本文選題：小兒夜啼　切入點：刮痧　出處：《福建中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:通過觀察導師臨床運用刮痧療法治療小兒"心經積熱"型夜啼的臨床療效,分析探討刮痧配合中藥治療該病的理論依據(jù)及具體方法,為治療心經積熱型夜啼患兒提供新的思路和治療方法。方法:本次研究采用隨機對照研究方法,收集廈門市中醫(yī)院兒科門診2015年12月-2017年1月符合小兒心經積熱型夜啼的患兒60例,隨機分為實驗組與對照組。實驗組30人運用刮痧配合導赤散加減口服治療,對照組30人運用導赤散加減口服治療對比,刮痧部位背部取足太陽膀胱經背部循行部分,手部部采取刮拭天河水穴、六腑穴,先沿脊柱旁開1.5寸從大椎至小腸腧循行部位刮試20～30次,刮拭方向從上向下,以皮膚潮紅為度,手肘部采取刮拭天河水、六腑,天河水為曲池往腕橫紋方向刮拭20次,六腑為肘橫紋往腕橫紋方向刮拭20次,刮痧程度視患兒承受能力而定,力度輕柔,以皮膚潮紅為度,刮痧1周2次。導赤散加減水煎服,每次煎藥量約50ml,日一劑,分早晚飯后服用,治療1個療程,2周為一療程,治療過程中均無脫落病例,治療前后主癥啼哭及各中醫(yī)次癥采用積分觀察表,記錄主癥前后積分變化及中醫(yī)次癥前后總積分變化,并作統(tǒng)計學處理。結果:兩組在治療前一般情況如性別、年齡、病程、主癥積分、各次癥積分、中醫(yī)癥狀總積分、舌象和指紋方面均P0.05,無統(tǒng)計學差異,具有可比性。治療后:①實驗組與對照組的治療方法均能降低小兒夜啼的癥狀積分及中醫(yī)證候總積分,即都能起到治療效果,但實驗組啼哭積分差值的均數(shù)(1.77±0.817)對照組啼哭積分差值的均數(shù)(0.87±0.507),說明實驗組對改善啼哭優(yōu)于對照組。②實驗組在啼哭有效率(90%)、中醫(yī)癥候總積分有效率(100%)分別高于對照組啼哭有效率(63.33%)、中醫(yī)證候總積分有效率(70%),啼哭有效率P=0.003,中醫(yī)癥候總積分有效率P=0.00,P值均0.05,說明二者比較差異有統(tǒng)計學意義,且實驗組在啼哭有效率方面明顯高于對照組。結論：應用刮痧配合導赤散加減治療小兒心經積熱型夜啼有效,且優(yōu)于口服導赤散加減治療,具有臨床價值。刮痧作為傳統(tǒng)的中醫(yī)外治手段,具有綠色、安全、無毒副作用,發(fā)揮中醫(yī)藥優(yōu)勢,體現(xiàn)了中醫(yī)藥特色,值得廣大兒科工作者進行推廣和應用。
[Abstract]:Objective: to observe the clinical curative effect of scrapping therapy on night-cry of "heart meridian and heat" in children, and to analyze the theoretical basis and concrete method of scraping combined with Chinese medicine in treating the disease. Methods: a randomized controlled study was used in this study to provide a new way of thinking and treatment for the treatment of night-crow children with heart meridian accumulation fever. From December 2015 to January 2017, 60 children were randomly divided into two groups: the experimental group and the control group. 30 patients in the experimental group were treated with scraping plus plus or minus oral administration of Daochi Powder. In the control group, 30 patients were treated by oral administration of Daochi Powder, the back of the scraping area was removed from the back of the sun and the bladder meridian along the back, and the hand part was taken to wipe the Tianhe water point and the six fu-organs point. At first, 1. 5 inches along the side of the spine, 1. 5 inches from Dazhui to the small intestine, 20 times, 20 times, 20 times in the direction of wiping from the top to the bottom, with the skin flushed red, the hands at the elbows taking the wiping of the Tianhe water, the six entrails, the Tianhe water for 20 times in the direction of the cross stripes of the wrists. The six Fu organs are cubital striations to the direction of wrist stripes for 20 times. The degree of scraping depends on the bearing capacity of the children. The degree of scraping is gentle, with skin flushing as a degree, scraping twice a week. Daochi San plus water reducing decoction, each time the amount of decoction is about 50 ml, one dose per day, They were taken in the morning and evening after meals, one course of treatment was given for 2 weeks. There were no cases of abscission in the course of treatment. Before and after treatment, the main symptoms cried and every TCM symptom was observed by integral observation table. Results: before and after treatment, the general conditions of the two groups were gender, age, course of disease, main symptom score, each symptom score, TCM symptom total score, There was no statistical difference in tongue image and fingerprint, which was comparable. After treatment, the treatment methods of both experimental group and control group could reduce the symptom score and the total score of TCM syndromes of children with nocturnal crow, that is, they could all play a therapeutic role. But the mean value of crying score difference was 1.77 鹵0.817 in the experimental group and 0.87 鹵0.507 in the control group, which indicated that the experimental group was superior to the control group in improving the crying rate by 90%, and the total effective rate of TCM symptom score was 100% higher than that in the control group. The effective rate of crying was 63.33%, the total integral rate of TCM syndromes was 70%, the effective rate of crying was 0.003, the total effective rate of TCM symptom score was 0.05, which indicated that the difference between the two groups was statistically significant. The effective rate of crying in the experimental group was significantly higher than that in the control group. Conclusion: the effect of scraping combined with the addition and subtraction of Daochi Powder in treating night-cry of heart meridian accumulation fever type in children is more effective and better than that in oral treatment. Scraping, as a traditional external treatment method of traditional Chinese medicine, has green, safe, no toxic side effects, exerts the advantages of traditional Chinese medicine, embodies the characteristics of traditional Chinese medicine, and is worth popularizing and applying to the vast number of pediatricians.
【學位授予單位】：福建中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R272

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