本文選題：馮氏捏積手法　切入點(diǎn)：脾腎兩虛證　出處：《北京中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：本文采用推拿配合馮氏捏積手法聯(lián)合中藥內(nèi)服及單純口服中藥兩種治療方案,對小兒遺尿病脾腎兩虛證的患兒治療,觀察其近期、遠(yuǎn)期臨床療效。從中醫(yī)證候方面觀察在夜間遺尿次數(shù)、睡眠深度、夜間尿量、白天尿頻等項目進(jìn)行觀察對比,進(jìn)而觀察遠(yuǎn)期治療效果的穩(wěn)定性,觀察兩組結(jié)果通過統(tǒng)計學(xué)計量和計數(shù)的科學(xué)分析,對比兩組前后是否具有顯著性差異,用統(tǒng)計數(shù)據(jù)結(jié)果證明特色手法(推拿配合馮氏捏積手法)配合中藥內(nèi)服治療效果是否優(yōu)于單純口服中藥的對照組。探討特色手法(推拿配合馮氏捏積手法)治療小兒遺尿病的機(jī)理。方法：參照2014年11月第十六屆全國兒科腎臟病學(xué)術(shù)會制訂的《中國兒童單癥狀性夜遺尿疾病管理專家共識》及《中醫(yī)病證診斷療效標(biāo)準(zhǔn)》及《中醫(yī)臨床診療術(shù)語國家標(biāo)準(zhǔn)(證候部分)》的脾腎兩虛證,納入110例符合小兒遺尿病脾腎兩虛證診斷的患兒,隨機(jī)分成推拿配合馮氏捏積手法聯(lián)合中藥內(nèi)服的治療組、單純口服中藥的對照組。治療前分別對夜間遺尿次數(shù)、睡眠深度、夜間尿量、白天尿頻、飲食、面色等項目進(jìn)行癥狀評分,并在第一療程治療結(jié)束后再次對以上項目進(jìn)行評分,在治療結(jié)束后3個月再次對以上項目進(jìn)行評分,從中醫(yī)證候上觀察推拿配合馮氏捏積手法聯(lián)合中藥內(nèi)服治療小兒遺尿病(脾腎兩虛證)的療效,通過統(tǒng)計學(xué)數(shù)據(jù)分析兩組的療效是否具有統(tǒng)計學(xué)意義。結(jié)果：通過治療4周后,對中醫(yī)證候的評分,對比推拿配合馮氏捏積手法聯(lián)合中藥內(nèi)服的治療組、單純口服中藥的對照組中醫(yī)證候在治療一個月后：推拿配合馮氏捏積手法聯(lián)合中藥內(nèi)服的治療組的有效率為72.7%、單純口服中藥的對照組為34.5%,治療組并沒有在治療后一個月在中醫(yī)證候方面明顯優(yōu)于對照組,兩組在統(tǒng)計學(xué)有差異,x2=16.122,P=0.000(P0.01),但在面色改善、飲食改善這獨(dú)立的中醫(yī)證候方面,推拿配合馮氏捏積手法聯(lián)合中藥內(nèi)服的治療組要優(yōu)于單純口服中藥的治療組,兩組在以上兩個具體項目都具有顯著差異(P0.01)；在三個月后療效：治療組有效率為96.5%、對照組為74.5%,x2=8.419,P=0.004(P0.01),推拿配合馮氏捏積手法聯(lián)合中藥內(nèi)服的治療組優(yōu)于單純口服中藥的對照組,尤其在夜間遺尿、尿量、白天尿頻改善、面色改善、飲食改善這獨(dú)立的中醫(yī)證候方面,兩組有顯著性差異(P0.05)。結(jié)論：推拿配合馮氏捏積手法聯(lián)合中藥內(nèi)服治療小兒遺尿病(脾腎兩虛證)在中醫(yī)證候療效方面高于單純中藥內(nèi)服,尤其在遠(yuǎn)期療效上治療組優(yōu)于對照組,體現(xiàn)了中醫(yī)整體觀念,辨證論治的思維在中醫(yī)特色手法中的應(yīng)用優(yōu)勢,能使遺尿患兒的整體中醫(yī)證候療效得到綜合改善,療效持久。
[Abstract]:Objective: to observe the short term and long term clinical effect of massage combined with Feng's kneading manipulation combined with internal Chinese medicine and oral Chinese medicine alone in treating children with deficiency of spleen and kidney of infantile enuresis.From the aspect of TCM syndromes, we observed and compared the number of nocturnal enuresis, sleep depth, nocturnal urine volume, daytime frequency of urine, and then observed the stability of long-term therapeutic effect.Through the scientific analysis of statistical measurement and counting, the results of the two groups were compared whether there were significant differences between the two groups before and after,The statistical data were used to prove whether the effect of characteristic manipulation (massage combined with Feng's kneading manipulation) combined with traditional Chinese medicine was better than that of the control group with oral Chinese medicine alone.To explore the mechanism of characteristic manipulation (massage combined with Feng's kneading manipulation) in the treatment of infantile enuresis.Methods: referring to the "expert consensus on the management of monomorphic nocturnal enuresis in Chinese children", "criteria for the diagnosis and curative effect of TCM Disease Syndrome" and "terms of Clinical diagnosis and treatment of traditional Chinese Medicine" formulated by the 16th National Academy of Pediatrics Kidney Disease in November 2014National standard (syndrome part) > spleen and kidney deficiency syndrome,110 cases of children with deficiency of spleen and kidney were randomly divided into two groups: massage