“鼻周骨膜压揉法”为主的推拿手法治疗肺虚感寒型小儿变应性鼻炎疗效观察

Observation on“peri-nasal periosteum compression and kneading method”on allergic rhinitis in children with lung deficiency and cold sensation syndrome

目的 观察以“鼻周骨膜压揉法”为主的推拿手法治疗肺虚感寒型小儿变应性鼻炎的疗效。方法 选择2019年1月—2022年9月就诊于北京按摩医院、北京中医药大学附属护国寺中医医院、北京市丰盛中医骨伤专科医院、北京市朝阳区金盏第二社区卫生服务中心的变应性鼻炎患儿60例,采用随机数字表法分为2组,各30例。对照组口服孟鲁司特钠,1次/d,1周为1个疗程,共治疗4个疗程;观察组在对照组基础上采用“鼻周骨膜压揉法”为主的推拿手法进行治疗,隔天1次,1周3次,治疗4周。对比2组临床疗效,以及治疗前后3个月主症(喷嚏、流涕、鼻塞、鼻痒)及次症(畏风怕冷、易感冒、自汗、气短乏力)评分。结果 2组总有效率比较,差异无统计学意义(P>0.05)。对照组治疗第1、2、3、4周喷嚏、流涕、鼻塞、鼻痒、易感冒积分均较治疗前降低(P<0.05);治疗第4周,畏风怕冷积分较治疗前降低(P<0.05);治疗第3、4周自汗症状积分较治疗前降低(P<0.05);气短乏力症状积分各时间点差异均无统计学意义(P>0.05)。观察组治疗第1、2、3、4周喷嚏、流涕、鼻塞、鼻痒、畏风怕冷、易感冒、自汗积分均较治疗前降低(P<0.05);治疗第2、3、4周气短乏力症状积分较治疗前降低(P<0.05)。治疗前及治疗第1周,2组主症积分差异均无统计学意义(P>0.05);治疗第2周,观察组喷嚏、鼻塞、鼻痒积分均低于对照组(P<0.05);治疗第3周,观察组主症积分均低于对照组(P<0.05);治疗第4周,观察组喷嚏、流涕、鼻塞积分低于对照组(P<0.05);2组各时间点次症积分差异均无统计学意义(P>0.05)。治疗后3个月,2组症状积分均较治疗前降低(P<0.05),观察组喷嚏、流涕、鼻塞、鼻痒、自汗积分低于对照组(P<0.05)。结论 “鼻周骨膜压揉法”为主的推拿手法可提高肺虚感寒型小儿变应性鼻炎临床疗效并改善患儿症状。

Objective To observe the efficacy of a massage technique primarily based on the“peri-nasal periosteum compression and kneading method”in treating allergic rhinitis children with lung deficiency and cold sensation syndrome.Methods A total of 60 children with allergic rhinitis who visited Beijing Massage Hospital,Affiliated Huguosi Hospital of Beijing University of Chinese Medicine,Beijing Fengsheng Traditional Chinese Medicine Orthopedic Hospital,and Jinzhan Second Community Health Service Center in Chaoyang District,Beijing,from January 2019 to September 2022 were selected.The patients were randomly divided into two groups,with 30 cases in each group using a random number table method.The control group was treated with montelukast sodium orally,once a day,for 1 week per course,for a total of 4 courses.The observation group received the“peri-nasal periosteum compression and kneading method”in addition to the treatment in the control group,applied every other day,3 times a week,for a total of 4 weeks.The clinical efficacy of the two groups was compared,as well as the scores for the primary symptoms(sneezing,nasal discharge,nasal congestion,and nasal itching)and secondary symptoms(fear of wind and cold,susceptibility to colds,spontaneous sweating,and shortness of breath/fatigue)before and after 3 months of treatment.Results There was no statistically significant difference between the two groups in total effective rate(P>0.05).In the control group,the scores for sneezing,nasal discharge,nasal congestion,nasal itching,and susceptibility to colds decreased at weeks 1,2,3,and 4 compared with those before treatment(P<0.05).At week 4,the fear of wind and cold score decreased(P<0.05).At weeks 3 and 4,the spontaneous sweating score decreased compared with those before treatment(P<0.05).There was no significant difference in shortness of breath/fatigue scores at any time point(P>0.05).In the observation group,the scores for sneezing,nasal discharge,nasal congestion,nasal itching,fear of wind and cold,susceptibility to colds,and spontaneous sweating decreased at weeks 1,2,3,and 4 compared with those before treatment(P<0.05).At weeks 2,3,and 4,the scores for shortness of breath/fatigue also decreased compared with those before treatment(P<0.05).There were no significant differences in primary symptom scores between the two groups before treatment and at week 1(P>0.05).At week 2,the observation group had significantly lower scores for sneezing,nasal congestion,and nasal itching compared with the control group(P<0.05).At week 3,the observation group had lower scores for all primary symptoms compared with the control group(P<0.05).At week 4,the observation group had significantly lower scores for sneezing,nasal discharge,and nasal congestion compared with the control group(P<0.05).There were no significant differences in secondary symptom scores between the two groups at any time point(P>0.05).Three months after treatment,the symptom scores in both groups were lower than those before treatment(P<0.05),and the observation group had significantly lower scores for sneezing,nasal discharge,nasal congestion,nasal itching,and spontaneous sweating than the control group(P<0.05).Conclusion The“peri-nasal periosteum compression and kneading method”can improve the clinical efficacy and alleviate symptoms in allergic rhinitis children with lung deficiency and cold sensation syndrome.