三字经流派推拿适宜技术推广方式研究

Study on the promotion way of the Three-Character-Classic-school massage

目的筛选三字经流派小儿推拿最佳培训方案,以利于更好地推广应用。方法采用短期(2～3 d)、中期(2周)、长期(3～6个月)培训,以小儿泄泻为例,选取2009年10月至2015年6月在青岛市中医医院及5家合作单位就诊的符合纳入排除标准的泄泻患儿660例作为观察对象,证型包括伤食泄泻、脾虚泄泻、风寒泄泻、脾肾阳虚泄泻、湿热泻。培训2周学员进入第一期验证(302例),培训3个月学员进入第二期验证(240例),培训6个月学员进入第三期验证(118例)。采用推拿治疗3 d后观察临床疗效及合并用药情况。结果 (1)经不同方案培训的临床医师进行操作,第一、二、三期临床验证总有效率分别为94.0%(284/302)、95.0%(228/240)、96.6%(114/118),不良反应发生率为0。(2)培训2周的学员,合并用药率为32.78%(99/302),培训3个月的学员,合并用药率为6.67%(16/240),培训6个月的学员,合并用药率为4.24%(5/118)。结论三字经流派推拿治疗小儿泄泻临床疗效显著和具有安全性,2周即可掌握,长期培训可降低合并用药率,是易掌握的一项适宜推广的技术。

Objective To screen for the best training program of Three-Character-Classic-school massage for children,in order to have better promotion and application.Methods The training was divided into 3 types:short-term(2-3 days),medium-term(2 weeks)and long-term(3-6 months).Take the childhood diarrhea as an example.A total of 660 children with diarrhea were included according to the inclusion and exclusion criteria,who were treated in Qingdao TCM Hospital and 5 other hospitals form October 2009 to June 2015.The type of diarrhea were:improper diet,spleen insufficiency,wind and cold,Yang-insufficiency of spleen and kidney,and wetness and heat.The trainees were tested at the first term(302 cases)after two weeks of training;the trainees were tested at the second term(240 cases)after 3 months of training;the trainees were tested at the third term(118 cases)after 6 months of training.Observe the clinical effect and the combination use of drugs after 3 days of massage treatment.Results(1)In the treatment by clinical physicians who were trained according to different training programs,the clinical total effective rate of the first,second and third term was 94.0%(284/302),95.0%(228/240)and 96.6%(114/118),respectively;the incidence rate of adverse reactions were 0.(2)The rate of combination use of drugs was 32.87%(99/302)in the trainees with 2 weeks of training,6.67%(16/240)in those with 3 months,and 4.24%(5/118)in those with 6 months.Conclusion The Three-Character-Classic-school massage treatment is significantly effective and safe in the clinical management of childhood diarrhea,which can be learned in 2 weeks.Long-term training can reduce the rate of combination use of drugs.It is easy to learn and suitable to be promoted.