立足“气一元论”从大气阳气论治小儿运动发育迟缓的临床观察

发布时间：2019-04-22 17:31

【摘要】：研究背景:随着医学科学技术的进步,新生儿抢救水平的提高,新生儿重症监护技术的加强,导致高危儿的出生率、存活率逐年提高,脑损伤患儿的发生率相应的呈现出增高趋势。同时因为人们生活水平、教育程度的提高,越来越多的家长关注孩子的精神运动发育情况,使得尽早、及时、有效的治疗小儿运动发育迟缓成为一项重大的课题。小儿发育迟缓属于儿科的疑难病,是世界性的医学难题,迄今仍没有特别行之有效的治疗方案,而且在纯中医的治疗方面更是尚属空白。本研究主要是总结导师吕英教授在临床上对小儿发育迟缓的理论认识及治疗经验,并对治疗效果进行客观的数据分析。研究目的:通过总结吕英导师对小儿发育迟缓的理论认识和治疗方法,认为小儿发育迟缓的治疗应从大气、阳气不足入手。通过对临床治疗思路的总结,对临床数据的收集、整理、分析来证明这一治疗方法的有效性,探讨总结出一套合理有效的纯中医治疗方案,从而改善患儿的运动能力。研究方法及内容:通过查阅文献、咨询专家后设计了一套临床疗效观察方法。对2015年1月至2017年3月来南方医科大学南方医院古中医疑难杂病诊疗中心就诊的符合纳入标准的30例运动发育迟缓的患儿进行信息采集,从大气、阳气入手,临床治疗时辨证论治,随证治之,方无定方,法无定法,纳入研究的患儿在治疗期间不接受其他任何的疗法。患儿每半个月于南方医科大学南方医院古中医科就诊一次,每次7剂药,每剂中药分为2日服用,每日分2次,每次50ml,每日早晚饭后一小时服药。每个纳入研究的患儿共就诊6次,分别于治疗前、治疗3次后半个月、治疗6次后半个月填写粗大运动能量评估表,对三次的数据进行收集整理,采用SPSS20.0统计软件建立数据库,采用单因素方差分析法对三次的数据进行分析、运用拉丁方方差分析法对可能影响数据结果的因素,包括年龄、性别、初始病情程度进行分析,均以P0.05为差异有统计学意义,进而探讨立足大气、阳气运用纯中药治疗小儿运动发育迟缓的临床疗效。研究结论:通过对临床数据的分析,可以得出立足大气、阳气,临证辨证论治的纯中医疗法来治疗小儿运动发育迟缓是可以改善患儿的粗大运动能力的。而且通过数据分析可知,在六次治疗中,前三次治疗后粗大运动功能评分上升的幅度大于后三次治疗,说明随着治疗时间的延长,治疗效果是不断提升的,但提升幅度有减小的趋势。在对可能影响患儿治疗效果的一些因素,例如性别、年龄、初始病情做分析后,发现性别、年龄、初始病情均对研究结果无影响,说明本治疗方法在治疗小儿运动发育迟缓方面具有普遍的效果,临床治疗时可不分年龄、不分性别、不分病情轻重。
[Abstract]:Background: with the advancement of medical science and technology, the improvement of neonatal rescue level and the strengthening of neonatal intensive care technology, the birth rate and survival rate of high-risk infants have been improved year by year. The incidence of brain injury in children showed an increasing trend accordingly. At the same time, due to the improvement of people's living standard and education, more and more parents pay attention to the mental and motor development of their children, which makes the treatment of children's motor retardation as soon as possible, timely and effective has become a major issue. Infantile stunting is a difficult and difficult disease in paediatrics, and it is a worldwide medical problem. So far, there is still no effective treatment scheme, and the treatment of pure traditional Chinese medicine is still blank. The main purpose of this study is to summarize the theoretical understanding and treatment experience of infantile stunting in clinical practice, and to analyze the effect of treatment with objective data. Objective: through summarizing Lu Ying's theoretical understanding and treatment of infantile stunting, the author thinks that the treatment of infantile stunting should begin with the deficiency of Yang Qi and atmosphere. Through the summary of clinical treatment ideas, collection, collation and analysis of clinical data to prove the effectiveness of this treatment method, explore and summarize a reasonable and effective pure Chinese medicine treatment plan, so as to improve the exercise ability of children. Methods and contents: a set of clinical efficacy observation methods was designed by consulting experts. From January 2015 to March 2017, 30 children with stunted movement who met the inclusion criteria from the Center for diagnosis and treatment of difficult and complex Diseases of Ancient Chinese Medicine in Southern Hospital of Southern Medical University were collected for information, starting from atmosphere and Yang Qi. The children who were included in the study did not receive any other therapy during the treatment of syndrome differentiation, syndrome differentiation and treatment with syndrome, prescription without definite prescription and method without definite method. The children were treated in ancient Chinese medicine every half month in Southern Hospital of Southern Medical University. Each dose of Chinese medicine was divided into 2 days, twice a day, 50 ml per day, and one hour after meal every morning and evening. Each child included in the study visited a total of 6 times, respectively before treatment, after 3 treatment for half a month, 6 times for the second half month of treatment to fill in the gross exercise energy assessment form, to collect and collate the data of three times. SPSS20.0 statistical software was used to establish the database, one-way ANOVA method was used to analyze the data of three times, and Latin variance analysis was used to analyze the factors that might affect the results of data, including age, sex, and so on. Analysis of the initial severity of the disease, P0.05 as a statistical difference, and then to explore the air-based, Yang Qi use of pure Chinese medicine in the treatment of children with motor retardation clinical efficacy. Conclusion: through the analysis of clinical data, it can be concluded that the pure TCM therapy based on atmosphere, Yang Qi and syndrome differentiation can improve the gross motor ability of children with motor retardation. And through the data analysis, it can be seen that in the six treatments, the increase of the gross motor function score after the first three treatments is greater than that of the latter three treatments, indicating that with the prolongation of the treatment time, the effect of the treatment is continuously improved. However, there is a decreasing trend in the range of increase. After analyzing the factors that might affect the outcome of treatment, such as sex, age and initial condition, it was found that sex, age and initial condition had no effect on the results of the study. It is concluded that this method has a universal effect in the treatment of children with motor retardation, and the clinical treatment can be conducted regardless of age, sex or severity of illness.
【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.7

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