世界中医药

作者	单位
王红娟1，郭凯1，肖和印1，毛娜1，陈艳霞1，黄长婷1，孟颖超2	1 中国中医科学院望京医院儿科,北京，100102； 2 北京中医药大学，北京,100102

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中文摘要:

目的：观察推拿敷贴对迁延性、慢性腹泻患儿的临床疗效，对其伴随消化不良症状的改善，并通过测定粪便pH值、还原糖及脂肪含量，确定推拿敷贴对迁慢性腹泻患儿脂肪及乳糖消化吸收不良的干预作用。方法：选取2015年1月至2016年12月中国中医科学院望京医院儿科门诊收治的迁慢性腹泻患儿150例，分为观察组和对照组，每组75例。观察组中，选择粪便脂肪定性可见脂肪滴、还原糖定性≥++、粪便pH值：＜6.9或＞7.2，以上3项指标均至少满足其中1项者患儿共收集38例，分别于治疗前后收集患儿粪便，测定粪便pH值、苏丹染色后镜检脂肪滴个数、醋酸铅法测定还原糖定性，比较治疗前后以上3个指标的改变。结果：观察组临床有效率为100%，显著高于对照组；观察组大便性状、腹胀、食欲、食量症状积分的改显著优于对照组；38例患儿粪便pH值治疗前后均在5.5～7之间，治疗后患儿粪便pH值有所升高，差异有统计学意义（P<0.05）；治疗前粪便中见脂肪滴者22例，治疗后较前好转，差异有统计学意义（P<0.05）；还原糖定性≥2+者21例，治疗后显著改善，差异有统计学意义（P<0.05）。结论：推拿敷贴治疗小儿迁慢性腹泻疗效确切，显著改善迁慢性腹泻患儿大便性状，促进患儿消化吸收功能；推拿敷贴治疗减少粪便中脂肪滴个数，减少粪便中还原糖含量，可促进脂肪、碳水化合物的消化吸收，有助于乳糖不耐受的恢复，发挥健脾止泻功能。

English Summary:

To observe the clinical efficacy of massage and application on the children with persistent and chronic diarrhea, and to observe the improvement about the accompanying symptoms of indigestion. By measuring the stool pH value, the contents of reducing sugar and fat, to determine the intervention effect of massage and application on poor digestive absorption of fat and lactose of children with chronic diarrhea. Methods:A total of 150 cases of children with chronic diarrhea who were treated in outpatient department of pediatric in our hospital were collected and divided into control group and treatment group, with 75 cases in each group. In the treatment group, 38 cases were collected and they at least met one of three following conditions. Fecal fat was selected with visible fat drops, and reducing sugar was larger than ++, fecal pH value＜6.9 or>7.2. The faeces before and after the treatment was collected respectively, and the fecal pH value, number of fat drops after sultan staining by microscopic examination were determined. Lead acetate method was used for the determination of reducing sugar qualitative. The changes of the above 3 indicators before and after treatment were compared. Results:The total effective rate in treatment group was 100%, significantly higher than that in control group; In the treatment group, symptom integral in the aspects of stool property, abdominal distension, loss of appetite and food intake was significantly better than the control group; The fecal pH value of 38 children was between 5.5 to 7.0 before and after treatment, and the fecal pH value increased was slightly increased. The difference was statistically significant (P<0.05); 22 cases children faeces were found fat drops before treatment, and the result was better after treatment. The difference was statistically significant (P<0.05); And sugar qualitative of 21 cases was larger than 2+, and significantly improved after treatment. The difference was statistically significant (P<0.05). Conclusion:Massage and application treatment of pediatric chronic diarrhea is an effective method, which can significantly improve stool property in children with chronic diarrhea, and promote the function of the digestion and absorption. The treatment of massage and application can reduce the number of fecal fat drops, reduce sugar content in feces, and also it can promote the function of the digestion and absorption in fat and carbohydrates, contributes to the recovery of lactose intolerance, plays a role in invigorating the spleen to arrest diarrhea.

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