儿童反复呼吸道感染外治方案优化研究
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摘要
目的通过比较单用及联用伏九穴位敷贴疗法、四时辨体捏脊疗法防治儿童反复呼吸道感染的临床疗效,选择最佳治疗方案。方法采用随机数字表法将96例患儿分为伏九穴位敷贴组、四时辨体捏脊组、伏九穴位敷贴合四时辨体捏脊组各32例,3组分别脱落2、4、1例。伏九穴位敷贴组予冬夏伏九敷贴,四时辨体捏脊组予四时辨体捏脊,伏九穴位敷贴合四时辨体捏脊组联合应用上述2种疗法。随访1年。比较3组临床疗效,观察3组治疗前后呼吸道感染疾病类型、发病次数、发作期病程,分析疗效相关影响因素(性别、年龄、起病年龄、出生体质量、生产方式、病程、疾病类型)。结果随访1年,伏九穴位敷贴合四时辨体捏脊组临床疗效优于其他2组,差异有统计学意义(P<0.05)。伏九穴位敷贴合四时辨体捏脊组减少单位时间内发病次数、缩短感染期病程、转变疾病类型(病种)优于其他2组,差异有统计学意义(P<0.05)。单因素分析显示,各组生产方式、病程比较,差异有统计学意义(P<0.05)。影响疗效的有序logistic回归分析显示,生产方式、病程、起病年龄在模型中均无统计学意义(P>0.05)。结论 3种外治法防治儿童反复呼吸道感染疗效显著,伏九穴位敷贴联合四时辨体捏脊疗法疗效更佳。
Objective To compare the clinical efficacy of single use of the acupoint application in both dog days and three nine-day periods after the winter solstice and the physical differentiation in four seasons of knead ridge method with the combination of the acupoint application in both dog days and three nine-day periods after the winter solstice and the physical differentiation in four seasons of knead ridge method in the prevention and treatment of recurrent respiratory tract infections in children; To optimize the treatment. Methods Totally 96 cases of recurrent respiratory tract infection in children were randomly divided into three groups, namely the acupoint application in both dog days and three nine-day periods after the winter solstice group, the physical differentiation in four seasons of knead ridge method group, and the combination of the acupoint application in both dog days and three nine-day periods after the winter solstice and the physical differentiation in four seasons of knead ridge method group, with 32 cases in each group, with 2 cases, 4 cases and 1 case lost, respectively. The acupoint application in both dog days and three nine-day periods after the winter solstice group was given the acupoint application in both dog days and three nine-day periods after the winter solstice every year; the physical differentiation in four seasons of knead ridge method group was given the physical differentiation in four seasons of knead ridge method therapy; the combination of the acupoint application in both dog days and three nine-day periods after the winter solstice and the physical differentiation in four seasons of knead ridge method group was given both therapies mentioned above. The follow-up lasted for 1 year. The clinical efficacy of the three groups was compared. The disease types, the number of episodes,and the duration of the respiratory tract infection before and after treatment were observed. The related factors(gender, age, age of onset, birth weight, mode of birth, duration of disease, type of disease) were analyzed.Results During the follow-up for one year, the clinical efficacy of the combination of the acupoint application in both dog days and three nine-day periods after the winter solstice and the physical differentiation in four seasons of knead ridge method group was better than the other groups, with statistical significance(P<0.05). The combination of the acupoint application in both dog days and three nine-day periods after the winter solstice and the physical differentiation in four seasons of knead ridge method group was better than the other two groups in the aspects of reducing the number of episodes per unit time, shortening the duration of infection period, and changing the type of disease(disease type), with statistical significance(P<0.05). Monofactor analysis showed that there was statistical significance in the mode of birth and duration of disease among the groups(P<0.05). Ordered logistic regression analysis affecting efficacy showed that there was no statistical significance in the mode of birth, duration of disease,and age of onset(P>0.05). Conclusion The three external therapies are effective in the prevention and treatment of children's recurrent respiratory tract infections. Among them, the combination of the acupoint application in both dog days and three nine-day periods after the winter solstice and the physical differentiation in four seasons of knead ridge method is the best one.
