“调运枢纽”推拿术在小儿厌食症临床护理中的应用

【目的】评价基于经络腧穴理论的"调运枢纽"推拿术在小儿厌食症的中医临床护理中的效果。【方法】选取小儿厌食症患儿120例,随机分为试验组和对照组,每组各60例。对照组在常规护理基础上给予捏脊疗法治疗,试验组在常规护理基础上给予以"调运枢纽"推拿术为核心的推拿治疗,包括清补脾胃经、平运内八卦、揉板门、揉腹、平调穴位(中脘、天枢、足三里)、捏脊为主线,结合虚实辨证,隔天治疗1次,3次为1个疗程,2个疗程后,评价2组患儿的临床疗效以及护理治疗前后中医证候积分、体格测量评价指标[身高、体质量、头围、胸围、年龄别身高(HT/A)、年龄别体质量(WT/A)等]的变化情况。【结果】(1)试验组有5例患儿中途脱落、退出试验(其中实证3例,虚证2例),对照组有6例患儿中途脱落、退出试验。(2)经2个疗程的护理治疗后,试验组的总有效率为94.55%,对照组为87.04%,试验组的疗效优于对照组,差异有统计学意义(P0.05)。(3)治疗后,2组患儿的食欲和食量、面色和唇色、饮水情况、烦急情况、小便情况评分和中医证候积分,以及试验组的WT/A均较治疗前有明显改善(P0.05);且试验组在改善食欲和食量、面色和唇色、烦急情况评分和中医证候积分方面明显优于对照组(P0.05或P0.001),在改善体质量、身高、头围、HT/A等体格测量评价项目方面也明显优于对照组(P0.05)。【结论】"调运枢纽"推拿术是一种基于经络腧穴理论及中医辨证论治理论的有效护理手段,用于小儿厌食症的治疗,起效快,临床效果满意,症状改善明显。

Application of Manipulations for Regulating Pivot in Clinical Nursing for Infantile Anorexia

Objective To evaluate the efficacy of pivot-regulating manipulations applied in traditional Chinese medicine (TCM) clinical nursing for infantile anorexia based on the meridian and acupoint theory. Methods One hundred and twenty children with anorexia were randomly divided into trial group and control group , 60 cases in each group. The control group was given spine-pinching therapy based on the conventional nursing care. The trial group was given pivot-regulating manipulations based on the conventional nursing care , and the pivot-regulating manipulations covered manipulating spleen -stomach meridian , regulating Neibagua, kneading Banmen, kneading abdomen, manipulating acupoints of Zhongwan, Tianshu and Zusanli, and pinching spine according to the deficiency-excess differentiation, once every other day and 3 times constituting one course of treatment. After treatment for 2 courses, the clinical efficacy of the two groups was evaluated. The changes in TCM symptom scores and physical examination indexes of body height, body mass, head circumference, chest circumference, height-for-age (HT/A), weight-for-age (WT/A) in the two groups were observed before and after treatment. Results(1) Five cases(3 differentiated into excess syndrome and 2 into deficiency syndrome) of the trial group dropped out and quitted from the trial, and 6 cases of the control group dropped out and quitted from the trial. (2) After two courses of treatment, the total effective rate of the trial group was 94.55％, and that of the control group was 87.04％, the difference being significant (P < 0.05). (3) After treatment, the scores of appetite and food-intake amount, complexion and lip color, water intake, restlessness, and urination as well as TCM symptom scores in both groups were improved; the WT/A of the trial group was also improved (P < 0.05 compared with those before treatment). The trial group had better effect on improving the scores of appetite and food-intake amount, complexion and lip color, and restlessness as well as TCM symptom scores than the control group (P < 0.05 or P < 0.001). The trial group also showed better effect on improving body mass, body height, head circumference, and HT/A than the control group(P<0.05). Conclusion As a nursing method based on the meridian and acupoint theory as well as syndrome differentiation and treatment, pivot-regulating manipulations are effective for the treatment of infantile anorexia by quickly starting an effect and obviously relieving the symptoms.