间用单因素方差分析。研究结果:通过对反复呼吸道感染治疗前后发病情况比较,接受治疗的40例患儿在发病次数、病程与病种中上均有一定的改善,显效26例,有效13例,无效1例,P0.05,提示益气活血运脾推拿法对防治反复呼吸道感染具有肯定的疗效。治疗前后感染期症状评分以及中医气虚证候评分经统计分析,均P0.05,说明治疗前后评分有显著差异,具有统计学意义。各评分的平均值在第一疗程和第二疗程后减少,而第二和第三个疗程评分的平均值差异并不明显。中医血瘀证候评分经统计分析,P0.05,说明治疗前后血瘀证候评分有差异,具有统计学意义。40例患儿的血瘀评分的平均值在治疗前、第一个疗程、第二疗程和第三疗程之间的平均值均有明显差异。在40例里,24例的患儿带有鼻梁青筋,经益气活血运脾推拿手法治疗后,19例的鼻梁青筋减轻或消失,5例无改变。经统计分析,P0.05,说明治疗前后鼻梁青筋体征有差异,有统计学意义。口臭、舔口唇、手足心热、眠中磨牙以及眠中翻身踢被症状在治疗前后的数据经统计分析,均P0.05,有统计学意义,说明治疗对以上5种症状确有改善。研究结论:益气活血运脾推拿法能明显改善反复呼吸道感染患儿的症状,使患儿的患病次数明显减少、病程减短、病种减轻,并且面色晦暗、眼眶暗黑、舌质紫暗瘀点等血瘀的症状明显减轻。从感染期症状评分和中医气虚证候评分在每个疗程后的平均值比较,提示患儿在经过两个疗程后症状基本好转,第三个疗程可作为稳定治疗。而从血瘀证候评分的平均值在治疗前与每个疗程后的比较,可推断益气活血运脾推拿法在反复呼吸道感染的血瘀证候干预有明显持续的作用。从19例带有鼻梁青筋的患儿中发现经过益气活血运脾推拿法后的改善,认为鼻梁青筋除了提示脾虚,还能提示血瘀。因此,认为此活血推拿手法在治疗慢性、反复性疾病的意义应予重视。另外,口臭、舔口唇、手足心热、眠中磨牙以及眠中翻身踢被症状提示反复呼吸道感染患儿容易出现脾胃积热的情况,因此治疗需同时重视运脾手法,升清降浊,消散脾胃积热,以保障临床效果。
[Abstract]:The purpose of this study is mainly based on Professor Wang Junhong Yiqihuoxue spleen method in treatment of children with recurrent respiratory tract infection (Recurrent Respiratory Tract Infection, RRTI) thought, for disease intervention with the corresponding massage technique, and to observe its clinical curative effect, Qi deficiency and blood stasis syndrome change, explore the significance of application of Huoxue massage technique in children with recurrent respiratory tract infection. Methods: selected from December 2015 to November 2016, Sanlitun street community and Dongzhimen hospital outpatient department of Pediatrics in children with recurrent respiratory tract infection, a total of 40 cases of Yiqihuoxue spleen massage therapy in remission, according to self control experiment. The principle of acupuncture prescription: spleen, Shunyun in gossip rub, rib, Zhongwan and Qihai peck pinch, chiropractic, total income method, according to the age of children, increase the number and time of treatment. Methods a week Massage 3 times, 1 months for a total of 1 courses, 3 courses. After each course of treatment were compared before and after infection period integral symptom score and TCM syndrome of qi deficiency and blood stasis treatment. Using SPSS20.0 software for statistical analysis, analysis of multiple sets of data using ANOVA. Results: the incidence of recurrent respiratory tract infection before and after treatment compared to receive the treatment of 40 cases of children in the incidence, improve the course and have certain diseases, 26 cases were markedly effective, 13 cases effective, 1 cases ineffective, P0.05, hint Yiqihuoxue spleen massage has certain curative effect on prevention of recurrent respiratory tract infection before and after treatment. Symptoms score and TCM syndrome of deficiency of Qi the score by statistical analysis, P0.05, shows the score before and after treatment were significantly different, with statistical significance. The average score decreased in the first course of treatment and second after treatment, while the second and third course score The average value of the difference is not obvious. After statistical analysis, the P0.05 score of blood stasis syndrome, blood stasis syndrome score before and after treatment showed a statistically significant difference,.40 cases of blood stasis score average before treatment, the first treatment, between second and third the average course of treatment was significantly different in 40 cases. In 24 cases of children with nasal veins, by Yiqihuoxue spleen massage after treatment, 19 cases of nasal veins decreased or disappeared in 5 cases, no change. After statistical analysis, P0.05, that before and after the treatment of nose veins were differences were statistically significant. The halitosis, licking lips, hot feeling, sleep in turn kicked by molars and sleep symptoms before and after treatment of the data by statistical analysis, P0.05, have statistical significance, indicating that the treatment of more than 5 kinds of symptoms have improved. Conclusion: Yiqihuoxue spleen massage can significantly improve the repeated call Respiratory tract infection in children with symptoms, the prevalence of children with significantly fewer disease duration shortened, reduced, and complexion, dark eyes, dark purple tongue petechia and blood stasis symptoms significantly reduced. The average scores were compared after each treatment from infection symptom score and TCM syndrome of deficiency of Qi, suggesting that children improved after two courses after symptoms, third courses can be used as a stable treatment. The score of blood stasis syndrome from the comparison of average value before treatment and after each treatment, it can be inferred that the Yiqihuoxue spleen massage method in blood stasis syndrome of recurrent respiratory tract infection intervention has obvious sustained effect. After Yiqihuoxue spleen massage after the improvement from 19 cases with nasal veins in children, in addition to that nose veins suggest that spleen deficiency, but also suggest that the blood and blood stasis. Therefore, massage in the treatment of chronic diseases, repeatedly We should pay more attention to the significance. In addition, bad breath, licking lips, hot feeling, sleep and sleep in turn kicked by molar symptoms suggesting prone to stomach heat accumulation of children with recurrent respiratory tract infection, so the treatment must also attach importance to the spleen technique, shengqingjiangzhuo, product of heat dissipation in order to protect the spleen and stomach, clinical effect.

【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】：2017
【分类号】：R272

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