本文選題：選擇性脊柱推拿 + 小兒疳證　； 參考：《云南中醫(yī)學(xué)院》2016年碩士論文

【摘要】：目的觀察選擇性脊柱推拿治療小兒疳證的臨床療效,并與常規(guī)對(duì)癥支持治療比較,旨在探索一種安全、有效、療程更短、依從性更好的治療方案。方法從就診于昆明醫(yī)科大學(xué)第一附屬醫(yī)院兒童保健科、云南省中醫(yī)醫(yī)院兒科和云南中醫(yī)學(xué)院附設(shè)中醫(yī)醫(yī)院(2014年08月-2016年01月)住院和門(mén)診病例中選擇符合納入標(biāo)準(zhǔn)的疳證患兒84例,剔除脫落病例4例,實(shí)際納入80例,按照數(shù)字表法隨機(jī)分為實(shí)驗(yàn)組(n=40)和對(duì)照組(n=40),對(duì)照組予常規(guī)對(duì)癥支持治療,實(shí)驗(yàn)組用選擇性脊柱推拿治療。兩組予相同的營(yíng)養(yǎng)及健康指導(dǎo)。按照自擬臨床癥狀積分值量表及身高、體重變化觀察表觀察治療前、一個(gè)療程后、兩個(gè)療程后的臨床癥狀積分值及身高、體重等客觀指標(biāo)的變化,比較實(shí)驗(yàn)組和對(duì)照組的臨床療效,對(duì)相關(guān)資料進(jìn)行統(tǒng)計(jì)學(xué)分析與比較。結(jié)果1.實(shí)驗(yàn)組和對(duì)照組治療前一般資料比較：兩組患兒性別、年齡、病程、治療前癥狀總積分,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。2.兩組患兒治療前后臨床癥狀積分值比較：治療前,兩組各臨床癥狀積分值比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。治療后,實(shí)驗(yàn)組一個(gè)療程與治療前相比,臨床癥狀積分值明顯下降,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療兩個(gè)療程后與一個(gè)療程相比,臨床癥狀積分值也有下降,差異有統(tǒng)計(jì)學(xué)的意義(P0.05)。對(duì)照組治療一個(gè)療程后,臨床癥狀積分值明顯下降,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療兩個(gè)療程后與一個(gè)療程相比,積分值也有下降,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組比較,治療一個(gè)療程后,實(shí)驗(yàn)組癥狀積分值的變化優(yōu)于對(duì)照組,其中實(shí)驗(yàn)組食欲、精神改善明顯。兩個(gè)療程后,實(shí)驗(yàn)組各臨床癥狀積分值的改善優(yōu)于對(duì)照組。3.治療前后身高、體重的變化比較。治療前,兩組身高、體重比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(PO.05),具有可比性。治療一個(gè)療程后,實(shí)驗(yàn)組、對(duì)照組的身高與治療前相比,無(wú)明顯變化,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。兩個(gè)療程后,兩組身高有所增長(zhǎng),實(shí)驗(yàn)組優(yōu)于對(duì)照組,差異有顯著性(P0.05)。兩組體重在治療一個(gè)療程后,與治療前相比,有所增長(zhǎng),實(shí)驗(yàn)組較對(duì)照組明顯,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療兩個(gè)療程后,實(shí)驗(yàn)組體重增長(zhǎng)較對(duì)照組明顯,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。4.兩組臨床療效比較：與治療前相比,一個(gè)療程后對(duì)照組的總有效率75.0%,實(shí)驗(yàn)組80.0%；二個(gè)療程后,對(duì)照組的總有效率為77.5%,實(shí)驗(yàn)組為90.0%。具有統(tǒng)計(jì)學(xué)意義(P0.05)。說(shuō)明實(shí)驗(yàn)組和對(duì)照組對(duì)小兒疳證均有療效,但選擇性脊柱推拿的總體療效優(yōu)于常規(guī)對(duì)癥支持治療。結(jié)論選擇性脊柱推拿可以改善小兒疳證的臨床癥狀,促進(jìn)生長(zhǎng)發(fā)育,總體療效優(yōu)于常規(guī)對(duì)癥支持治療,可以作為小兒疳證的有效治療方案,值得臨床進(jìn)一步探索研究,并推廣使用。
[Abstract]:Objective to observe the clinical effect of selective spinal massage in treatment of infantile chancre syndrome, and to explore a safe, effective, shorter course of treatment and better compliance.Methods from the Children's Health Department of the first affiliated Hospital of Kunming Medical University,The Department of Pediatrics of Yunnan traditional Chinese Medicine Hospital and the affiliated Hospital of traditional Chinese Medicine of Yunnan University of traditional Chinese Medicine (2010-08 ~ 2016-January 2016) selected 84 children with chancre syndrome who met the inclusion criteria, eliminated 4 cases of shedding cases, and actually included 80 cases.According to the method of digital table, the experimental group was randomly divided into two groups: the experimental group (n = 40) and the control group (n = 40). The control group was treated with routine symptomatic support therapy, and the experimental group was treated with selective spinal massage.The two groups were given the same nutrition and health guidance.According to the self-designed clinical symptom integral value scale, height and weight change observation table, observe the change of clinical symptom integral value, height, weight and other objective indexes before treatment, after one course of treatment, two courses of treatment, etc.The clinical efficacy of the experimental group and the control group were compared, and the related data were statistically analyzed and compared.Result 