膀胱经刮痧对肺炎发热儿童持续退热效果及内生致热原水平的影响研究  

Study on the effect of bladder meridian scrapping on continuous antipyretic effects and endogenous pyrogen levels in fever children with pneumonia

作　　者：张宁宁 吴力群[2] 廖欣婷 陈海鹏[2] ZHANG Ningning;WU Liqun;LIAO Xinting;CHEN Haipeng(The Second Clinical College of Beijing University of Chinese Medicine,Beijing 100078,China;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学第二临床医学院,北京100078 [2]北京中医药大学东方医院,北京100078

出　　处：《现代中西医结合杂志》2021年第32期3576-3580,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：北京中医药大学青年教师科研基金项目(2018-JYBZZ-JS122)。

摘　　要：目的观察膀胱经刮痧对肺炎发热患儿持续退热效果及内生致热原的影响,阐明膀胱经刮痧退热的作用机制,为其临床推广应用提供依据。方法选取2018年7月—2019年6月北京中医药大学东方医院儿科病房及门诊诊治的肺炎发热患儿100例作为研究对象,最后观察组41例、对照组45例完成研究。对照组给予抗感染及蒿芩麻杏石甘汤治疗3 d,观察组在对照组治疗基础上加背部膀胱经刮痧1次。比较2组持续退热疗效(体温ROC曲线下面积、3 d内使用退热西药次数、完全退热时间、72 h完全退热率),检测2组治疗前及治疗3 d后血清白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)水平。结果观察组体温ROC曲线下面积明显小于对照组(P<0.05),3 d内使用退热西药次数明显少于对照组(P<0.05),完全退热时间明显短于对照组(P<0.05);观察组72 h完全退热率为95.1%(39/41),对照组为55.6%(25/45),观察组的完全退热率明显高于对照组(P<0.05)。2组治疗3 d后血清IL-1β、IL-6、TNF-α、IFN-γ水平均明显降低(P均<0.05),且观察组血清IL-1β、TNF-α水平均明显低于对照组(P均<0.05),2组血清IL-6、IFN-γ水平比较差异无统计学意义(P均>0.05)。结论膀胱经刮痧对肺炎发热患儿具有较好的持续退热效果,其可能是通过降低内生致热原IL-1β、TNF-α水平,从而下调体温调定点而起到降低体温作用。Objective It is to observe the effect of bladder meridian scrapping on continuous antipyretic effects and endogenous pyrogen levels in fever children with pneumonia,so as to provide evidences for its clinical promotion.Methods A total of 100 children with pneumonia and fever diagnosed and treated in the Pediatric Ward and Outpatient Department of Dongfang Hospital of Beijing University of Traditional Chinese Medicine from July 2018 to June 2019 were selected as the research objects.Finally,41 cases in the observation group and 45 cases in the control group completed the study.The control group was treated with anti-infection and Hao Qin Ma Xin Shi Gan Decoction for 3 days,and the observation group was treated with bladder meridian scrapping on the back on the basis of the treatment of the control group.The continuous antipyretic effects(the area under the ROC curve of body temperature,the times of antipyretic western medicines used within 3 days,the complete antipyretic time,the 72 h complete antipyretic rate)were compared between the two groups,the levels of serum interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ)were detected before treatment and 3 days after treatment in the two groups.Results The area under the ROC curve of body temperature in the observation group was significantly smaller than that of the control group(P<0.05),the times of using antipyretic western medicine within 3 days was significantly less than that of the control group(P<0.05),and the complete antipyretic time was significantly shorter than that of the control group(P<0.05).The 72 h complete antipyretic rate in the observation group was 95.1%(39/41),and that in the control group was 55.6%(25/45),the complete antipyretic rate in the observation group was significantly higher than that of the control group(P<0.05).The levels of serum IL-1β,IL-6,TNF-α,IFN-γin the two groups were significantly reduced after 3 days of treatment(all P<0.05),and the serum IL-1βand TNF-αlevels in the observa

关 键 词：肺炎 儿童 刮痧 膀胱经 发热 内生致热原 

分 类 号：R563.1[医药卫生—呼吸系统]