小兒推拿治療消化系統疾病常用穴位與手法分析：1994-2020文獻分析

Analysis of common acupoints and manipulations of pediatric Tuina for digestive system diseases: Literature review from 1994 to 2020

目的：小兒推拿為中醫兒科常用外治手法，本研究探討小兒推拿療法治療小兒消化系統疾病的辨證分型、特定穴與手法分析。方法：收集整理1994-2020年《中國期刊全文數據庫》（CNKI）、《華藝線上圖書館》（Airiti Library，含CEPS+CETD）及PubMed文獻進行檢索。用Microsoft Excel建立資料庫，通過資料篩選及排序等功能對選用特定穴與手法的使用次數與中醫辨證證型進行統計分析。結果：推拿治療小兒消化系統疾病的文獻共219篇，其中排序前三之小兒消化系統疾患分別為腹瀉121篇、厭食43篇、便秘15篇。脾虛瀉是腹瀉症中最常見的證型，使用最多特定穴依序為大腸經、脾經、腹臍、七節骨與捏脊；脾胃氣虛是厭食症中最常見證型；使用最多特定穴依序為脾經、捏脊、四橫紋、內八卦、板門、足三里與腹臍；虛證型便秘是便秘症中最常見證型，使用最多特定穴依序為七節骨、腹臍、六腑、足三里、大腸經、脾經、捏脊與膊陽池。結論：小兒推拿療法治療消化系統疾病選穴多以小兒特定穴為主，而非一般十二經絡穴位，本研究分析結果可作為未來小兒消化系統疾病的推拿處方的臨床研究與治療參考。

Objectives: Pediatric tunia is a common external therapy in Chinese medicine pediatrics. This study aimed to explore the syndrome differentiation, specific acupoints, and techniques of pediatric tuina (massage therapy) in treating pediatric digestive system diseases. Methods: Literature from 1994 to 2020 were extracted from China National Knowledge Infrastructure, Airiti Library (including CEPS and CETD), and PubMed for review. Microsoft Excel was used to build databases. Data screening and sequencing functions were used to perform statistical analysis of frequencies of specific acupoints selected and techniques used, as well as the syndromes determined through traditional Chinese medicine dialectic classification. Results: A total of 219 studies involved tuina treatment of pediatric digestive system diseases. The diseases with top 3 rankings in the number of studies were diarrhea (n=121), poor appetite (n=43), and constipation (n=15). Diarrhea caused by spleen deficiency is the most common pattern of diarrhea. Most frequently used specific acupoints and techniques to treat the symptom were large intestine meridian, spleen meridian, navel, qijiegu, and chiropractics. Spleen and stomach qi-deficiency was the most common pattern in anorexia. Most frequently used specific acupoints and techniques were the spleen meridian, chiropractics, sihengwen, neibagua, banmen, zusanli, and navel. The deficiency type is the most common pattern of constipation. The most frequently used specific acupoints and techniques were qijiegu, navel, six bowels, zusanli, the large intestine meridian, the spleen meridian, chiropractics, and yangchi. Conclusion: The acupoints selected in pediatric tuina to treat digestive system diseases were mostly specific acupoints instead of the acupoints in the 12 channels. The results can serve as references for conducting research and treating pediatric digestive system diseases in the future.