本文選題：推拿 + 小兒脾虛質(zhì)��； 參考：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:小兒脾虛質(zhì)是小兒體質(zhì)中常見的一種體質(zhì)類型,推拿對干預(yù)小兒脾虛質(zhì)具有一定的療效。本課題依據(jù)《中醫(yī)治未病實踐指南·推拿干預(yù)小兒脾虛質(zhì)》(評價稿)的內(nèi)容,運(yùn)用臨床觀察及醫(yī)學(xué)統(tǒng)計等方法,對推拿干預(yù)小兒脾虛質(zhì)臨床一致性和臨床療效進(jìn)行探討分析,為進(jìn)一步制訂符合臨床實際需要的兒科治未病指南提供臨床支持。方法:本研究分兩部分進(jìn)行。第一部分,采用病例調(diào)查分析方法,在《中醫(yī)治未病實踐指南·推拿干預(yù)小兒脾虛質(zhì)》專家指導(dǎo)組指導(dǎo)下,選取了不同地域11個醫(yī)療機(jī)構(gòu)作為評價單位,病例選取時間范圍為近1年內(nèi),且不少于200例。從診斷、辨證、治療等方面與指南進(jìn)行比較,填寫《中醫(yī)診療指南一致性測試表(病例調(diào)查表)》,提交項目課題組。通過臨床一致性評價分析結(jié)果來探討《中醫(yī)治未病實踐指南·推拿干預(yù)小兒脾虛質(zhì)》的臨床實用性。第二部分,將符合脾虛質(zhì)診斷的70例患兒,隨機(jī)分成推拿組和藥物組各35例,推拿組:采用《中醫(yī)治未病實踐指南·推拿干預(yù)小兒脾虛質(zhì)》(評價稿)中推拿穴位處方。藥物組:小兒壯兒飲口服液(江蘇省中醫(yī)院制劑,規(guī)格250ml/瓶,蘇藥制藥批號:Z04000520),用法:0～3歲兒童每次10ml,每日3次,3～6歲兒童每次15ml,每日3次,6～12歲兒童每次20ml,每日3次。療程:5日為1個療程,共四個療程。觀察小兒脾虛質(zhì)治療前后各項癥狀積分,比較臨床效果差異。結(jié)果第一部分1.對11個評價單位的213例小兒脾虛質(zhì)一致性測試表匯總統(tǒng)計后可以看出:四個方面一致率均為100%。選穴及與操作相關(guān)因素的一致率因存在個體體質(zhì)差異和地區(qū)地域的不同,其一致率雖為100%,但是比較一致率在其中所占比例較大。2.213例脾虛質(zhì)病例中脾氣虛和脾虛肝旺所占比例稍高,分別為43%、30%。11個醫(yī)院評價單位在臨床診治脾虛質(zhì)時采用的辨證分型與項目工作組提供的脾虛質(zhì)治未病指南評價稿基本一致.3.穴位共使用27個共計1570頻次,使用指南推薦穴位16個共1461頻次,所占比例93%,說明推拿干預(yù)小兒脾虛質(zhì)指南評價稿中選穴臨床評價一致性較高。第二部分1.治療前組間比較:推拿組和藥物組在患兒性別、年齡及癥狀積分無統(tǒng)計學(xué)差異(P0.05)2.治療后比較(1)兩組組內(nèi)比較:治療中和治療前對比,P0.05兩者具有統(tǒng)計學(xué)差異,治療末與治療前比較,P0.05,兩組也有統(tǒng)計學(xué)差異,(2)兩組比較:推拿組治療中、治療末平均總積分均高于藥物組,P值均小于0.05,兩者均有統(tǒng)計學(xué)差異。結(jié)論:1.《中醫(yī)治未病實踐指南·推拿干預(yù)小兒脾虛質(zhì)》(評價稿)臨床一致性評價中體質(zhì)判斷、體質(zhì)分型、判斷依據(jù)及推拿操作、調(diào)護(hù)預(yù)防臨床一致率均達(dá)到了 100%。2.推拿對干預(yù)小兒脾虛質(zhì)的總體療效要優(yōu)于小兒壯兒飲口服藥。3.《中醫(yī)治未病實踐指南·推拿干預(yù)小兒脾虛質(zhì)》與中醫(yī)兒科或推拿科干預(yù)小兒脾虛質(zhì)的診斷、治療等方面一致,且具有顯著的臨床效果。
[Abstract]:Objective: spleen deficiency in children is a common type of constitution in children, massage has a certain effect on intervention of spleen deficiency in children.According to the contents of massage intervention on spleen deficiency in children (evaluation draft), the clinical consistency and clinical effect of massage intervention on spleen deficiency in children were analyzed by clinical observation and medical statistics.To provide clinical support for the further development of guidelines for the treatment of pediatric diseases that meet the actual clinical needs.Methods: the study was divided into two parts.In the first part, using the method of case investigation and analysis, under the guidance of the expert guidance group, 11 medical institutions in different regions were selected as evaluation units under the guidance of the "practice Guide of Chinese Medicine for preventing Diseases" and Massage intervention in Children with spleen deficiency.The time range of case selection was within one year, and not less than 200 cases.Compare the diagnosis, syndrome differentiation and treatment with the guidelines, fill out the conformance test form of TCM diagnosis and treatment guidelines (case questionnaire) and submit it to the project group.The clinical practicability of massage intervention on spleen deficiency in children was discussed through the results of clinical consistency evaluation.In the second part, 70 children with spleen deficiency were randomly divided into massage group (35 cases) and