本文選題：外感咳嗽 + 風(fēng)熱型��； 參考：《山東中醫(yī)藥大學(xué)》2014年碩士論文

【摘要】：目的：觀察推拿配合刺血療法治療小兒風(fēng)熱型咳嗽的臨床療效，以期為臨床治療小兒風(fēng)熱型咳嗽提供安全、規(guī)范、有效的治療方案。 方法：選取符合小兒風(fēng)熱型咳嗽診斷標(biāo)準(zhǔn)的87例門診患者，按照隨機(jī)數(shù)字表（通過SPSS17.0數(shù)據(jù)統(tǒng)計軟件生成）隨機(jī)分為綜合（推拿配合刺血療法）組（29例）、推拿組（29例）、刺血組（29例）。①綜合組：推拿療法：清肺經(jīng)4min、清天河水4min、揉風(fēng)門2min、按揉肺俞2min、按揉掌小橫紋4min、分推肩胛骨3min。每日1次，4次為1療程。刺血療法：取穴：肺俞、大椎、尺澤。操作：用碘伏消毒穴位皮膚，然后左手拇指、食指捏緊局部皮膚，用一次性采血針疾刺約1～2mm，，每穴擠血5滴，每滴如綠豆大小。然后用無菌干棉球壓迫止血。隔日1次，4次為1療程。②推拿組：臨床取穴、操作、療程等與綜合組推拿療法相同。③刺血組：臨床取穴、操作、療程等均與刺血療法相同。1個療程結(jié)束后，觀察比較三組患兒，治療后的總體臨床療效評分、癥狀體征評分、安全性及患兒依從性評分等。 結(jié)果：①總體療效觀察：1個療程后，綜合組治愈率為82.76%，總有效率為96.55%。推拿組治愈率為55.17%，總有效率為93.10%。刺血組治愈率為51.72%，總有效率為89.66%。三組患兒治愈率比較差異有統(tǒng)計學(xué)意義：P＜0.05。三組患兒總有效率比較無顯著差異：P＞0.05。提示三種方法治療小兒風(fēng)熱型咳嗽皆有療效，尤以綜合組療效佳。②臨床癥狀及體征綜合評分觀察：綜合組與推拿組、刺血組比較，差異均有統(tǒng)計學(xué)意義（P＜0.05），提示綜合組在改善患兒癥狀體征方面療效優(yōu)于其他兩組。③安全性觀察：治療過程中三組患兒基本生命體征如呼吸、心率、血壓無明顯變化，未出現(xiàn)感染、骨折、皮膚損傷、皮下淤血等情況，說明三種治療方法安全性高，適于臨床應(yīng)用。④患兒依從性觀察：比較三組患兒治療過程的依從性（P＞0.05），差異無統(tǒng)計學(xué)意義。提示三組患兒依從性都很高，患兒配合良好，適于臨床應(yīng)用。 結(jié)論：推拿配合刺血療法綜合治療小兒風(fēng)熱型咳嗽療效佳，值得臨床推廣應(yīng)用。
[Abstract]:Objective: to observe the clinical effect of massage combined with blood pricking therapy on wind-heat cough in children, so as to provide a safe, standardized and effective treatment scheme for children with wind-heat cough. Methods: 87 outpatients who met the diagnostic criteria of wind-heat cough in children were selected. According to the random digital table (generated by SPSS 17.0 data statistical software), randomly divided into comprehensive (massage combined with blood pricking therapy) group (29 cases), massage group (29 cases), blood pricking group (29 cases): massage therapy: clear lung meridian 4 minutes, clear Tianhe water 4 min, 2 min, 2min, 2min, 4min, 3 min. Once a day, 4 times as a course of treatment. Prick blood therapy: take point: lung Shu, Dazhui, ruler Ze. Operation: sterilize acupoint skin with iodophor, then pinch local skin with left thumb and index finger, prick about 1 ~ 2 mm with a single blood collection needle, squeeze 5 drops of blood per point, each drop is the size of mung bean. Then use sterile dry cotton balls to stop bleeding. Every other day, 4 times were used as a course of treatment. 2 massage group: clinical acupoint extraction, operation, course of treatment were the same as that of the combined group. 3. 3 blood pricking group: clinical acupoint collection, operation, course of treatment were the same as that of blood pricking therapy. After one course of treatment, the treatment period was the same as that of the blood pricking therapy. The total clinical efficacy score, symptom and sign score, safety and compliance score were observed and compared among the three groups. Results the general curative effect observation of 1: 1: after one course of treatment, the cure rate of the comprehensive group was 82.76 and the total effective rate was 96.55. The cure rate of massage group was 55.17 and the total effective rate was 93.10. The cure rate of blood pricking group was 51.72 and the total effective rate was 89.66. The difference of cure rate among the three groups was statistically significant (P < 0.05). There was no significant difference in the total effective rate between the three groups (P > 0.05). It is suggested that all the three methods are effective in the treatment of wind-heat cough in children, especially the comprehensive score of clinical symptoms and signs in the comprehensive group: the comprehensive group was compared with the massage group, the blood pricking group, and the blood pricking group. All the differences were statistically significant (P < 0.05), indicating that the curative effect of the comprehensive group in improving the symptoms and signs of the children was better than that of the other two groups: the basic vital signs such as respiration, heart rate and blood pressure did not change significantly in the three groups during the course of treatment. There was no infection, fracture, skin injury, subcutaneous congestion, etc., which indicated that the three treatment methods were safe and suitable for clinical observation of compliance of 4 children. The compliance of the three groups was compared (P > 0.05), and there was no significant difference between the three groups. The results suggest that the compliance of the three groups is very high, the children cooperate well and are suitable for clinical application. Conclusion: massage combined with blood acupuncture therapy is effective in treating children with wind-heat cough, and it is worth popularizing.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R246.4

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