小儿推拿联合运脾方治疗厌食症患儿的疗效观察

doi:10.20274/j.cnki.issn.1674-3865.2026.04.015

摘要/Abstract

摘要：

目的观察小儿推拿联合运脾方治疗厌食症患儿的临床疗效。方法选择2023年4月至2025年6月平顶山市中医医院儿科收治住院的厌食症患儿112例，随机分为观察组和对照组各56例。对照组患儿口服双歧杆菌四联活菌片治疗，观察组患儿采用穴位推拿联合运脾方治疗。两组连续治疗4周后，比较两组患儿临床疗效、中医证候积分、胃肠激素、D-木糖、食欲因子水平及不良反应。结果观察组总有效率为96.43%（54/56），高于对照组83.93%（47/56），差异有统计学意义（P<0.05）。治疗后观察组中医证候（食欲不振、厌恶进食、胸脘痞闷、嗳气泛恶、大便不调、食后脘腹饱胀）积分均低于治疗前，且观察组低于对照组，差异均有统计学意义（P<0.05）。治疗后观察组胃肠激素（血清胃泌素、胃动素）、D-木糖水平均高于治疗前，且观察组高于对照组，差异均有统计学意义（P<0.05）。治疗后观察组食欲因子神经肽Y水平高于治疗前，且观察组高于对照组，差异有统计学意义（P<0.05）；治疗后观察组食欲因子瘦素水平低于治疗前，且观察组低于对照组，差异有统计学意义（P<0.05）。两组均无明显不良反应。结论小儿推拿联合运脾方治疗厌食症患儿疗效明显，可有效降低中医证候积分，改善胃肠激素、肠道吸收、食欲因子水平，且安全性好。

关键词: 厌食症, 推拿, 运脾方, 中医证候积分, 儿童

Abstract:

Objective To observe the clinical efficacy of paediatric Tuina combined with the Yunpi formula in the treatment of children with anorexia. Methods A total of 112 children with anorexia admitted to the Paediatric Department of Pingdingshan Hospital of Traditional Chinese Medicine between April 2023 and June 2025 were selected and randomly divided into an observation group and a control group, each comprising 56 cases. Children in the control group were treated with oral bifidobacterium quadruple live bacteria tablets. Children in the observation group received treatment combining acupoint Tuina with the Yunpi formula. After 4 weeks of continuous treatment, the clinical efficacy, TCM syndrome scores, gastrointestinal hormone levels, D-xylose levels, appetite factor levels and adverse reactions were compared between the two groups. Results The overall effective rate in the observation group was 96.43%(54/56), which was higher than that in the control group (83.93%, 47/56), and the difference was statistically significant(P<0.05). After treatment, the TCM syndrome scores(loss of appetite, aversion to food, epigastric fullness and distension, belching and nausea, irregular bowel movements, and postprandial epigastric and abdominal distension) in the observation group were all lower than before treatment, and the observation group's scores were lower than those of the control group; all differences were statistically significant(P<0.05). After treatment, the levels of gastrointestinal hormones(serum gastrin, motilin) and D-xylose in the observation group were higher than before treatment, and the observation group was higher than the control group, with all differences being statistically significant(P<0.05). The level of the appetite factor neuropeptide Y after treatment in the observation group was higher than that before treatment, and the observation group's level was higher than that of the control group, with statistically significant differences(P<0.05). The level of the appetite factor leptin after treatment in the observation group was lower than that before treatment, and the observation group's level was lower than that of the control group, with statistically significant differences(P<0.05). No significant adverse reactions were observed in either group. Conclusion The combination of paediatric Tuina with Yunpi formula demonstrates significant efficacy in the treatment of children with anorexia. It effectively reduces the traditional Chinese medicine syndrome scores, improves gastrointestinal hormone levels, intestinal absorption and appetite factor levels, and is very safe.

Key words: Anorexia, Tuina, Yunpi formula, Traditional Chinese medicine syndrome score, Child

中图分类号:

R442.1

张欢欢, 李君, 徐灿灿, 陈万越. 小儿推拿联合运脾方治疗厌食症患儿的疗效观察[J]. 中国中西医结合儿科学, 2026, 18(4): 348-352.

Huanhuan ZHANG, Jun LI, Cancan XU, Wanyue CHEN. Efficacy observation of pediatric Tuina combined with Yunpi formula in the treatment of children with anorexia[J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2026, 18(4): 348-352.

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组别	n	性别（男/女，n）	年龄（x±s，岁）	病程（x±s，月）	体质量（x±s，kg）	病因（n）
组别	n	性别（男/女，n）	年龄（x±s，岁）	病程（x±s，月）	体质量（x±s，kg）	喂养不当	情志失调
对照组	56	31/25	3.41±0.57	5.79±1.63	15.44±1.67	31	25
观察组	56	33/23	3.59±0.60	5.90±1.84	14.86±1.82	34	22

组别	n	痊愈	有效	无效	总有效
对照组	56	17（30.36）	30（53.57）	9（16.07）	47（83.93）
观察组	56	36（64.29）	18（32.14）	2（3.57）	54（96.43）

组别	n	食欲不振		厌恶进食		胸脘痞闷
组别	n	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	56	2.68±0.47	1.42±0.38^a	1.89±0.33	0.97±0.22^a	1.58±0.38	0.88±0.20^a
观察组	56	2.70±0.45	0.72±0.21^a	1.95±0.36	0.64±0.17^a	1.63±0.35	0.39±0.08^a
t值		0.230	12.065	0.919	8.882	0.724	17.023
P值		0.819	<0.001	0.360	<0.001	0.470	<0.001
组别	n	嗳气泛恶		大便不调		食后脘腹饱胀
组别	n	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	56	1.70±0.43	1.08±0.29^a	1.48±0.29	1.06±0.18^a	2.04±0.55	1.47±0.38^a
观察组	56	1.78±0.41	0.75±0.12^a	1.44±0.31	0.77±0.13^a	2.10±0.48	1.05±0.29^a
t值		1.008	7.868	0.705	9.774	0.615	6.575
P值		0.316	<0.001	0.482	<0.001	0.540	<0.001

组别	n	胃泌素（ng/L）		胃动素（ng/L）		D-木糖（μmol/L）
组别	n	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	56	21.36±4.73	46.79±5.88^a	182.17±17.84	248.02±13.82^a	0.51±0.09	0.62±0.17^a
观察组	56	22.49±5.01	63.28±6.07^a	180.03±19.57	301.38±10.86^a	0.49±0.10	0.84±0.24^a
t值		1.227	14.602	0.605	22.718	1.112	5.598
P值		0.222	<0.001	0.547	<0.001	0.268	<0.001

组别	n	神经肽Y		瘦素
组别	n	治疗前	治疗后	治疗前	治疗后
对照组	56	16.48±2.18	20.73±2.24^a	49.28±5.18	35.34±4.37^a
观察组	56	15.97±2.73	26.46±2.53^a	48.07±4.94	27.61±4.01^a
t值		1.092	12.689	1.265	9.753
P值		0.277	<0.001	0.209	<0.001