中医“五部推拿法”在早产儿喂养不耐受治疗中的应用研究

Application pf "Five Part Massage" in The Treatment of Feeding Intolerance in Preterm Infants

目的 探讨中医“五部推拿法”治疗早产儿喂养不耐受的有效性与安全性。方法 选取医院新生儿科住院部的72例喂养不耐受早产儿,随机分为两组各36例,均给予常规护理。对照组口服双歧杆菌三联活菌肠溶胶囊,观察组采取中医“五部推拿法”进行推拿按摩。观察两组早产儿的喂养不耐受症状、血清胃动素(MTL)及胃泌素(GAS)变化,对比两组的疗效、达全肠道喂养时间、住院时间等。结果 与治疗前相比,两组治疗后的奶量、呕吐、腹胀、胃潴留评分均明显降低,血清MTL、GAS水平明显升高(P<0.05),观察组各症状评分均低于对照组,血清MTL、GAS水平均高于对照组(P<0.05)。观察组达到全肠内喂养时间、恢复出生体重时间及出院时间明显短于对照组(P<0.05)。观察组总有效率88.89%高于对照组的63.89%(P<0.05)。结论 中医“五部推拿法”治疗早产儿喂养不耐受能够有效改善患儿的临床症状,促进患儿体重增长,缩短达到全肠道喂养时间,应用成效显著,安全性好。

Objective To explore the efficacy and safety of "five part massage" which treats with preterm infants with feeding intolerance. Methods 72 cases of feeding intolerant preterm infants in the neonatal department of our hospital were randomly divided into two groups(36 cases in each group). The two groups were given routine nursing, the control group was given Bifidobacterium triple viable enteric coated capsule, and the experimental group was given massage by "five part massage" of traditional Chinese medicine. The feeding intolerance symptoms, the changes of serum motilin(MTL) and gastrin(GAS) in the two groups were observed, and the curative effects, total intestinal feeding time and hospitalization time of the two groups were compared. Results Compared with before treatment, the milk volume, vomiting, abdominal distension and gastric retention in the 2 groups were significantly lower, and the serum MTL and GAS levels increased significantly(P<0.05). The symptom scores of the study group were lower than those of the control group, and the levels of serum MTL and gas were higher than those of the control group(P<0.05). The time to achieve total enteral feeding, recovery of birth weight and discharge in the experimental group were significantly shorter than control group(P<0.05). The total effective rate of the experimental group was significantly higher than the control group(88.89% vs 63.89%(P<0.05). Conclusion Traditional Chinese medicine "five part massage" in the treatment of feeding intolerance of preterm infants can effectively improve the clinical symptoms of children, promote the weight growth of children, shorten the time to reach total intestinal feeding, with remarkable application effect and good safety.