捏脊疗法对哮喘儿童身高影响的临床研究

发布时间：2019-06-20 14:17

【摘要】：目的：本课题是通过应用捏脊疗法辅助治疗哮喘儿童1年,观察该疗法对治疗组儿童身高、体重的影响,同时观察该疗法对哮喘儿童的症状及直接医疗成本的影响。方法：通过抽取70例4～5岁门诊就诊的哮喘患儿,分成捏脊治疗组35例和非捏脊对照组35例,并对他们的病情进行评估分级。按照病情需要使用西药治疗如ICS、茶碱类、β2受体激动剂等,在此基础上,捏脊治疗组加以捏脊疗法,由专人培训患儿家长掌握捏脊方法：自长强穴捏至大椎穴,如此反复7遍,每日1次,操作可在夜间睡前或洗澡后进行。非捏脊对照组则不施加捏脊治疗。同时并设立健康对照组,取同期同龄健康儿童35例。观察时间为12个月,每月通过门诊复诊或电话随访收集临床资料；观察指标包括：1、三组观察对象的身高、体重的变化情况；2、哮喘患儿的喘息发作次数、日间症状(鼻塞流涕、咳嗽、喷嚏、气促)和夜间症状(夜间憋醒、咳嗽)的天数；3、患儿每次就诊的费用即直接医疗成本(挂号费、诊查费、治疗费、药费)。结果：同健康对照组儿童年平均身高、体重年增长相比,轻度哮喘患儿年平均身高、体重增长分别减少了0.31cm、0.07kg, P＞0.05,差异无统计学意义。捏脊治疗组经治疗后身高年平均增长比非捏脊组的年平均身高增长增加了0.82cm,差异有统计学意义(P0.05)；捏脊治疗组患儿经治疗后体重年平均增长比非捏脊对照组增加了0.5kg,P0.05,差异有统计学意义；捏脊治疗组患儿经治疗后其身高年平均增长7.48cm,正常儿童年平均增长6.97,cm,两组相比,差异有显著性(P0.05)；捏脊治疗组患儿经治疗后其体重年平均增长2.04kg,正常儿童年平均增长1.81kg,两组相比,差异有显著性(P0.05)。捏脊治疗组哮喘患儿喘息发作的次数少于非捏脊组患儿,差异有统计学意义(P0.01)。捏脊治疗组与非捏脊治疗组的临床症状(日间症状、夜间症状)相比较,差异有显著性(P0.01)。非捏脊组哮喘患儿年平均直接医疗费用为4798.70元,捏脊治疗组年平均直接医疗费用为363.79元,两组费用相比,P0.01,差异有显著性。结论：捏脊疗法操作简便、耗时少,依从性好,易被患儿及家长接受。捏脊疗法不仅能促进哮喘患儿身高、体重的增长,并且能减少哮喘患儿的喘息发作次数、改善患儿的临床症状(日间症状和夜间症状),同时还可以降低哮喘患儿的直接医疗成本,减轻患儿家长的精神和经济负担。另外,哮喘患儿身高、体重的年增长值和健康儿童的身高、体重年增长值差异无显著性。
[Abstract]:Objective: To study the effect of this therapy on the children's height and body weight in the treatment group, and to observe the effect of the therapy on the symptoms and direct medical cost of children with asthma. Methods: A total of 70 children with asthma from 4 to 5 years of age were collected,35 cases of the treatment group and 35 cases of the non-pinch control group were divided into the treatment group, and their condition was assessed and graded. According to the condition, western medicine can be used for treating such as ICS, theophylline and other receptor agonists. The operation can be carried out before or after night. No pinch treatment was applied in the non-pinch control group. At the same time, a healthy control group was established to take 35 cases of healthy children of the same age in the same period. The observation time was 12 months, and the clinical data were collected every month through the clinic visit or the telephone follow-up; the observation indexes include:1, the change of the height and the weight of the three groups of observation objects;2. the number of wheezing episodes and the daytime symptoms of the children with asthma (nasal obstruction, nasal discharge, cough, sneezing, The number of days of gas and night symptoms (night-up and cough);3. The cost of each visit to the child is the direct medical cost (the medical expense, the medical fee, the treatment fee, the medical expense). Results: The average height and body weight of the children with mild asthma decreased by 0.31 cm, 0.07 kg and P> 0.05, respectively, with no statistical significance compared with the average height of the children in the healthy control group. The average increase of height in the treatment group was 0.82 cm, the difference was statistically significant (P0.05). The average increase of the body weight in the treatment group was 0.5kg, P0.05, and the difference was of statistical significance. In the treatment group, the average height of the children in the treatment group was 7.48 cm, the average growth of the normal children was 6.97, cm, and the difference was significant (P0.05). The average increase of the body weight of the children with the treatment group was 2.04 kg and the average of the normal children was 1.81 kg, compared with that of the two groups. The difference was significant (P0.05). The number of wheezing episodes in the patients with asthma in the treatment group was less than that of the non-pinch group (P0.01). The clinical symptoms (daytime and night symptoms) of the treatment group and the non-pinching treatment group were significant (P0.01). The average direct medical cost of the non-pinching group was 4798.70 yuan, the average direct medical expense in the treatment group was 363.79 yuan, and the difference between the two groups was significantly higher than that of the two groups. Conclusion: The method is simple, time-consuming and good in compliance, and is easy to be accepted by children and parents. The invention can not only promote the height and body weight of the children with asthma, but also can reduce the number of wheezing episodes of the children with asthma, improve the clinical symptoms of the children (daytime symptoms and night symptoms), and also can reduce the direct medical cost of the children with asthma, And the mental and economic burden of the parent of the child is reduced. In addition, the annual growth of height and body weight of children with asthma and the height of healthy children were not significant.
【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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