Objective To compare the clinical efficacy of single use of the acupoint application in both dog days and three nine-day periods after the winter solstice and the physical differentiation in four seasons of knead ridge method with the combination of the acupoint application in both dog days and three nine-day periods after the winter solstice and the physical differentiation in four seasons of knead ridge method in the prevention and treatment of recurrent respiratory tract infections in children; To optimize the treatment. Methods Totally 96 cases of recurrent respiratory tract infection in children were randomly divided into three groups, namely the acupoint application in both dog days and three nine-day periods after the winter solstice group, the physical differentiation in four seasons of knead ridge method group, and the combination of the acupoint application in both dog days and three nine-day periods after the winter solstice and the physical differentiation in four seasons of knead ridge method group, with 32 cases in each group, with 2 cases, 4 cases and 1 case lost, respectively. The acupoint application in both dog days and three nine-day periods after the winter solstice group was given the acupoint application in both dog days and three nine-day periods after the winter solstice every year; the physical differentiation in four seasons of knead ridge method group was given the physical differentiation in four seasons of knead ridge method therapy; the combination of the acupoint application in both dog days and three nine-day periods after the winter solstice and the physical differentiation in four seasons of knead ridge method group was given both therapies mentioned above. The follow-up lasted for 1 year. The clinical efficacy of the three groups was compared. The disease types, the number of episodes,and the duration of the respiratory tract infection before and after treatment were observed. The related factors(gender, age, age of onset, birth weight, mode of birth, duration of disease, type of disease) were analyzed.Results During the follow-up for one year, the clinical efficacy of the combination of the acupoint application in both dog days and three nine-day periods after the winter solstice and the physical differentiation in four seasons of knead ridge method group was better than the other groups, with statistical significance(P<0.05). The combination of the acupoint application in both dog days and three nine-day periods after the winter solstice and the physical differentiation in four seasons of knead ridge method group was better than the other two groups in the aspects of reducing the number of episodes per unit time, shortening the duration of infection period, and changing the type of disease(disease type), with statistical significance(P<0.05). Monofactor analysis showed that there was statistical significance in the mode of birth and duration of disease among the groups(P<0.05). Ordered logistic regression analysis affecting efficacy showed that there was no statistical significance in the mode of birth, duration of disease,and age of onset(P>0.05). Conclusion The three external therapies are effective in the prevention and treatment of children's recurrent respiratory tract infections. Among them, the combination of the acupoint application in both dog days and three nine-day periods after the winter solstice and the physical differentiation in four seasons of knead ridge method is the best one.
引文
[1]中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.反复呼吸道感染的临床概念和处理原则[J].中华儿科杂志,2008,46(2):108-110.
[2]陈宣名,汪受传.小儿反复呼吸道感染的病因病机认识与治疗[J].中国中西医结合儿科学,2010,2(2):160-162.
[3]霍莉莉,宣小平,虞坚尔.伏九敷贴防治小儿反复呼吸道感染临床观察及免疫功能分析[J].辽宁中医杂志,2014,41(4):701-705.
[4]沈增晖.冬病夏治穴位敷贴法治疗小儿反复呼吸道感染49例临床观察[J].中医儿科杂志,2016,12(6):42-44.
[5]马融,杜春雁,杨常泉,等.四时辨体捏脊疗法预防小儿反复呼吸道感染的临床应用[J].中华中医药杂志,2012,27(5):1315-1317.
[6]中华中医药学会.中医儿科常见病诊疗指南[M].北京:中国中医药出版社,2012:27-30.
[7]胡仪吉.反复呼吸道感染诊断依据[J].中华儿科杂志,1988,26(1):41.
[8]邓运正,杨显,张晓春.中医外治疗法治疗小儿反复呼吸道感染的研究概况[J].广西中医药大学学报,2017,20(3):55-59.
[9]黄辉,王鹏.伏九膏贴敷防治小儿反复呼吸道感染临床观察[J].中国中医药信息杂志,2010,17(3):81-82.
[10]霍莉莉,虞坚尔,夏以琳,等.离子导入三伏贴防治反复呼吸道感染临床观察[J].云南中医学院学报,2013,36(5):40-43.
[2]陈宣名,汪受传.小儿反复呼吸道感染的病因病机认识与治疗[J].中国中西医结合儿科学,2010,2(2):160-162.
[3]霍莉莉,宣小平,虞坚尔.伏九敷贴防治小儿反复呼吸道感染临床观察及免疫功能分析[J].辽宁中医杂志,2014,41(4):701-705.
[4]沈增晖.冬病夏治穴位敷贴法治疗小儿反复呼吸道感染49例临床观察[J].中医儿科杂志,2016,12(6):42-44.
[5]马融,杜春雁,杨常泉,等.四时辨体捏脊疗法预防小儿反复呼吸道感染的临床应用[J].中华中医药杂志,2012,27(5):1315-1317.
[6]中华中医药学会.中医儿科常见病诊疗指南[M].北京:中国中医药出版社,2012:27-30.
[7]胡仪吉.反复呼吸道感染诊断依据[J].中华儿科杂志,1988,26(1):41.
[8]邓运正,杨显,张晓春.中医外治疗法治疗小儿反复呼吸道感染的研究概况[J].广西中医药大学学报,2017,20(3):55-59.
[9]黄辉,王鹏.伏九膏贴敷防治小儿反复呼吸道感染临床观察[J].中国中医药信息杂志,2010,17(3):81-82.
[10]霍莉莉,虞坚尔,夏以琳,等.离子导入三伏贴防治反复呼吸道感染临床观察[J].云南中医学院学报,2013,36(5):40-43.