Method Research Of Treating And Effect Evaluation On Children With Diarrhea By Tuina

Child Diarrhea is a global health issure, which has been listed as one of four pediatric diseases by Health Ministry of China and has been one of threats for children's health. Based on the dicipline of syndrome differenciation in clinic, food damage syndrome is one of common patterns. Currently, significant advantage has been shown in Tuina therapy but without scientific evidence.Supported by China's State Administration of TCM, as one of "Fifty Demonstration Projects of Clinical Standardization Research on Diagnosis and Treatment Technologies in TCM" in the task of "TCM Science Technology Research", this research is part of clinical research on child diarrhea treatment of Tuina (No.2009ZL25). Based on the principle of multi-center, randomized and parallel controlled, the trial on the effectiveness and safety of Tuina was conducted by the special research groups composed of the affiliated hospital of Nanjing University of Chinese Medicine, Yancheng city TCM hospital and Zhenjiang city TCM hospital of Jiangsu Province. 280 cases were observed in the effect and safty aspects, in which there were 106 cases of food damage syndrome.Objective1. To evaluate curative effect of Tuina therapy in child diarrhea of food damage syndrome objectively.2. To compare the safety of Tuina therapy in child diarrhea of food damage syndrome.3. To explore and establish a new effect evaluation method on child diarrhea of food damage syndrome.Methods1. Multi-center, stratified randomization, equal control methods were applied in this clinical research on child diarrhea of food damage syndrome. Controlled by Bifico and Smectite, Tuina therapy was used in test group.3 days for one course and each case was observed for 1 or 2 courses.2. Dominant symptoms including frequency, texture, property and quality of stool, secondary symptomes including borborygmus, abdominal pain, abdominal distension, vomiting, epitite, spirit, thirsty, urine condition, the colour of stool, tongue and finger venules or pulse manifestation on different points during treatment, stool examination, rotavirus test were observed on pre and post treatment. After treatment, the comprehenive efficacy of disease, difference of scores in dominant symptoms, the total scores of dominant symptoms and the sum of scores between pre and post treatment in two groups were compared and evaluated. The recovery rates of dominant symptoms were analyzed by survival analysis. 3. The statistical soft wares of SPSS 11.5 and SPSS16.0 were used.Results1. Comparison of comprehensive efficacy based on total scores and reduced scores of dominant symptoms between two groups:After treatment for 3 days, the total effective rate were 93.42% and 50.00% respectively in test group and control group. There were statistically significant difference between two groups and the effect of test group was better than that in control group(P<0.01). After treatment for 6 days, the total effective rate were 96.05% and 73.33% respectively in test group and control group. There were also statistically significant difference between two groups and the effect of test group was much better than that in control group(P<0.01).2. Comparison of the sum of scores in dominant symptoms between two groups:The rate of 1 plus 2 grade were 63.16% and 23.33% respectively in test group and control group. There were statistically significant difference between two groups and the effect of test group was much better than that in control group(P<0.01).3. Comparison of survival analysis:There were statistically significant difference in recovery of dominant symptoms between two groups and the effect of test group was much earlier than that in control group(P<0.01).4. Comparison of safety:There was no statistical difference between two groups(P>0.05).Conlusion1. Tuina therapy based on the principle of activating spleen and resolving dampness, promoting digestion and resolving food stagnation is a safe and effective treatment of child diarrhea due to food damage, which is better than Bifico plus Smectite, however, safty advantage has not been shown.2. A new and more objective method of theraputic evaluation has been established by survival analysis, demonstrating prominent superiority of Tuina therapy for child diarrhea of food damage syndome.