本文選題：小兒推拿 + 鼻部八法　； 參考：《廣州中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:觀察小兒推拿鼻部八法治療肺氣虛寒型小兒過敏性鼻炎的療效,與西藥組(氯雷他定與糠酸莫米松聯(lián)合應(yīng)用)進行比較,評估兩種治療方法臨床療效的差異,旨在闡明小兒推拿鼻部八法治療肺氣虛寒型過敏性鼻炎的優(yōu)越性。方法:本研究采用隨機對照臨床試驗方法,研究對象為64例3～10周歲符合標準的患兒,將合格的患兒分入治療組與對照組,兩組均32例。治療組采用小兒推拿鼻部八法治療,對照組采用西藥(氯雷他定與糠酸莫米松聯(lián)合應(yīng)用)治療。治療組每兩天進行1次治療,對照組每天服藥,10天為1療程,共治療2個療程。分別記錄評分兩組治療前后的主癥(鼻塞、鼻癢、噴嚏、流清涕)、次癥(畏風(fēng)怕冷、易感冒、自汗、氣短乏力)、體征(鼻甲、鼻黏膜),并對第1、2療程、隨訪3月療效進行比較分析。結(jié)果:共收集64例患兒,4例脫落,兩組各完成30例。兩組患兒治療前的一般資料經(jīng)比較未存在明顯的差異(P0.05),說明兩組具有可比性。分別對治療組治療前、后的主癥、次癥、體征進行比較,均有統(tǒng)計學(xué)意義(P0.05)。提示鼻部八法小兒推拿治療有效。分別對照組治療前、后的主癥、次癥、體征進行比較,可得對照組能有效改善患兒主癥、體征及部分次癥(易感冒、自汗)(P0.05),對于畏風(fēng)怕冷、氣短乏力次癥療效不明顯(P0.05)。分別對兩組治療后主癥、次癥、體征進行比較,經(jīng)統(tǒng)計學(xué)分析,提示治療后兩組在改善鼻癢、噴嚏、易感冒、自汗、鼻甲方面療效無明顯差異(P0.05);在改善鼻塞、流清涕、畏風(fēng)怕冷、氣短乏力、鼻黏膜方面差異較明顯(P0.05),說明鼻部八法小兒推拿療效較西藥氯雷他定與糠酸莫米松聯(lián)合應(yīng)用佳。治療組顯效率為70.00%、總有效率為93.33%均高于對照組顯效率43.33%、總有效86.67%,提示說明鼻部八法小兒推拿療效較西藥氯雷他定與糠酸莫米松聯(lián)合應(yīng)用佳。第1療程后兩組療效無差異(PO.05),第2療程后有差異(P0.05),提示近期療效鼻部八法小兒推拿療效較西藥氯雷他定與糠酸莫米松聯(lián)合應(yīng)用佳。隨訪3月后兩組復(fù)發(fā)情況差異有統(tǒng)計學(xué)意義(P0.05),表明遠期療效治療組較對照組優(yōu),提示小兒推拿鼻部八法較西藥氯雷他定與糠酸莫米松聯(lián)合應(yīng)用更能有效降低復(fù)發(fā)率。結(jié)論:(1)改善患兒主癥、次癥、體征,兩者均有效,其中改善鼻塞、流清涕、畏風(fēng)怕冷、氣短乏力之癥、體征鼻黏膜,鼻部八法小兒推拿療效較西藥氯雷他定與糠酸莫米松聯(lián)合應(yīng)用佳。(2)小兒推拿鼻部八法與西藥氯雷他定與糠酸莫米松聯(lián)合應(yīng)用治療肺氣虛寒型小兒過敏性鼻炎均有效,第1療程者療效無差異、第2療程及遠期療效小兒推拿鼻部八法優(yōu)于西藥氯雷他定與糠酸莫米松聯(lián)合應(yīng)用,表明小兒推拿鼻部八法治療肺氣虛寒型過敏性鼻炎具有確切的優(yōu)越性與穩(wěn)定性。
[Abstract]:Objective: to observe the curative effect of eight methods of massage and nasal part in treating allergic rhinitis in children with asthenia of lung qi, compare with western medicine group (combined with loratadine and momethasone furoate), and evaluate the difference of clinical curative effect between the two methods. The purpose of this study was to elucidate the advantages of the eight methods for treating allergic rhinitis with deficiency of lung qi and cold. Methods: a randomized controlled clinical trial was conducted with 64 children aged 3 to 10 years old who met the criteria. The eligible children were divided into treatment group and control group with 32 cases in both groups. The treatment group was treated with eight methods of infantile massage and nasal part, while the control group was treated with western medicine (loratadine combined with momethasone furoate). The treatment group was treated once every two days, and the control group was treated with 10 days for a course of treatment, a total of 2 courses of treatment. The scores of main symptoms (nasal congestion, itching, sneezing, runny snot, cold fear, colds, self-sweating, shortness of breath, physical signs (turbinate, nasal mucosa), and second course of treatment were recorded before and after treatment, respectively. Follow up for 3 months to compare and analyze the curative effect. Results: a total of 64 children with 4 cases of abscission were collected, 30 cases in each group. There was no significant difference in general data before treatment between the two groups, indicating that the two groups were comparable. The main symptoms, secondary symptoms and physical signs of the treatment group were compared before and after treatment, all of which had statistical significance (P 0.05). The results suggest that the eight methods