推拿配合冯氏捏积手法治疗小儿遗尿病脾肾两虚证的临床研究

发布时间：2018-04-03 19:37

本文选题：冯氏捏积手法　切入点：脾肾两虚证　出处：《北京中医药大学》2016年硕士论文

【摘要】：目的：本文采用推拿配合冯氏捏积手法联合中药内服及单纯口服中药两种治疗方案,对小儿遗尿病脾肾两虚证的患儿治疗,观察其近期、远期临床疗效。从中医证候方面观察在夜间遗尿次数、睡眠深度、夜间尿量、白天尿频等项目进行观察对比,进而观察远期治疗效果的稳定性,观察两组结果通过统计学计量和计数的科学分析,对比两组前后是否具有显著性差异,用统计数据结果证明特色手法(推拿配合冯氏捏积手法)配合中药内服治疗效果是否优于单纯口服中药的对照组。探讨特色手法(推拿配合冯氏捏积手法)治疗小儿遗尿病的机理。方法：参照2014年11月第十六届全国儿科肾脏病学术会制订的《中国儿童单症状性夜遗尿疾病管理专家共识》及《中医病证诊断疗效标准》及《中医临床诊疗术语国家标准(证候部分)》的脾肾两虚证,纳入110例符合小儿遗尿病脾肾两虚证诊断的患儿,随机分成推拿配合冯氏捏积手法联合中药内服的治疗组、单纯口服中药的对照组。治疗前分别对夜间遗尿次数、睡眠深度、夜间尿量、白天尿频、饮食、面色等项目进行症状评分,并在第一疗程治疗结束后再次对以上项目进行评分,在治疗结束后3个月再次对以上项目进行评分,从中医证候上观察推拿配合冯氏捏积手法联合中药内服治疗小儿遗尿病(脾肾两虚证)的疗效,通过统计学数据分析两组的疗效是否具有统计学意义。结果：通过治疗4周后,对中医证候的评分,对比推拿配合冯氏捏积手法联合中药内服的治疗组、单纯口服中药的对照组中医证候在治疗一个月后：推拿配合冯氏捏积手法联合中药内服的治疗组的有效率为72.7%、单纯口服中药的对照组为34.5%,治疗组并没有在治疗后一个月在中医证候方面明显优于对照组,两组在统计学有差异,x2=16.122,P=0.000(P0.01),但在面色改善、饮食改善这独立的中医证候方面,推拿配合冯氏捏积手法联合中药内服的治疗组要优于单纯口服中药的治疗组,两组在以上两个具体项目都具有显著差异(P0.01)；在三个月后疗效：治疗组有效率为96.5%、对照组为74.5%,x2=8.419,P=0.004(P0.01),推拿配合冯氏捏积手法联合中药内服的治疗组优于单纯口服中药的对照组,尤其在夜间遗尿、尿量、白天尿频改善、面色改善、饮食改善这独立的中医证候方面,两组有显著性差异(P0.05)。结论：推拿配合冯氏捏积手法联合中药内服治疗小儿遗尿病(脾肾两虚证)在中医证候疗效方面高于单纯中药内服,尤其在远期疗效上治疗组优于对照组,体现了中医整体观念,辨证论治的思维在中医特色手法中的应用优势,能使遗尿患儿的整体中医证候疗效得到综合改善,疗效持久。
[Abstract]:Objective: to observe the short term and long term clinical effect of massage combined with Feng's kneading manipulation combined with internal Chinese medicine and oral Chinese medicine alone in treating children with deficiency of spleen and kidney of infantile enuresis.From the aspect of TCM syndromes, we observed and compared the number of nocturnal enuresis, sleep depth, nocturnal urine volume, daytime frequency of urine, and then observed the stability of long-term therapeutic effect.Through the scientific analysis of statistical measurement and counting, the results of the two groups were compared whether there were significant differences between the two groups before and after,The statistical data were used to prove whether the effect of characteristic manipulation (massage combined with Feng's kneading manipulation) combined with traditional Chinese medicine was better than that of the control group with oral Chinese medicine alone.To explore the mechanism of characteristic manipulation (massage combined with Feng's kneading manipulation) in the treatment of infantile enuresis.Methods: referring to the "expert consensus on the management of monomorphic nocturnal enuresis in Chinese children", "criteria for the diagnosis and curative effect of TCM Disease Syndrome" and "terms of Clinical diagnosis and treatment of traditional Chinese Medicine" formulated by the 16th National Academy of Pediatrics Kidney Disease in November 2014National standard (syndrome part) > spleen and kidney deficiency syndrome,110 cases of children with deficiency of spleen and kidney were randomly divided into two groups: massage combined with Feng's kneading manipulation combined with traditional Chinese medicine, and only oral Chinese medicine as the control group.Before treatment, the number of nocturnal enuresis, sleep depth, nocturnal urine volume, daytime urine frequency, diet, facial color and other items were scored respectively, and the above items were scored again after the first course of treatment.Three months after the end of the treatment, the above items were scored again, and the curative effect of massage combined with Feng's kneading manipulation combined with traditional Chinese medicine on the treatment of infantile enuresis (spleen and kidney deficiency syndrome) was observed from TCM syndrome.Statistical data were used to analyze whether the curative effect of the two groups was statistically significant.Results: after 4 weeks of treatment, the scores of TCM syndromes were compared with those of massage combined with Feng's kneading manipulation combined with traditional Chinese medicine.After one month of treatment, the effective rate of the treatment group with massage combined with Feng's kneading manipulation combined with internal Chinese medicine administration was 72.7%, while that of the control group with oral Chinese medicine was 34.5%. The treatment group was not treated after treatment.One month is obviously superior to the control group in TCM syndromes.There was a statistical difference between the two groups in terms of statistics. However, the treatment group with massage combined with Feng's kneading manipulation combined with internal Chinese medicine administration was better than the treatment group with oral Chinese medicine alone in the improvement of facial color and the improvement of diet, which was an independent TCM syndrome.There were significant differences between the two groups in the above two specific items, and after three months, the curative effect was: the effective rate of the treatment group was 96.5a, and the control group was 74.5x2X 8.419p 0.004P0.01.The treatment group of massage combined with Feng's kneading manipulation combined with traditional Chinese medicine was superior to the control group with oral Chinese medicine alone.Especially in the nocturnal enuresis, urine volume, daytime urine frequency improvement, facial improvement, diet improvement of the independent TCM syndrome, there was a significant difference between the two groups (P 0.05).Conclusion: the therapeutic effect of massage combined with Feng's kneading manipulation combined with traditional Chinese medicine for the treatment of infantile enuresis (spleen and kidney deficiency syndrome) is higher than that of traditional Chinese medicine alone, especially the treatment group is superior to the control group in the long-term curative effect.It embodies the whole concept of Chinese medicine and the application advantage of dialectical thinking in the characteristic manipulation of traditional Chinese medicine, which can improve the curative effect of the whole TCM syndrome of children with enuresis comprehensively, and the curative effect is lasting.
【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】：2016
【分类号】：R244.1

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