drug group (35 cases).Drug group: children Zhuangeryin oral liquid (Jiangsu Provincial Hospital of traditional Chinese Medicine, standard 250ml/ bottle, Soviet pharmacy batch number: 10 ml / time, 15 ml / day, 3 times / day, 6 years old, 20 ml / day, 3 times a day, 3 times a day).Course of treatment: 5 days as a course of treatment, a total of four courses.To observe the symptom scores before and after treatment of spleen deficiency in children and to compare the clinical effect.Results the first part 1.According to the statistics of 213 children's spleen deficiency conformance test table in 11 evaluation units, it can be seen that the consistent rate of four aspects is 100.The consistency rate of acupoint selection and operation related factors was different in individual physique and region.Although the consistency rate was 100, the relatively consistent rate accounted for a large proportion of the cases with spleen deficiency. The proportion of spleen Qi deficiency and spleen deficiency liver prosperity was a little higher in 2.213 cases of spleen deficiency.The syndrome differentiation and classification used in clinical diagnosis and treatment of spleen deficiency were basically consistent with the evaluation draft provided by the project working group for the treatment of spleen deficiency.A total of 27 points were used for 1570 times and 16 points were recommended for 1461 frequencies, accounting for 93% of the total, indicating that the clinical evaluation consistency of acupoints selection was high in the evaluation draft of massage intervention guide for spleen deficiency in children.Part 1.Comparison before treatment: there was no significant difference in gender, age and symptom score between massage group and drug group (P 0.05).Comparison after treatment: comparison between two groups: there was a statistical difference between the two groups (P0.05) in treatment and before treatment, P0.05 at the end of treatment and before treatment, and there was also a statistical difference between two groups (P < 0.05): in the treatment of massage group, there was also a statistical difference between the two groups: in the treatment of massage group, there was a significant difference between the two groups.The mean total score at the end of treatment was higher than that in the drug group (P < 0.05), and there was statistical difference between the two groups.Conclusion 1. In the clinical consistency evaluation, constitution judgment, constitution classification, judgment basis and massage operation, the consistent rate of regulating nursing and preventing clinical were 100. 2.The overall curative effect of massage on children's spleen deficiency is better than that of children's Zhuangeryin oral medicine .3.The practice guide of traditional Chinese medicine for preventing disease intervention is consistent with that of Chinese pediatrics or massage department in the diagnosis and treatment of children's spleen deficiency, and in the intervention of Chinese pediatrics or massage department in the diagnosis and treatment of children's spleen deficiency.And has the remarkable clinical effect.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R244.1