1.Comparison of the general data before treatment between the experimental group and the control group: sex, age, course of disease, total score of symptoms before treatment, there was no significant difference between the two groups (P 0.05).Comparison of clinical symptom scores before and after treatment: before and after treatment, there was no significant difference between the two groups in the scores of clinical symptoms (P 0.05), which was comparable.After treatment, the scores of clinical symptoms in the experimental group decreased significantly after one course of treatment compared with that before treatment, and the difference was statistically significant (P 0.05).Compared with one course of treatment, the score of clinical symptoms decreased after two courses of treatment, and the difference was statistically significant (P 0.05).After a course of treatment, the clinical symptom score of the control group decreased significantly (P 0.05).After two courses of treatment compared with one course of treatment, the integral value also decreased, the difference was statistically significant (P 0.05).After a course of treatment, the change of symptom score in the experimental group was better than that in the control group, in which appetite and mental improvement were obvious in the experimental group.After two courses of treatment, the improvement of clinical symptom integral value in the experimental group was better than that in the control group.The changes of height and weight before and after treatment were compared.Before treatment, there was no significant difference in height and weight between the two groups.After a course of treatment, the height of the experimental group and the control group had no significant change compared with that before treatment, and the difference was not statistically significant (P 0.05).After two courses of treatment, the height of the two groups increased, the experimental group was better than the control group, the difference was significant (P 0.05).After one course of treatment, the body weight of the two groups increased compared with that before treatment. The experimental group was more obvious than the control group, and the difference was statistically significant (P 0.05).After two courses of treatment, the weight gain in the experimental group was significantly higher than that in the control group, and the difference was statistically significant.Comparison of clinical efficacy between the two groups: compared with before treatment, the total effective rate of the control group was 75.0 after one course of treatment, and that of the experimental group was 80.0; after two courses of treatment, the total effective rate of the control group was 77.5, and that of the experimental group was 90.0.It has statistical significance (P 0.05).The results showed that both the experimental group and the control group had curative effect on infantile chancre syndrome, but the overall curative effect of selective spinal massage was better than that of routine treatment of symptomatic support.Conclusion selective spinal massage can improve the clinical symptoms and promote the growth and development of children's chancre syndrome. The overall curative effect is better than that of routine symptomatic support therapy. It can be used as an effective treatment scheme for infantile chancre syndrome, and it is worthy of further clinical exploration and study.And popularizing the use.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R244.1

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