小儿推拿辅助治疗儿童泄泻脾虚证67例临床观察

Clinical observation on 67 cases of children with diarrhea due to spleen deficiency with infantile tuina

目的 观察小儿推拿辅助治疗儿童泄泻脾虚证的临床疗效及对大便α1-抗胰蛋白酶(α1-AT)和血清D-木糖水平的影响。方法 选取2018年6月至2020年12月绍兴市妇幼保健院儿保科和儿科收治的泄泻脾虚证患儿134例,采用随机数字表法分为对照组和治疗组,各67例。对照组给予补液、纠正酸中毒和水电解质紊乱、禁乳糖、忌油腻食物等常规治疗,并予双歧杆菌四联活菌片口服,治疗组在对照组治疗方法的基础上予小儿推拿治疗。2组均5 d为1个疗程,治疗1个疗程后统计临床疗效。结果 对照组总有效率为82.09%(55/67),治疗组为94.03%(63/67),2组比较,差异有统计学意义(P<0.05)。2组治疗前中医证候积分比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组中医证候积分均显著下降,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组下降更显著(P<0.05)。治疗后治疗组大便次数和大便性状恢复正常时间以及精神萎靡消失时间均短于对照组,2组比较,差异均有统计学意义(P<0.05)。2组治疗前大便α1-AT和血清D-木糖水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组大便α1-AT水平均显著降低,血清D-木糖水平显著升高,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组降低或升高更显著(P<0.05)。结论 小儿推拿辅助治疗儿童泄泻脾虚证,不仅能显著改善患儿的临床症状、体征,而且能防止肠道蛋白质的丢失,促进肠道对碳水化合物的吸收,疗效显著,值得临床推广应用。

ObjectiveTo observe the clinical efficacy of infantile tuina in the treatment of children with diarrhea due to spleen deficiency and the effect on stool α1-antitrypsin(α1-AT) and serum D-xylose levels.MethodsA total of 134 children with diarrhea due to spleen deficiency who were admitted to the Departments of Children Health Care and Pediatrics in Shaoxing Maternal and Child Health Hospital between June2018 and December 2020 were selected and divided equally into 2 groups using a random number table. The control group was given conventional treatment such as fluid infusion,correction of acidosis and water electrolyte disorder,lactose prohibition,avoidance of greasy food,and oral administration of bifidobacterium tetravaccine tablets. The treatment group was treated with infantile tuina on the basis of the treatment of the control group. Both groups were treated for 5 days as a course,and we kept statistics about the clinical efficacy of the two groups before and after one course of treatment.ResultsThe total effective rate of the control group was 82.09%(55/67),that of the treatment group was 94.03%(63/67),and the difference was statistically significant(P>0.05). Before treatment,the difference was not statistically significant in TCM syndrome total score(P>0.05),indicating comparability. After treatment,the scores in the two groups were decreased significantly when compared with those in the same group before treatment and the difference was statistically significant(P>0.05),the decrease in the treatment group was more significant(P>0.05). After treatment, the recovery time of stool frequency,stool character and the disappearance time of mental malaise in the treatment group were shorter than those in the control group,differences being significant(P<0.05). There was no significant difference in the levels of fecal α1-antitrypsin(α1-AT)and serum D-xylose between the two groups before treatment(P>0.05),indicating that they were comparable. After treatment,the levels of fecal α1-antitrypsin(α1-AT)in the two groups were significantly decreased,but the levels of serum D-xylose were increased significantly,and the difference was statistically significant in the same group(P>0.05),and the decrease or increase in the treatment group was more significant(P>0.05).ConclusionInfantile tuina in the adjuvant treatment of children with diarrhea and spleen deficiency syndrome can not only improve the clinical symptoms and signs of children significantly,but also prevent the loss of intestinal protein and promote the absorption of carbohydrates in the intestine.The curative effect is significant and worthy of clinical application.