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 亓勇;趙學(xué)印;呂翠霞;;臍火療法治療脾虛型慢性乙肝肝纖維化的臨床研究[J];中醫(yī)外治雜志;2008年03期

2 李士林,吳玉生,高秀芬,權(quán)啟鎮(zhèn),李志;脾虛型幽門螺旋桿菌感染的治療[J];前衛(wèi)醫(yī)藥雜志;1996年06期

3 賈鵬;;黃鼬粉治療脾虛型慢性特發(fā)性血小板減少性紫癜8例[J];實用中醫(yī)內(nèi)科雜志;2008年05期

4 許長照;張瑜瑤;;脾虛低熱的實驗研究[J];南京中醫(yī)學(xué)院學(xué)報;1985年01期

5 徐重明;夏天;饒國洲;于文彬;劉寶瑞;萬發(fā)銀;;脾虛型與腎虛型腎臟疾患血清及尿中有關(guān)蛋白質(zhì)含量的臨床研究[J];遼寧中醫(yī)雜志;1993年05期

6 張明雄;;中西醫(yī)結(jié)合治療肺熱脾虛型小兒肺炎78例[J];中原醫(yī)刊;1989年04期

7 胡筱娟,喬富渠;近十年對脾虛實質(zhì)研究的概況[J];中國醫(yī)藥學(xué)報;1991年05期

8 孫明異;黃世林;;桂枝治脾虛型貧血[J];中醫(yī)雜志;1994年12期

9 錢進(jìn);止瀉膏外用治療小兒脾虛型腹瀉47例臨床觀察[J];北京中醫(yī);1999年02期

10 沈志華;王萍;舒青龍;;中醫(yī)藥治療抗生素相關(guān)性脾虛型腹瀉53例療效分析[J];江西中醫(yī)學(xué)院學(xué)報;2013年02期

相關(guān)會議論文 前10條

1 沈一菁;陳志偉;金義成;;推拿治療30例小兒脾虛型腹瀉的臨床療效觀察[A];第十二次全國推拿學(xué)術(shù)年會暨推拿手法調(diào)治亞健康臨床應(yīng)用及研究進(jìn)展學(xué)習(xí)班論文集[C];2011年

2 李霞;汝明權(quán);;脾虛型大白鼠腮腺的細(xì)胞學(xué)研究[A];中國細(xì)胞生物學(xué)學(xué)會第五次會議論文摘要匯編[C];1992年

3 李小軍;;背部砭石療法對脾虛型亞健康狀態(tài)的療效觀察[A];2008全國砭石與刮痧療法學(xué)術(shù)交流大會論文匯編[C];2008年

4 耿堅;張閩光;張安君;;脾虛X線征象研究的現(xiàn)狀和展望[A];第六次全國中西醫(yī)結(jié)合影像學(xué)術(shù)研討會論文專輯[C];2000年

5 邱健;;重用益氣健脾治療脾虛型功能性消化不良60例[A];中華中醫(yī)藥學(xué)會脾胃病分會第二十次全國脾胃病學(xué)術(shù)交流會論文匯編[C];2008年

6 王迎寒;;健脾化濕顆粒治療脾虛型腸易激綜合征的機(jī)理研究[A];中華中醫(yī)藥學(xué)會脾胃病分會第十九次全國脾胃病學(xué)術(shù)交流會論文匯編[C];2007年

