小儿推拿对虚证哮喘患儿哮喘控制水平和生存质量的影响

发布时间：2018-04-15 09:42

本文选题：哮喘患儿 + 推拿手法　；参考：《广州中医药大学》2016年硕士论文

【摘要】：背景：儿童支气管哮喘具有病程长,易复发,治疗周期长的发病特点,严重影响患者心理和生理健康,如何减少哮喘发作频率,提高哮喘控制水平及患儿生命质量已成为目前儿童哮喘研究亟需解决的问题。持久的规范化治疗配合中医推拿手法日益受到重视。中医推拿手法,作为一种有效的外治措施,具有取穴少、简便有效、患儿易于接受的特点,临床应用广泛,但缺乏规范的疗效评价。目的：本研究从门诊哮喘虚证患儿入手,观察推拿手法在提高虚证哮喘患儿哮喘控制状况及生活质量方面的有效性。方法：本课题研究对象为2015年3月至2016年3月广东省中医院儿科门诊就诊,符合纳入标准的患儿,对其提供定期哮喘健康教育,随机分成治疗组例,对照组例,共60例。治疗组给予提供哮喘规范化治疗基础上加用推拿手法,证属虚证推拿治疗基本处方：补脾经300,补肾经300,清肺平肝300,捏脊5遍,合计30分钟,隔天治疗1次,一周3次,连续治疗8周。对照组仅提供哮喘规范化治疗。所有入组患儿或其监护人在试验结束后需要完成儿童哮喘控制测试量表(C-ACT)以评估哮喘控制情况,完成小儿哮喘生存质量量表(PAQLAQ)以评估哮喘对患者生命质量的影响。结果：两组患儿接受干预措施前后,统计分析结果如下：哮喘控制状况：接受干预措施前,治疗组完全控制病人10人,部分控制13人,未控制6人；对照组完全控制9人,部分控制14人,未控制5人；接受干预措施后,治疗组完全控制11人,部分控制16人,未控制2人；对照组完全控制8人,部分控制15人,未控制5人；经秩和检验,2组自身前后对比均提示P0.05；组间对比提示P0.05,结果治疗组、对照组在哮喘控制方面无差异。生活质量状况：治疗组治疗前后,经相关检验,总分、症状、活动积分对比,P0.05,差异有统计学意义。结果治疗组在接受哮喘规范化治疗和推拿8周后,生活质量总分积分、症状积分、活动积分评定方面优于治疗前。对照组治疗前后,经t检验,生活质量各维度P0.05,差异无统计学意义。结果：在接受哮喘规范化治疗8周后,哮喘规范化治疗8周对哮喘患儿生活质量改善无意义。情感障碍积分方面,2组治疗前后对比,经秩和检验,P0.05,。结果提示治疗8周后,2组情感障碍积分同治疗前无差别。生活质量方面组间对照,经秩和检验,两组治疗后各维度差值对比提示,症状积分P0.05,两组间差异有统计学意义。结果治疗组生活质量症状改善积分方面优于对照组。结论：运用哮喘规范化治疗联合推拿手法在改善缓解期虚证哮喘患儿生活质量方面疗效显著,主要体现在症状积分、活动受限积分领域,在提高生活质量方面可进一步推广。短期内哮喘控制状况欠佳,探索新的干预措施提高哮喘患儿控制状况十分必妥。
[Abstract]:Background: bronchial asthma in children is characterized by long course of disease, easy recurrence and long treatment cycle, which seriously affects the psychological and physiological health of patients, and how to reduce the frequency of asthma attack.Improving asthma control level and children's quality of life has become an urgent problem in children asthma research.Long-lasting standardized treatment combined with traditional Chinese medicine massage technique has been paid more and more attention.Chinese massage, as an effective external treatment measure, has the characteristics of few points, simple and effective, easy to accept in children, widely used in clinic, but lack of standardized evaluation of curative effect.Objective: to observe the effectiveness of massage manipulation in improving asthma control and quality of life of asthmatic children.Methods: from March 2015 to March 2016, paediatric outpatient of Guangdong traditional Chinese Medicine Hospital, who met the inclusive criteria, were randomly divided into treatment group (n = 60) and control group (n = 60).The treatment group was given the basic prescriptions of massage therapy on the basis of providing standardized treatment for asthma, and the syndrome belonged to deficiency syndrome. The basic prescriptions of massage treatment were: reinforcing spleen meridian 300, tonifying kidney meridian 300, clearing lung and calming liver 300 times, pinching ridges for 5 times, total 30 minutes, treating once every other day, 3 times a week,The patients were treated continuously for 8 weeks.The control group only provided standardized treatment for asthma.All the children or their guardians were required to complete the Child Asthma Control scale (C-ACTs) to assess the asthma control and to evaluate the impact of asthma on the quality of life of the patients after the completion of the Pediatric Asthma quality of Life scale (PAQLAQ).Results: before and after the intervention, the results of statistical analysis were as follows: asthma control: before the intervention, 10 patients were completely controlled in the treatment group, 13 patients were partially controlled, 6 patients were not controlled, and 9 patients were completely controlled in the control group.After the intervention, 11 patients in the treatment group were completely controlled, 16 in the treatment group and 2 in the control group, 8 in the control group, 15 in the control group, and 5 in the control group.The results showed that there was no difference in asthma control between treatment group and control group.Quality of life: before and after treatment, the treatment group, through the correlation test, total score, symptoms, activity score compared with P0.05, the difference was statistically significant.Results the quality of life score, symptom score and activity score of the treatment group were better than those before treatment after 8 weeks of standardized treatment and massage therapy.Before and after treatment in the control group, there was no significant difference in all dimensions of quality of life (P0.05) by t test.Results: after 8 weeks of standardized treatment of asthma, 8 weeks of standardized treatment of asthma had no significance to improve the quality of life of asthmatic children.The scores of affective disorders were compared before and after treatment with rank sum test (P 0.05).The results showed that there was no difference in the scores of affective disorders between the two groups after 8 weeks of treatment.In terms of quality of life (QOL) control, the difference between the two groups after treatment showed that the symptom score (P0.05) was significantly different between the two groups by rank sum test.Results the improvement score of QOL in the treatment group was better than that in the control group.Conclusion: the standard treatment of asthma combined with massage is effective in improving the quality of life of asthmatic children with asthenia in remission, mainly in the field of symptom score and restricted activity score, and can be further popularized in improving the quality of life of asthmatic children.The short-term asthma control condition is poor, it is necessary to explore new intervention measures to improve the asthma children's control situation.
【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】：2016
【分类号】：R244.1

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