| 摘要: | 研究背景：根據世界衛生組織統計1990年到2000年腹瀉發病率和死亡率，每年有250萬人腹瀉死亡，其中年齡5歲以下兒童腹瀉死亡者佔所有腹瀉死亡人數的21%。兒童腹瀉除了使病童飽受到疾病煎熬外，父母、照護者及國家所必須承擔極大醫療及社會成本支出。小兒腹瀉在西醫的治療方式主要以症狀治療為主，然而小兒畏懼打針或服藥困難，對於患者及家屬而言不啻是種折磨。小兒穴位推拿乃透過刺激相對應的經絡輸穴，達到調和脾胃，化濕止瀉之效，為一簡便安全之輔助療法。 研究動機：許多關於小兒推拿之文獻，以治療小兒腹瀉之研究最多，足見以推拿治療小兒腹瀉之方法所受到的重視。儘管如此，當前的研究成果欠缺對明清推拿典籍對於小兒腹瀉之論述的系統和全面的疏理，以及與今日臨床醫案的相互印證，難以彰顯其應用價值。 研究目的：1.明清小兒推拿典籍中關於小兒腹瀉治法記述的系統整理。2.小兒腹瀉推拿之不同部位及穴位治法所受的重視程度。3.以現代臨床醫案印證小兒腹瀉推拿的有效性。 研究結果：明清時期運用推拿治療小兒腹瀉的8本典籍，選用的部位及穴位共有25處，由出現的頻率高低分別是「推大腸」、「揉臍」、「揉龜尾」、「推三關」、「分陰陽」出現7次，「推脾土」、「運八卦」各出現6次。而2000年後發表之有關推拿治療小兒腹瀉的49篇現代醫案中，所選用的部位及穴位共有40處，依其出現的頻率高低分別是「推脾土」出現42次，「推上七節骨」出現40次，「推大腸」出現36次，「摩腹」出現36次，「揉龜尾」出現36次，「捏脊」出現23次，「揉臍」20次。 結論：本研究首次系統整理匯總了明清時期小兒推拿典籍與現代醫案中記載之有關推拿治療小兒腹瀉的復方穴，建議以推拿治療小兒腹瀉使用之部位及穴位有「推大腸」、「推脾土」、「揉臍」、「揉龜尾」、「推上七節骨」與「摩腹」等。
Research background: Based on 1990 to 2000 diarrhea and death rate, the statistics of the World Health Organization, 25 million people died from diarrhea annually, of which children below age 5 who died from diarrhea occupies about 21% of the people who died from diarrhea. Children suffering from diarrhea endure not only pain but also burden their parents, caretakers, and country with great medical and social expenses. Children suffering from diarrhea are mainly treated dfor their symptoms in the treatment method of the Western medicine. However, children are afraid of injection and the trouble of taking medicine and to the sufferers or their parents it is no less than a torture. Children’s acupoint massage is through stimulation of its corresponding meridian points to achieve the effect of harmony between spleen and stomach, to remove wet and stop spurting out. It is an easy, convenient, and safe supplementary treatment method. Research motive: Of a lot of literature about children massage, the research into curing children with diarrhea is the largest one. It is obvious that massage in curing children with diarrhea is most highly respected. Nevertheless, up to the present, the research results still lack of systematic discussions and overall treatment about massage classics of the Ming-Qing dynasties and modern medical cases in curing children with diarrhea. So it is hard to manifest its applicable value. Research purpose: (1) a systematic treatment about statements concerning children’s diarrhea in the massage classics of the Ming-Qing dynasties. (2) Different locations and points and acupoints in massaging children with diarrhea have been highly respected. (3) The evidences show the efficacy of massaging children with diarrhea in modern medical cases. Research result: The result of the research shows that in the Ming-Qing dynasties, there are 8 classics for application of acupoints in curing children with diarrhea, of which there are 25 acupoints. From the frequency of appearance, they are 7 appearances of ”Tui-ta-chang”, ”Rou-chi”, “Rou-kuei-wei”, ”Tui-san-kuan”, ”Fen-yin-yang”, and 6 appearances of ” Tui-pi-tu”, ”Yun-pa-kua”. In 2000, there are 49 papers in modern medical cases on the application of the acupoint in medical cases in curing children with diarrhea, of which the selected acupoints are 40 in total. According to the frequency of appearance, there are 42 appearances of “Tui-pi-tu”, 40 appearances of “Tui-shang-chi-chieh-ku”, 36 appearances of “Tui-ta-chang”, and 36 appearances of “Mo-fu”, 36 appearances of “Rou-kuei-wei”, 23 appearances of “nieh-chi”, and 20 appearances of “Rou-chi”. Conclusion: This research first systematically collects massage classics of the Ming-Qing dynasties and modern medical cases for the application of children with diarrhea and suggests the acupoints in massaging children with diarrhea be “Tui-ta-chang”, “Tui-pi-tu”, Rou-chi”, ”Rou-kuei-wei”, “Tui-shang-chi-chieh-ku”, and “Mo-fu”, etc. |
