【摘要】：目的:本研究以脾虛型疳積患兒為臨床干預(yù)對(duì)象,通過(guò)運(yùn)用小兒捏脊結(jié)合嶺南中醫(yī)流派獨(dú)特的推拿手法對(duì)脾虛型疳積患兒進(jìn)行調(diào)治,觀察其臨床療效及對(duì)患兒的影響,并通過(guò)與小建中湯科學(xué)中藥顆粒進(jìn)行比較,分析不同療法的優(yōu)劣,為進(jìn)一步臨床應(yīng)用推廣提供科學(xué)依據(jù)。方法:于2016年2月-2016年12月在廣東省第二中醫(yī)院白云分院針灸門診及黃陂醫(yī)院針灸門診收集確診為疳積(脾虛型)的患兒70例。疳積的診斷標(biāo)準(zhǔn)依據(jù)《中醫(yī)病癥診斷療效標(biāo)準(zhǔn)》中疳癥的診斷:(1)飲食異常,有明顯脾胃功能失調(diào)者;(2)形體消瘦,體重低于正常平均值15%~40%;(3)兼有精神不振,煩躁易怒,喜揉眉擦眼,吮指磨牙等癥;(4)有喂養(yǎng)不當(dāng),病后失調(diào),長(zhǎng)期消瘦史;(5)"蛔疳"大便鏡檢蟲卵陽(yáng)性;(6)貧血者伴血紅蛋白,紅細(xì)胞減少;(7)營(yíng)養(yǎng)性水腫,血清總蛋白在45g/L以下,血清白蛋白20g/L以下。脾虛證辨證依據(jù)《中藥新藥臨床研究指導(dǎo)原則》(2002年衛(wèi)生部版)(1)主癥:久不欲食,食而不化,食后腹脹,便溏或久泄;(2)次癥:少氣懶言,腹痛綿綿,形體偏瘦,面色少華;(3)舌脈象:舌質(zhì)淡,苔薄白,脈緩無(wú)力。具2項(xiàng)主癥,或1項(xiàng)主癥加2項(xiàng)次癥,即可診斷。將納入的70例對(duì)象按就診先后順序編號(hào),再據(jù)隨機(jī)數(shù)字表分為治療組及對(duì)照組2組,每組35例。治療組采用小兒捏脊療法結(jié)合嶺南中醫(yī)流派推拿手法進(jìn)行治療,1個(gè)月為1個(gè)療程,連續(xù)治療2個(gè)療程;對(duì)照組內(nèi)服小建中湯科學(xué)中藥顆粒。藥物組成:桂枝6g,甘草2g,芍藥8g,生姜2片,膠怡5g。每日1劑(3歲的用2/3量)。1個(gè)月為1個(gè)療程,連續(xù)治療2個(gè)療程后統(tǒng)計(jì)療效。在治療前和治療后分別采用相關(guān)量表對(duì)患兒進(jìn)行評(píng)分,評(píng)價(jià)捏脊結(jié)合嶺南推拿手法對(duì)脾虛型小兒疳積的臨床療效及作用。結(jié)果:治療前兩組中醫(yī)證候具有可比性(P0.05);治療組治療后與治療前中醫(yī)證候比較,經(jīng)秩和檢驗(yàn),Z=-4.788,P=0.0000.01,對(duì)照組治療后與治療前中醫(yī)證候比較,經(jīng)秩和檢驗(yàn),Z=-4.792,P=0.0000.01,差異有顯著統(tǒng)計(jì)學(xué)意義,說(shuō)明兩組均對(duì)小兒厭食癥中醫(yī)證候的改變有顯著的作用。兩組治療后組間比較,經(jīng)秩和檢驗(yàn),Z=-2.206,P=0.0270.05,差異有統(tǒng)計(jì)學(xué)意義,說(shuō)明治療組在改善中醫(yī)證候方面優(yōu)于對(duì)照組。治療組與對(duì)照組治療前后癥狀積分比較,差異均具有統(tǒng)計(jì)學(xué)意義(P0.05,P0.01);治療組與對(duì)照組治療后食后腹脹、少氣懶言癥狀積分比較有統(tǒng)計(jì)學(xué)意義(P0.05)。提示小建中湯對(duì)各臨床表現(xiàn)有明顯的改善作用,對(duì)照組對(duì)各臨床表現(xiàn)也有改善作用,但治療組對(duì)食后腹脹、少氣懶言方面的改善作用優(yōu)于對(duì)照組。治療組無(wú)不良反應(yīng)發(fā)生,對(duì)照組不良反應(yīng)發(fā)生率為2.8%兩組不良反應(yīng)發(fā)生率經(jīng)X2分析,X2=0.000,P=1.0000.05,差異無(wú)統(tǒng)計(jì)學(xué)意義,說(shuō)明兩組安全性都較高。結(jié)論:捏脊結(jié)合嶺南推拿手法及小建中湯對(duì)脾虛型疳積患兒厭食癥中醫(yī)證侯及食后腹脹、少氣懶言癥狀的改善均具有一定的效果,但捏脊結(jié)合嶺南推拿手法的效果更佳。
[Abstract]:Objective: in this study, the children with spleen deficiency type chancre accumulation were taken as the clinical intervention object, and the children with spleen deficiency type chancre accumulation were treated by using the unique massage technique of children kneading ridges combined with Lingnan traditional Chinese medicine school, and the clinical curative effect and its influence on children were observed, and the advantages and disadvantages of different treatments were analyzed by comparing them with Xiaojianzhong decoction scientific traditional Chinese medicine granules, so as to provide scientific basis for further clinical application. Methods: from February 2016 to December 2016, 70 children with chancre accumulation (spleen deficiency type) were collected from the acupuncture clinic of Baiyun Branch Hospital of the second traditional Chinese Medicine Hospital of Guangdong Province and the acupuncture clinic of Huangpi Hospital. The diagnostic criteria of chancre accumulation were based on the diagnosis of chancre in traditional Chinese medicine: (1) abnormal diet, with obvious dysfunction of spleen and stomach; (2) body wasting, body weight less than 15% 鈮，

本文編號(hào)：2502416