7 宋悅;趙秋生;譚秀芬;譚海燈;;完帶湯治療脾虛型BV改善陰道微生態(tài)的臨床研究[A];中華醫(yī)學(xué)會第十次全國婦產(chǎn)科學(xué)術(shù)會議婦科盆底會場（女性盆底學(xué)組、婦科感染協(xié)作組）論文匯編[C];2012年

8 楊卓欣;卓緣圓;;電針對脾虛型幼鼠腦內(nèi)堿性成纖維細(xì)胞生長因子(bFGF)及其mRNA表達(dá)的影響[A];2011中國針灸學(xué)會年會論文集（摘要）[C];2011年

9 楊卓欣;卓緣圓;;電針對脾虛型幼鼠腦內(nèi)堿性成纖維細(xì)胞生長因子(bFGF)及其mRNA表達(dá)的影響[A];廣東省針灸學(xué)會第十二次學(xué)術(shù)研討會暨全國腦卒中及脊柱相關(guān)性疾病非藥物診療技術(shù)培訓(xùn)班論文集[C];2011年

10 楊卓欣;卓緣圓;;電針對脾虛型幼鼠海馬區(qū)光鏡和電鏡結(jié)構(gòu)影響的研究[A];2011中國針灸學(xué)會年會論文集（摘要）[C];2011年

相關(guān)重要報紙文章 前4條

1 史志敏;婦女功血食療方[N];中國中醫(yī)藥報;2006年

2 紀(jì)京林;婦女“功血”食療方[N];中國醫(yī)藥報;2007年

3 茉 莉;寶寶腹瀉的家庭食療法[N];中國中醫(yī)藥報;2002年

4 彭麗麗;婦女“功血”用食療[N];大眾衛(wèi)生報;2003年

相關(guān)博士學(xué)位論文 前2條

1 廉永紅;加味四君子湯對脾虛型IBS-D的治療作用及機(jī)理的研究[D];廣州中醫(yī)藥大學(xué);2012年

2 陳潤邦;針灸聯(lián)合參芪固本方對化療后脾虛癥狀及血液細(xì)胞的干預(yù)研究[D];廣州中醫(yī)藥大學(xué);2015年

相關(guān)碩士學(xué)位論文 前10條

1 郭愛英;孫氏五部推拿法治療小兒泄瀉（脾虛型）的臨床療效觀察[D];安徽中醫(yī)藥大學(xué);2015年

2 周琳;基于數(shù)據(jù)挖掘方法的脾虛文獻(xiàn)研究[D];遼寧中醫(yī)藥大學(xué);2015年

3 羅曉娟;圍刺結(jié)合穴位注射治療黃褐斑（脾虛型）的臨床觀察[D];成都中醫(yī)藥大學(xué);2015年

4 胡夢;捏脊為主的推拿療法治療脾虛型小兒泄瀉的臨床療效評價[D];浙江中醫(yī)藥大學(xué);2016年

5 賈偉玲;灸藥結(jié)合治療濕疹（脾虛濕蘊(yùn)證）的臨床研究[D];遼寧中醫(yī)藥大學(xué);2016年

6 張蝶;“大腸”獨(dú)穴推拿治療小兒脾虛型腹瀉的臨床療效觀察[D];浙江中醫(yī)藥大學(xué);2016年

7 徐夢茜;基于“脾主時”理論運(yùn)用盒灸治療腹瀉型腸易激綜合征（脾虛型）的臨床研究[D];成都中醫(yī)藥大學(xué);2016年

8 王菊菊;推拿干預(yù)小兒脾虛質(zhì)的臨床評價研究[D];南京中醫(yī)藥大學(xué);2017年

9 馮蘊(yùn)哲;邵氏摩按頂揉法治療小兒脾虛型泄瀉臨床研究[D];南京中醫(yī)藥大學(xué);2017年

10 汪梅姣;基于糞便上清代謝組學(xué)及基因組學(xué)探討脾虛型痛風(fēng)的生物學(xué)特征[D];浙江中醫(yī)藥大學(xué);2013年

，

本文編號：1765035