穴位贴敷联合推拿治疗小儿功能性便秘脾虚肝旺证疗效观察  

Clinical effect of acupoint patching combined with massage for functional constipation in children syndrome of spleen deficiency and liver hyperactivity

作　　者：陆影[1] 李巧香[1] 詹红艳[1] 唐美美 LU Ying;LI Qiaoxiang;ZHAN Hongyan;TANG Meimei(Department of Pediatrics,The Second Affiliated Hospital of Hunan University of Chinese Medicine,Changsha,Hunan 410000)

机构地区：[1]湖南中医药大学第二附属医院儿科,湖南长沙410000

出　　处：《河北中医》2022年第4期651-655,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教发〔2013〕47号)。

摘　　要：目的观察穴位贴敷联合推拿治疗小儿功能性便秘脾虚肝旺证的临床疗效。方法选择2017年1月至2021年10月湖南中医药大学第二附属医院儿科功能性便秘脾虚肝旺证门诊患儿92例,按随机数字表法分为对照组和联合组,各46例。对照组给予西药治疗,联合组在对照组基础上采用穴位贴敷联合推拿治疗。比较2组便秘改善情况、便秘患者临床评分量表(CCS)评分、中医证候评分及胃肠激素、血清炎症指标水平,统计临床疗效。结果联合组首次排便时间、症状消失时间显著低于对照组(P<0.05),周排便次数显著高于对照组(P<0.05)。2组治疗后CCS评分较本组治疗前均下降(P<0.05),且联合组治疗后CCS评分低于对照组(P<0.05)。2组治疗后中医证候各项评分及总分较本组治疗前均下降(P<0.05),且联合组治疗后低于对照组(P<0.05)。2组治疗后胃泌素(GAS)较本组治疗前均下降(P<0.05),血管活性肠肽(VIP)、P物质(SP)较本组治疗前均升高(P<0.05),且联合组治疗后GAS低于对照组(P<0.05),VIP、SP高于对照组(P<0.05)。2组治疗后白细胞介素6(IL-6)、IL-10、C反应蛋白(CRP)水平较本组治疗前均下降(P<0.05),且联合组治疗后IL-6、IL-10、CRP均低于对照组(P<0.05)。联合组总有效率95.65%(44/46),对照组总有效率82.61%(38/46),联合组疗效优于对照组(P<0.05)。结论穴位贴敷联合推拿治疗可显著改善功能性便秘脾虚肝旺证症状,恢复或提高患儿胃肠功能,其作用机制可能与调节胃肠激素及炎症指标水平有关。Objective To observe the clinical effect of acupoint patching combined with massage for functional constipation(FC)in children(syndrome of spleen deficiency and liver hyperactivity).Methods Totally 92 children with FC(syndrome of spleen deficiency and liver hyperactivity)admitted to Department of Pediatrics,the Second Affiliated Hospital of Hunan University of Chinese Medicine from January 2017 to October 2021 were randomly assigned into the combination group(n=46)and the control group(n=46).All patients were managed by Western medicine treatment,and those in the combination group were additionally treated with acupoint patching combined with massage.The aim was to compare improvement of constipation,the clinical scoring scale(CCS)of patients with constipation,traditional Chinese medicine(TCM)syndrome score,gastrointestinal hormone,serum inflammatory markers;the curative effect was assessed.Results Compared with the control group,first defecation time,symptom disappearance time in the combination group were significantly decreased,while weekly defecation frequency was significantly increased(P<0.05).After treatment,CCS scores in groups were decreased(P<0.05),which were lower in the combination group than in the control group(P<0.05);TCM syndrome scores in groups were decreased(P<0.05),the reduction in the combination group was more prevalent(P<0.05);decreased GAS and increased VIP,SP were measured in groups(all P<0.05);lower GAS,and higher VIP,SP were detected in the combination group than those in the control group(all P<0.05);IL-6,IL-10,CRP in groups were decreased(P<0.05),the combination group was more common,and with statistically significant difference(P<0.05).The overall effective rate was 95.65%(44/46)in the combination group,higher than that of 82.61%(38/46)in the control group,the difference of two groups being significant(P<0.05).Conclusion For children with FC(syndrome of spleen deficiency and liver hyperactivity),acupoint patching combined with massage has a significant improvement effect,and which ca

关 键 词：便秘 脾虚 肝火上炎 穴位贴敷法 小儿推拿 

分 类 号：R256.35[医药卫生—中医内科学]