of nasal massage are effective in the treatment of children. Before and after treatment, the main symptoms, secondary symptoms and physical signs of the control group were compared. The results showed that the control group could effectively improve the main symptoms, physical signs and partial symptoms of children (susceptible to colds, self-sweating, P0.05N), and had no significant effect on fear of wind and cold, and asthenia of shortness of breath (P0.05N). The main symptoms, secondary symptoms and physical signs of the two groups after treatment were compared respectively. The statistical analysis indicated that there was no significant difference in the curative effect between the two groups in improving nasal itching, sneezing, colds, sweating and turbinate after treatment; Fear of wind and cold, asthenia of short breath and obvious difference in nasal mucosa (P 0.05) indicated that the curative effect of eight methods of nasal massage on children was better than that of western medicine loratadine combined with momethasone furoate. The effective rate of the treatment group was 70.00,93.33% higher than that of the control group (43.33%), and the total effective rate was 86.67%, indicating that the curative effect of the eight methods of nasal massage was better than that of the western medicine loratadine and amethasone furoate. There was no difference in curative effect between the two groups after the first course of treatment, but there was difference between the two groups after the second course of treatment (P 0.05), which suggested that the short-term curative effect of the eight methods of nasal massage was better than that of western medicine loratadine combined with amethasone furoate. There was significant difference in recurrence between the two groups after 3 months follow-up, which indicated that the long-term curative effect in the treatment group was better than that in the control group. It suggested that the eight methods of massage and nasal part of children could reduce the recurrence rate more effectively than the combination of western medicine loratadine and momethasone furoate. Conclusion 1) improving the main symptoms, secondary symptoms and signs, both of which are effective, including nasal obstruction, runny, fear of wind and cold, shortness of breath and asthenia, signs of nasal mucosa. Eight methods of nasal massage were more effective in treating allergic rhinitis in children with asthenia of lung qi than that of western medicine loratadine combined with momethasone furoate) the eight methods of infantile massage and western medicine loratadine combined with amethasone furoate were more effective in treating allergic rhinitis in children with asthenia of lung qi. There was no difference in the effect of the first course of treatment. The second course of treatment and the long-term curative effect were better than the western medicine loratadine combined with momethasone furoate. The results showed that the eight methods of massage and nasal part had definite superiority and stability in treating allergic rhinitis with deficiency of lung qi and cold.
【學(xué)位授予單位】：廣州中醫(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

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