冯氏捏脊手法改善厌食儿童食欲的特色挖掘随机对照研究

Treatment of anorexia in children by Feng’s spine-pinching manipulation:a randomized controlled trial

目的通过不同捏脊手法、捏脊部位对厌食症患儿食欲因子影响的随机对照研究,挖掘冯氏捏脊手法特色。方法将127例厌食症患儿随机分为3组:冯氏捏脊治疗组(简称冯氏组)46例、三指捏脊治疗组(简称三指组)42例、非捏脊穴位对照组(简称对照组)39例。剔除脱落病例后,冯氏组37例、三指组35例、对照组30例。观察胃饥饿素(Ghrelin)和瘦素(Leptin)水平、症状量表评分、临床疗效、身高、体重、身体质量指数(BMI),并进行安全性评估。结果3组患儿Ghrelin水平比较,三指组和对照组Ghrelin水平较本组治疗前均上升,差异均有统计学意义(P<0.05)。3组治疗前后差值比较,差异有统计学意义(P<0.05)。与对照组比较,冯氏组Ghrelin水平治疗前后差值较低,差异有统计学意义(P<0.05)。3组患儿Leptin水平比较,对照组Leptin水平较本组治疗前下降,差异有统计学意义(P<0.05)。3组症状量表评分较本组治疗前均下降,差异均有统计学意义(P<0.05)。3组症状量表评分治疗前后差值比较,差异有统计学意义(P<0.05)。与对照组比较,冯氏组症状量表评分治疗前后差值较低,差异有统计学意义(P<0.05)。与冯氏组比较,三指组症状量表评分治疗前后差值较低,差异有统计学意义(P<0.05)。对治疗后各指标进行Spearman秩相关分析,结果显示治疗后患儿的Ghrelin和年龄呈正相关关系(r=0.248,P=0.012)。结论冯氏捏脊手法善于增强饮食摄入和(或)营养吸收,提高BMI或脂肪含量。

Objective To explore the characteristics of Feng’s spine-pinching manipulation by measuring the effect of different manipulations and positions of pinching on the secretion of ghrelin and leptin,two factors that affect appetite,of children with anorexia.Methods 102 children were randomly divided into three groups:46 in the group of Feng’s spine-pinching manipulation(the Feng’s group),42 in the group of the“three-finger”spine-pinching manipulation(the three-finger group)and 39 in the control group(manipulations conducted at locations that are not the acupoints targeted by the Feng technique).After those who dropped out were removed,there were 37 patients in the Feng’s group,35 in the threefinger group,and 30 in the control group.Their levels of ghrelin and leptin were measured before and after treatment,along with other indicators including symptom scale score,clinical efficacy,height,weight,BMI,and safety assessment.Results A comparison of ghrelin levels of children in the three groups reveals that ghrelin levels in both the three-finger and control groups increased compared to their respective pre-treatment levels,and the differences were statistically significant(P<0.05).The differences before and after treatment in the three groups were statistically significant(P<0.05).Compared with the control group,the difference of ghrelin level in the Feng’s group before and after treatment was lower,and the difference was statistically significant(P<0.05).The post-treatment leptin level in the control group decreased compared with that before treatment,and the difference was statistically significant(P<0.05).The respective differences in the symptom scale scores in the 3 groups before and after treatment were statistically significant(P<0.05).Compared with the control group,the difference between the pre-and post-treatment symptom scale scores was lower in the Feng’s group,and the difference was statistically significant(P<0.05).Compared with the Feng’s group,the difference between pre-and post-treatment was lower in the symptom scale scores in the three-finger group,and the difference was statistically significant(P<0.05).Spearman’s rank correlation analysis of the post-treatment indicators showed a positive correlation between ghrelin levels and age of the children after treatment(r=0.248,P=0.012).Conclusions Feng’s spine-pinching manipulation can effectively promote dietary intake and/or digestion to increase the BMI or fat content.