【作者】 蔡洁；

【导师】 邵瑛；

【作者基本信息】 广州中医药大学 ， 针灸推拿学（专业学位）， 2020， 硕士

【摘要】 目的:研究滋水涵木推拿法配合常规推拿法治疗肝旺脾虚型小儿厌食的临床疗效,并与采用常规推拿法组进行对照,比较两组临床疗效差异。旨在阐明滋水涵木推拿法治疗肝旺脾虚型小儿厌食的优越性。方法:收集符合肝旺脾虚型小儿厌食诊断标准及纳入标准的病例72例,签署知情同意书后随机分至试验组和对照组,按剔除标准、脱落标准等筛除,最后收集病例为试验组35人,对照组34人。试验组采用滋水涵木推拿法配合常规推拿法治疗,对照组采用常规推拿法进行治疗。两组分别治疗4个疗程。研究过程中,分别记录两组患儿的性别、年龄、病程、治疗前后的体重及中医症状积分。最后运用SPSS 23.0对两组患儿治疗前后体重、中医症候积分以及临床疗效进行评估比较。结果:1.纳入本研究的72例病例中,共出现3例病例脱失。试验组实际完成35例,对照组实际完成34例。2.试验组和对照组两组患儿的在治疗前性别、年龄、病程、体重、中医症状积分、各症状项目积分差异均无统计学意义(P>0.05),具有良好可比性。3.临床疗效比较:(1)体重:两组患儿的体重均较前明显增加(P<0.05);组间比较,两组的体重及治疗前后体重差值进行比较,试验组体重增加幅度大于对照组(P<0.05)。(2)中医各症状项目积分:两组的中医各症状积分均较治疗前明显下降(P<0.05);组间比较,在食量、烦躁易怒、兴奋躁动、嗳气、夜寐难安这五个症状项目积分方面,试验组改善程度均大于对照组(P<0.05),在食欲、大便失调这两个症状项目积分方面,两组积分差异无统计学意义(P>0.05)。(3)中医症状积分:两组的中医症状积分均较前明显降低(P<0.05);组间比较,两组的中医症状积分及治疗前后差值进行比较,试验组下降幅度均大于对照组(P<0.05)。(4)总有效率:本研究发现试验组和对照组治疗肝旺脾虚型小儿厌食均有疗效。试验组的总有效率为94.3%,对照组的总有效率为82.4%。试验组的总有效率高于对照组(P<0.05)。结论:滋水涵木推拿法配合常规推拿法与单纯采用常规推拿法对治疗肝旺脾虚型小儿厌食均有疗效。其中,滋水涵木推拿法配合常规推拿法治疗肝旺脾虚型小儿厌食疗效显著,滋水涵木推拿法在改善肝旺脾虚型小儿厌食的食量、烦躁易怒、兴奋躁动、嗳气、夜寐难安症状方面,疗效优于单纯采用常规推拿法。更多还原

【Abstract】 ObjectiveTo study the clinical effect of nourishing kidney and clearing liver massotherapy combined with conventional massotherapy in treating infantile anorexia of hyperactivity of liver and insufficiency of spleen.The aim of this study is to clarify the advantages of nourishing kidney and clearing liver massotherapy in treating infantile anorexia of hyperactivity of liver and insufficiency of spleen.MethodsA total of 72 children who met the diagnostic criteria and inclusion criteria of infantile anorexia of hyperactivity of liver and insufficiency of spleen were enrolled in this study.After signing the informed consent form,this 72 cases were randomly divided into experimental group and control group.Finally,35 cases were collected in experimental group and 34 cases in control group according to the exclusion and falling off criteria.The experimental group was treated with nourishing kidney and clearing liver massotherapy combined with conventional massotherapy,and the control group was treated with conventional massotherapy.The two groups were treated with 4 courses of treatment.In the course of the study,the sex,the age,the course of disease,the weight before and after treatment,and the score of TCM symptoms were recorded respectively.Finally,we used SPSS 23.0 to evaluate and compare the weight,the TCM symptom score before and after treatment and the clinical effect of the two groups.Results1.A total of 3 cases were absent in the 72 cases in this study.The experimental group actually completed 35 cases,and the control group actually completed 34 cases.2.There was no significant difference in sex,age,course of disease,weight,TCM symptom score and each symptom score between the two groups before treatment(P>0.05),which was of good comparability.3.Comparisons of clinical efficacy:(1)Weight:The weight of children in the two groups increased significantly(P<0.05).The weight of the two groups and the weight’s difference before and after treatment were compared between the two groups,the weight gain of the experimental group were greater than those of the control group(P<0.05).(2)Each TCM symptom score:The scores of TCM symptoms in the two groups were significantly lower than those before treatment(P<0.05).In the five symptom items of food intake,irritability,excitement and restlessness,belching and sleep distress,the improvement of the experimental group were greater than those of the control group(P<0.05).In the two symptom items of appetite and defecating disorder,the difference between the two groups were not statistically significance(P>0.05).(3)TCM symptom score:The TCM symptom score was significantly lower than that before treatment(P<0.05).The TCM symptom score and the difference before and after treatment were compared between the two groups,The decrease of the experimental group were greater than those of the control group(P<0.05).(4)Total effective rate:This study found that the experimental group and the control group were effective in the treatment of infantile anorexia of hyperactivity of liver and insufficiency of spleen.The total effective rate of the experimental group was 94.3%,and the total effective rate of the control group was 82.4%.The total effective rate of the experimental group was higher than that of the control group(P<0.05).ConclusionNourishing kidney and clearing liver massotherapy combined with conventional massotherapy and conventional massotherapy in the treatment of infantile anorexia of hyperactivity of liver and insufficiency of spleen all have curative effect.However,the effect of nourishing kidney and clearing liver massotherapy combined with conventional massotherapy for the treatment of infantile anorexia of hyperactivity of liver and insufficiency of spleen is remarkable.In improving the aspects of food intake,irritability,excitement and restlessness,belching and sleep distress of infantile anorexia of hyperactivity of liver and insufficiency of spleen,the effect of nourishing kidney and clearing liver massotherapy is better than that of conventional massotherapy.更多还原