Clinical effect of acupoint massage based on syndrome differentiation combined with Western medicine on children with epigastric distention and fullness
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摘要: 目的 探究辨证取穴推拿联合西医治疗脘痞患儿的临床疗效。方法 选取2023年1月-2023年6月诊治的90例脘痞患儿为研究对象，按随机数字表法分为两组，每组各45例。对照组采用双歧杆菌乳杆菌三联活菌片治疗，观察组在对照组基础上应用辨证取穴推拿。观察两组患儿治疗后的临床疗效、症状改善时间、胃肠激素[胃泌素(gastrin，GAS)、胃动素(motilin，MTL)、生长抑素(somatostatin，SS)]及血清神经肽Y(serum neuropeptide Y，NPY)、增食欲素A(Orexin-A)和瘦素(Leptin)水平。结果 治疗后，观察组患儿的总有效率(97.78%，44/45)显著高于对照组(82.22%，37/45)，差异有统计学意义(P < 0.05)。治疗后，观察组患儿的满闷不舒、上腹胀、嗳气等症状改善时间比对照组更短(P < 0.05)；GAS水平降低，MTL、SS水平升高，且比对照组改善幅度更优(P < 0.001)。治疗后，两组患儿的NPY、Orexin-A、Leptin水平均较治疗前上升，且观察组患儿的NPY、Orexin-A、Leptin水平均高于对照组，差异有统计学意义(P < 0.05)。结论 辨证取穴推拿结合双歧杆菌乳杆菌三联活菌片治疗脘痞患儿可缩短症状改善时间，提高临床疗效，并改善胃肠激素及血清NPY、Orexin-A和Leptin水平。Abstract: Objective To explore the clinical effect of acupoint massage based on syndrome differentiation and Western medicine in treating children with epigastric distention and fullness.Methods Ninety children with epigastric distention and fullness diagnosed and treated in our hospital from January, 2023 to June, 2023 were selected as the research object, and were randomly divided into two groups, 45 cases in each group. The control group was treated with treatment of Bifidobacterium and Lactobacillus triple viable bacteria tablets, while the observation group was treated with acupoint massage based on syndrome differentiation. Clinical efficacy, time of symptom improvement, gastrointestinal hormones (gastrin[GAS], motilin[MTL] and somatostatin[SS]) and serum neuropeptide Y(NPY), Orexin-A and Leptin levels were observed in the two groups after treatment.Results After treatment, the total response rate of the observation group 97.78%(44/45) was significantly higher than that of the control group 82.22%(37/45), which was statistically significant(P < 0.05). After treatment, the improvement time of symptoms such as fullness, upper abdominal distension, belching in the observation group was shorter than that in the control group(P < 0.05), the GAS level of the observation group decreased, MTL and SS levels were higher than before treatment, and better than the control group(P < 0.001). After treatment, the levels of NPY, Orexin-A and Leptin in both groups increased compared with those before treatment, and the levels of NPY, Orexin-A and Leptin in the observation group were higher than that of the control group, showing a statistically significant difference(P < 0.05).Conclusion Clinical effect of acupoint massage combined with Western medicine on children with epigastric distention and fullness can shorten the time of symptom improvement, improve clinical efficacy, and improve gastrointestinal hormones and serum NPY, Orexin-A and Leptin levels.
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表 1 两组患儿的临床资料比较
例(%)，X±S 组别 例数 性别 年龄/岁 BMI 病程/月 男 女 观察组 45 24(53.33) 21(46.67) 8.38±1.09 17.29±1.20 2.76±0.65 对照组 45 22(48.89) 23(51.11) 8.56±1.22 17.37±1.30 2.93±0.81 χ2/t 0.178 -0.729 -0.320 -1.153 P 0.673 0.468 0.749 0.252 
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表 2 两组患儿的临床疗效比较
例(%) 组别 例数 显效 有效 无效 总有效 观察组 45 25(55.56) 19(42.22) 1(2.22) 44(97.78) 对照组 45 18(40.00) 19(42.22) 8(17.78) 37(82.22) χ2 4.444 P 0.035
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表 3 两组患儿的症状改善时间比较
d，X±S 组别 例数 满闷不舒 上腹胀 嗳气 观察组 45 3.36±0.77 3.22±0.60 3.07±0.45 对照组 45 4.67±0.77 4.60±0.69 4.96±0.52 t -8.066 -10.137 -18.469 P < 0.001 < 0.001 < 0.001
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表 4 两组患儿治疗前后胃肠激素水平的比较
ng/L，X±S 组别 例数 GAS MTL SS 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 观察组 45 168.44±22.35 78.32±18.231) 188.25±40.31 272.43±36.411) 148.33±23.43 214.52±20.621) 对照组 45 166.14±21.42 102.54±20.151) 190.41±41.45 243.51±37.231) 150.44±24.14 192.44±21.461) t 0.499 -5.980 -0.250 3.727 -0.420 4.977 P 0.619 < 0.001 0.803 < 0.001 0.676 < 0.001 与治疗前比较，1)P < 0.05。
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表 5 两组患儿治疗前后NPY、Orexin-A、Leptin水平的比较
X±S 组别 例数 NPY/(ng/L) Orexin-A/(ng/L) Leptin/(ng/mL) 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 观察组 45 20.68±2.94 25.22±3.121) 1.35±0.48 1.82±0.531) 0.48±0.19 1.66±0.431) 对照组 45 20.37±3.02 22.15±3.751) 1.38±0.52 1.54±0.431) 0.46±0.17 1.26±0.371) t 0.493 4.222 -0.284 2.750 0.526 4.739 P 0.623 < 0.001 0.777 0.007 0.600 < 0.001 与治疗前比较，1)P < 0.05。
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