推拿捏脊联合加味异功散治疗小儿厌食症脾胃气虚证疗效观察及对食欲调节因子的影响  

Clinical effect of chiropractic of massage combined with modified Yigong Powder for infantile anorexia of spleen-stomach-qi deficiency and how to impact on appetite regulator

作　　者：荆素华 徐永红[2] 郑薏 李秋香 JING Suhua;XU Yonghong;ZHENG Yi;LI Qiuxiang(Chinese Medicine Teaching and Research Office,Department of Clinical Medicine,Xiamen Medical College,Xiamen,Fujian 361000;Department of Pediatrics,People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian 350000)

机构地区：[1]厦门医学院临床医学系中医教研室,福建厦门361000 [2]福建中医药大学附属人民医院儿科,福建福州350000

出　　处：《河北中医》2022年第7期1168-1172,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：福建省教育厅2018年福建省中青年教师教育科研项目(编号:JAS180693)。

摘　　要：目的观察推拿捏脊联合加味异功散治疗厌食症脾胃气虚证患儿的临床疗效及对食欲调节因子的影响。方法将90例厌食症脾胃气虚证患儿按照随机数字表法分为2组。对照组45例(脱落4例)予加味异功散治疗,观察组45例(脱落1例)在对照组治疗基础上加推拿捏脊治疗,均治疗4周。比较2组临床疗效,以及治疗前后中医证候评分、血清食欲调节因子[神经肽Y(NPY)、促人生长激素腺释放肽(GHR)、瘦素(Lep)、胆囊收缩素(CCK)]水平。结果观察组总有效率97.73%(43/44),对照组总有效率85.37%(35/41),观察组总有效率高于对照组(P<0.05)。治疗后,2组食欲不振等各项中医证候评分及总分均低于本组治疗前(P<0.05),且观察组食欲不振、食量减退、神疲倦怠、脘腹胀满、形体偏瘦评分及总分均低于对照组(P<0.05)。治疗后,2组血清NPY、GHR水平均高于本组治疗前(P<0.05),Lep、CCK水平均低于本组治疗前(P<0.05),且观察组血清NPY、GHR水平均高于对照组(P<0.05),Lep、CCK水平均低于对照组(P<0.05)。结论推拿捏脊联合加味异功散治疗能够改善厌食症脾胃气虚证患儿中医症状,提高临床疗效,可能与调节患儿食欲调节因子平衡有关。Objective To observe the clinical effect of chiropractic of massage combined with modified Yigong Powder for infantile anorexia(IA)of spleen-stomach-qi deficiency and how to impact on appetite regulator.Methods Totally 90 IA patients(spleen-stomach-qi deficiency)were randomly assigned into the observation group(n=45,1 case of shedding)and the control group(n=45,4 cases of shedding).All patients were managed by modified Yigong Powder,and those in the observation group were additionally treated with chiropractic of massage.A 4-week treatment was performed to compare traditional Chinese medicine(TCM)symptom scores,appetite regulator(neuropeptide Y[NPY],growth hormone receptor[GHR],leptin[Lep],cholecystokinin[CCK]);the curative effect was assessed.Results The effective rates were higher in the observation group(97.73%[43/44])compared with the control group(85.37%[35/41]),(P<0.05).After treatment,TCM syndrome(inappetence,etc.)scores in groups were decreased(P<0.05),TCM syndrome(inappetence,diet loss,fatigue burnout,epigastric pain,thin body)scores were lower in the observation group than in the control group(P<0.05);NPY,GHR in groups were increased(P<0.05),while Lep,CCK in groups were decreased(P<0.05);higher NPY and GHR levels,and lower Lep and CCK levels were detected in the observation group than those in the control group(all P<0.05).Conclusion For IA patients(spleen-stomach-qi deficiency),chiropractic of massage combined with modified Yigong Powder can improve TCM symptoms and clinical efficacy by adjusting the balance of appetite regulator.

关 键 词：厌食 儿童 脾胃气虚 捏脊 异功散 食欲调节 中医疗法 

分 类 号：R442.105[医药卫生—诊断学] R244.1[医药卫生—临床医学]