本文關(guān)鍵詞：益氣活血運(yùn)脾小兒推拿法防治反復(fù)呼吸道感染　出處：《北京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

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【摘要】：目的:本次研究主要基于導(dǎo)師王俊宏教授益氣活血運(yùn)脾法治療小兒反復(fù)呼吸道感染(Recurrent Respiratory Tract Infection,RRTI)的思想,用相應(yīng)的小兒推拿手法進(jìn)行疾病干預(yù),并且觀察其臨床療效以及氣虛血瘀證候的改變,探討活血推拿手法在小兒反復(fù)呼吸道感染中的應(yīng)用意義。研究方法:選取于2015年12月至2016年11月期間,三里屯街道社區(qū)以及東直門醫(yī)院兒科門診的反復(fù)呼吸道感染患兒,共40例,在緩解期進(jìn)行益氣活血運(yùn)脾推拿法干預(yù)治療,依據(jù)自身前后對(duì)照原則進(jìn)行試驗(yàn)。選穴組方:補(bǔ)脾經(jīng)、順運(yùn)內(nèi)八卦、搓摩脅肋、啄捏中脘與氣海穴、捏脊、總收法,根據(jù)患兒年齡增加手法次數(shù)和時(shí)間。療程為每周推拿3次,1個(gè)月為1療程,一共3個(gè)療程。每個(gè)療程后進(jìn)行感染期癥狀評(píng)分和中醫(yī)氣虛血瘀證候治療前后積分對(duì)比。運(yùn)用SPSS20.0軟件進(jìn)行統(tǒng)計(jì)分析,多組數(shù)據(jù)間用單因素方差分析。研究結(jié)果:通過對(duì)反復(fù)呼吸道感染治療前后發(fā)病情況比較,接受治療的40例患兒在發(fā)病次數(shù)、病程與病種中上均有一定的改善,顯效26例,有效13例,無效1例,P0.05,提示益氣活血運(yùn)脾推拿法對(duì)防治反復(fù)呼吸道感染具有肯定的療效。治療前后感染期癥狀評(píng)分以及中醫(yī)氣虛證候評(píng)分經(jīng)統(tǒng)計(jì)分析,均P0.05,說明治療前后評(píng)分有顯著差異,具有統(tǒng)計(jì)學(xué)意義。各評(píng)分的平均值在第一療程和第二療程后減少,而第二和第三個(gè)療程評(píng)分的平均值差異并不明顯。中醫(yī)血瘀證候評(píng)分經(jīng)統(tǒng)計(jì)分析,P0.05,說明治療前后血瘀證候評(píng)分有差異,具有統(tǒng)計(jì)學(xué)意義。40例患兒的血瘀評(píng)分的平均值在治療前、第一個(gè)療程、第二療程和第三療程之間的平均值均有明顯差異。在40例里,24例的患兒帶有鼻梁青筋,經(jīng)益氣活血運(yùn)脾推拿手法治療后,19例的鼻梁青筋減輕或消失,5例無改變。經(jīng)統(tǒng)計(jì)分析,P0.05,說明治療前后鼻梁青筋體征有差異,有統(tǒng)計(jì)學(xué)意義�？诔�、舔口唇、手足心熱、眠中磨牙以及眠中翻身踢被癥狀在治療前后的數(shù)據(jù)經(jīng)統(tǒng)計(jì)分析,均P0.05,有統(tǒng)計(jì)學(xué)意義,說明治療對(duì)以上5種癥狀確有改善。研究結(jié)論:益氣活血運(yùn)脾推拿法能明顯改善反復(fù)呼吸道感染患兒的癥狀,使患兒的患病次數(shù)明顯減少、病程減短、病種減輕,并且面色晦暗、眼眶暗黑、舌質(zhì)紫暗瘀點(diǎn)等血瘀的癥狀明顯減輕。從感染期癥狀評(píng)分和中醫(yī)氣虛證候評(píng)分在每個(gè)療程后的平均值比較,提示患兒在經(jīng)過兩個(gè)療程后癥狀基本好轉(zhuǎn),第三個(gè)療程可作為穩(wěn)定治療。而從血瘀證候評(píng)分的平均值在治療前與每個(gè)療程后的比較,可推斷益氣活血運(yùn)脾推拿法在反復(fù)呼吸道感染的血瘀證候干預(yù)有明顯持續(xù)的作用。從19例帶有鼻梁青筋的患兒中發(fā)現(xiàn)經(jīng)過益氣活血運(yùn)脾推拿法后的改善,認(rèn)為鼻梁青筋除了提示脾虛,還能提示血瘀。因此,認(rèn)為此活血推拿手法在治療慢性、反復(fù)性疾病的意義應(yīng)予重視。另外,口臭、舔口唇、手足心熱、眠中磨牙以及眠中翻身踢被癥狀提示反復(fù)呼吸道感染患兒容易出現(xiàn)脾胃積熱的情況,因此治療需同時(shí)重視運(yùn)脾手法,升清降濁,消散脾胃積熱,以保障臨床效果。
[Abstract]:The purpose of this study is mainly based on Professor Wang Junhong Yiqihuoxue spleen method in treatment of children with recurrent respiratory tract infection (Recurrent Respiratory Tract Infection, RRTI) thought, for disease intervention with the corresponding massage technique, and to observe its clinical curative effect, Qi deficiency and blood stasis syndrome change, explore the significance of application of Huoxue massage technique in children with recurrent respiratory tract infection. Methods: selected from December 2015 to November 2016, Sanlitun street community and Dongzhimen hospital outpatient department of Pediatrics in children with recurrent respiratory tract infection, a total of 40 cases of Yiqihuoxue spleen massage therapy in remission, according to self control experiment. The principle of acupuncture prescription: spleen, Shunyun in gossip rub, rib, Zhongwan and Qihai peck pinch, chiropractic, total income method, according to the age of children, increase the number and time of treatment. Methods a week Massage 3 times, 1 months for a total of 1 courses, 3 courses. After each course of treatment were compared before and after infection period integral symptom score and TCM syndrome of qi deficiency and blood stasis treatment. Using SPSS20.0 software for statistical analysis, analysis of multiple sets of data using ANOVA. Results: the incidence