combined with Feng's kneading manipulation combined with traditional Chinese medicine, and only oral Chinese medicine as the control group.Before treatment, the number of nocturnal enuresis, sleep depth, nocturnal urine volume, daytime urine frequency, diet, facial color and other items were scored respectively, and the above items were scored again after the first course of treatment.Three months after the end of the treatment, the above items were scored again, and the curative effect of massage combined with Feng's kneading manipulation combined with traditional Chinese medicine on the treatment of infantile enuresis (spleen and kidney deficiency syndrome) was observed from TCM syndrome.Statistical data were used to analyze whether the curative effect of the two groups was statistically significant.Results: after 4 weeks of treatment, the scores of TCM syndromes were compared with those of massage combined with Feng's kneading manipulation combined with traditional Chinese medicine.After one month of treatment, the effective rate of the treatment group with massage combined with Feng's kneading manipulation combined with internal Chinese medicine administration was 72.7%, while that of the control group with oral Chinese medicine was 34.5%. The treatment group was not treated after treatment.One month is obviously superior to the control group in TCM syndromes.There was a statistical difference between the two groups in terms of statistics. However, the treatment group with massage combined with Feng's kneading manipulation combined with internal Chinese medicine administration was better than the treatment group with oral Chinese medicine alone in the improvement of facial color and the improvement of diet, which was an independent TCM syndrome.There were significant differences between the two groups in the above two specific items, and after three months, the curative effect was: the effective rate of the treatment group was 96.5a, and the control group was 74.5x2X 8.419p 0.004P0.01.The treatment group of massage combined with Feng's kneading manipulation combined with traditional Chinese medicine was superior to the control group with oral Chinese medicine alone.Especially in the nocturnal enuresis, urine volume, daytime urine frequency improvement, facial improvement, diet improvement of the independent TCM syndrome, there was a significant difference between the two groups (P 0.05).Conclusion: the therapeutic effect of massage combined with Feng's kneading manipulation combined with traditional Chinese medicine for the treatment of infantile enuresis (spleen and kidney deficiency syndrome) is higher than that of traditional Chinese medicine alone, especially the treatment group is superior to the control group in the long-term curative effect.It embodies the whole concept of Chinese medicine and the application advantage of dialectical thinking in the characteristic manipulation of traditional Chinese medicine, which can improve the curative effect of the whole TCM syndrome of children with enuresis comprehensively, and the curative effect is lasting.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R244.1

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