三步通便法推拿治疗婴幼儿便秘燥热内结证30例临床观察

Clinical observation on 30 cases of infantile constipation with internal accumulation of dryness and heat syndrome treated with three-step laxative plus tuina therapy

目的观察三步通便法推拿治疗婴幼儿便秘燥热内结证的临床疗效。方法选取2018年4月至2019年12月温州市中西医结合医院推拿科小儿门诊就诊的便秘燥热内结证患儿60例,采用随机数字表法分为对照组和治疗组,各30例。2组均给予基础治疗,对照组加常规推拿治疗,治疗组在对照组治疗方法的基础上再予三步通便法进行治疗,比较2组治疗后的临床疗效、主症积分和3个月后复发情况。结果治疗组总有效率为96.67%(29/30),显著高于对照组的83.33%(25/30),2组比较,差异有统计学意义(P<0.05)。治疗后,2组中医主症排便困难程度、大便颜色、大便性状、排便时间、排便频率积分和总积分比较,差异无统计学意义(P>0.05),具有可比性;治疗后,与同组治疗前比较,各项积分均显著降低(P<0.05),且治疗组降低更显著(P<0.05)。随访3个月后,治疗组复发率为3.34%(1/29),对照组为8.00%(2/25),2组比较,差异有统计学意义(P<0.05)。结论三步通便法推拿治疗婴幼儿便秘燥热内结证,可显著降低中医主症积分,缓解便秘症状,降低复发率,值得临床推广应用。

Objective To observe the clinical efficacy of the three-step laxative plus tuina therapy in the treatment of infantile constipation with internal accumulation of dryness and heat syndrome.Methods Sixty cases of infantile constipation with internal accumulation of dryness and heat syndrome were selected from April 2018 to December 2019 in the pediatric outpatient clinic of the Department of Tuina,Wenzhou Hospital of Integrated Chinese and Western Medicine,and were divided into a control group and a treatment group,30 cases each,using the random number table method.The children in both groups were given basic treatment,and the children in the treatment group were treated with the three-step laxative plus acupoints tuina therapy.The clinical efficacy,main symptom score and recurrence after 3 months were compared between the two groups.Results The total effective rate of the treatment group was 96.67%(29/30),significantly higher than 83.33%(25/30)of the control group.The difference between the two groups was statistically significant(P<0.05).Before treatment,there was no statistically significant difference(P>0.05)between the two groups in terms of difficulty in defecation,stool color,stool characteristics,defecation time,defecation frequency,and total score,indicating comparability.After treatment,compared with before treatment in the same group,all scores were significantly reduced(P<0.05),and the decrease was more significant in the treatment group(P<0.05).After a follow-up of 3 months,the recurrence rate in the treatment group was 3.34%(1/29),while in the control group it was 8.00%(2/25).The difference between the two groups was statistically significant(P<0.05).Conclusion The three-step laxative plus tuina therapy for the treatment of infantile constipation with internal accumulation of dryness and heat syndrome can significantly reduce the main symptoms of Chinese medicine,alleviate the symptoms of constipation,and reduce the recurrence rate,which is worthy of clinical promotion and application.