of recurrent respiratory tract infection before and after treatment compared to receive the treatment of 40 cases of children in the incidence, improve the course and have certain diseases, 26 cases were markedly effective, 13 cases effective, 1 cases ineffective, P0.05, hint Yiqihuoxue spleen massage has certain curative effect on prevention of recurrent respiratory tract infection before and after treatment. Symptoms score and TCM syndrome of deficiency of Qi the score by statistical analysis, P0.05, shows the score before and after treatment were significantly different, with statistical significance. The average score decreased in the first course of treatment and second after treatment, while the second and third course score The average value of the difference is not obvious. After statistical analysis, the P0.05 score of blood stasis syndrome, blood stasis syndrome score before and after treatment showed a statistically significant difference,.40 cases of blood stasis score average before treatment, the first treatment, between second and third the average course of treatment was significantly different in 40 cases. In 24 cases of children with nasal veins, by Yiqihuoxue spleen massage after treatment, 19 cases of nasal veins decreased or disappeared in 5 cases, no change. After statistical analysis, P0.05, that before and after the treatment of nose veins were differences were statistically significant. The halitosis, licking lips, hot feeling, sleep in turn kicked by molars and sleep symptoms before and after treatment of the data by statistical analysis, P0.05, have statistical significance, indicating that the treatment of more than 5 kinds of symptoms have improved. Conclusion: Yiqihuoxue spleen massage can significantly improve the repeated call Respiratory tract infection in children with symptoms, the prevalence of children with significantly fewer disease duration shortened, reduced, and complexion, dark eyes, dark purple tongue petechia and blood stasis symptoms significantly reduced. The average scores were compared after each treatment from infection symptom score and TCM syndrome of deficiency of Qi, suggesting that children improved after two courses after symptoms, third courses can be used as a stable treatment. The score of blood stasis syndrome from the comparison of average value before treatment and after each treatment, it can be inferred that the Yiqihuoxue spleen massage method in blood stasis syndrome of recurrent respiratory tract infection intervention has obvious sustained effect. After Yiqihuoxue spleen massage after the improvement from 19 cases with nasal veins in children, in addition to that nose veins suggest that spleen deficiency, but also suggest that the blood and blood stasis. Therefore, massage in the treatment of chronic diseases, repeatedly We should pay more attention to the significance. In addition, bad breath, licking lips, hot feeling, sleep and sleep in turn kicked by molar symptoms suggesting prone to stomach heat accumulation of children with recurrent respiratory tract infection, so the treatment must also attach importance to the spleen technique, shengqingjiangzhuo, product of heat dissipation in order to protect the spleen and stomach, clinical effect.

【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R272

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