推拿特定穴治疗小儿实证便秘的临床研究  

Clinical study on the treatment of children with the excess syndrome of constipation with massage at specific points

作　　者：于世亭[1] 王先滨[1] 张可心[1] 杜晔[1] 王婷 客蕊[1] 张明明 Yu Shiting;Wang Xianbin;Zhang Kexin;Du Ye;Wang Ting;Ke Rui;Zhang Mingming(Preventive Treatment Center of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学附属第一医院治未病中心,哈尔滨150040

出　　处：《吉林中医药》2023年第7期852-856,共5页Jilin Journal of Chinese Medicine

基　　金：黑龙江省中医药科研项目(ZHY2020-095)。

摘　　要：目的探讨推拿特定穴治疗小儿实证便秘的临床效果。方法予以随机数字表法将80例2021年2月-2022年4月黑龙江中医药大学附属第一医院收治的实证便秘患儿分为清大肠组(40例)和下推七节骨组(40例),另选取健康儿童作为健康对照组(40例)。清大肠组给予清大肠推拿方法治疗,下推七节骨组给予下推七节骨推拿方法治疗,均共治疗5 d,健康对照组推拿方法同清大肠组,共治疗1 d,并随访至第5 d。结果下推七节骨组治疗5 d后的总有效率高于清大肠组(95.00%vs 80.00%,P<0.05)。与清大肠组比较,下推七节骨组首次排便时间、腹胀、腹痛、呕吐症状消失时间均较短,每周排便次数较多(P<0.05)。与治疗前比较,治疗5 d后,2组Wexner便秘积分、Bristol粪便积分、中医症候积分均降低,且下推七节骨组低于清大肠组(P<0.05)。治疗前,下推七节骨组、清大肠组升结肠、横结肠、降结肠、直肠频率及波幅均低于健康对照组(P<0.05);治疗5 d后,3组升结肠、横结肠、降结肠、直肠频率及波幅均高于治疗前,且健康对照组降结肠、直肠频率及波幅高于下推七节骨组、清大肠组,下推七节骨组降结肠、直肠频率及波幅高于清大肠组(P<0.05)。治疗前,下推七节骨组、清大肠组血清胃泌素(GAS)、C反应蛋白(CRP)水平均高于健康对照组(P<0.05),血清P物质(SP)、血管活性肠肽(VIP)水平均低于健康对照组(P<0.05);治疗5 d后,下推七节骨组、清大肠组血清GAS、CRP水平均低于治疗前(P<0.05),血清SP、VIP水平均高于治疗前(P<0.05)。结论清大肠和下推七节骨推拿方法均可调节实证便秘患儿胃肠激素,缓解炎症反应,但相比清大肠推拿方法,下推七节骨可更好地改善患儿胃肠电图,进而可促进患儿便秘症状的改善。Objective To explore the clinical effect of massage at specific acupoints in the treatment of children with the excess syndrome of constipation.Methods A total of 80 children with the excess syndrome of constipation admitted to the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from February 2021 to April 2022 were randomly divided into the large intestine group(40 cases)and the seventh bone group(40 cases),and healthy children were selected as the control group(40 cases).The large intestine group was treated with large intestine clearing massage for a total of 5 days,and the seventh bone group was treated with seventh bone pushing massage for a total of 5 days.The control group was treated with the same massage method as the large intestine group for a total of one day,and was followed up until the 5th day.Results After 5 days of treatment,the total effective rate of the seventh bone group was higher than that of the large intestine group(95.00%vs 80.00%,P<0.05).Compared with the large intestine group,thefirst defecation time,the disappearance time of abdominal distension,abdominal pain and vomiting in the seventh bone group were shorter,and the defecation times per week were more(P<0.05).Compared with before treatment,after 5 days of treatment,the scores of Wexner's constipation,Bristol's stool and TCM symptoms in the two groups were decreased,and those in the seventh bone group were lower than those in the large intestine group(P<0.05).Before treatment,the frequency and amplitude of ascending colon,transverse colon,descending colon and rectum in the seventh bone group and the large intestine group were lower than those in the control group(P<0.05).After 5 days of treatment,the frequency and amplitude of ascending colon,transverse colon,descending colon and rectum in the three groups were higher than those before treatment,and the frequency and amplitude of descending colon and rectum in the control group were higher than those in the seventh bone group and the large intestine group,a

关 键 词：便秘 实证 七节骨 大肠 胃肠电图 胃肠激素 炎症 

分 类 号：R244.1[医药卫生—针灸推拿学]