| Objective:1.To understand the cognition of infantile Tuina in the crowd,so as to find and explore its promotion methods and existing problems in the crowd,so as to create conditions for further research and promotion of infantile Tuina disease spectrum.2.Explore the disease spectrum of modern infantile Tuina,generate the corresponding evidence-based disease spectrum and frequency disease spectrum,and compare with the disease spectrum of modern and contemporary infantile Tuina monographs,so as to provide reference for modern infantile Tuina clinic.Method:1.Questionnaire design,distribution and result analysisThrough the questionnaire interview method to carry out the pre survey,collected the opinions of 5 teachers or parents of Anshan Road Primary School and Mi Ge International Kindergarten in Heping District of Tianjin,and combined with the relevant teaching materials and teachers’ opinions,wrote the questionnaire.There are 15 items in the questionnaire,including 5 multiple-choice questions,9 single choice questions and 1 open question.This paper selects the college students of Tianjin University of traditional Chinese medicine as the research object,estimates the sample size of the questionnaire through two ways,and calculates that at least 423 questionnaires are needed to meet the needs of the survey.The wechat Questionnaire Star program was used for electronic questionnaire distribution,and all questionnaires were filled in by electronic terminals.The maximum number of times for each respondent to fill in the questionnaire was set to one time.At the same time,the questionnaire was promoted through posters and associations.During one month(from 8:00a.m on October11,2020 to 8:00a.m on November 10,2020),511 electronic questionnaires were actually collected by the survey terminal,2 of which were excluded(non Tianjin IP address),and 509 valid questionnaires were actually collected,with the actual recovery rate of 120%(509 / 423).The final data is sorted out through the questionnaire star website and Excel software,and the corresponding bar and sector statistical charts are drawn through spss22.0 to understand the actual selection of each option.2.Bibliometric study on the disease spectrum of infantile TuinaThrough Wanfang medical thesaurus,Mesh in Pub Med and many times of pre search to determine the keywords,using the thesaurus method,through the selection of eight domestic and foreign databases,four foreign databases,Pub Med,web of science,EMBASE,Cochane Library.And CNKI,VIP,Wangfang and CBM are the four major databases in China.The retrieval time of all databases is from January 1st,1978 to December 31 st,2020.All the search literature titles are imported into Note Express 3.3 for duplicate search and disease classification.The 11 th revision of international classification of diseases is adopted for disease classification and disease name determination The Chinese version of ICD-11 was combined with the textbook pediatrics of the 13 th five year plan published by people’s Health Publishing House and the textbook pediatrics of traditional Chinese Medicine published by China traditional Chinese Medicine Publishing House for systematic classification,standardization and combination of disease names and symptoms.At the same time,the corresponding literature was eliminated by using the principle of "isolated syndrome but not established" in literature research,and the disease spectrum data was finally obtained.3.Study on the disease spectrum of infantile TuinaThe results of disease spectrum literature in Study 2 were selected as the research object,and the manual classification and screening were carried out according to the four categories of Systematic Review or Meta analysis,independent intervention RCT literature,RCT literature and other clinical literature.The PRISMA principle was adopted in the literature screening process,and the disease spectrum grade of evidence-based and frequency of infantile Tuina was established according to the corresponding standards.According to the existing research situation of infantile Tuina disease spectrum and the actual situation of literature,according to the evidence principle of evidence-based medicine,the literature evidence grade evaluation and literature quality bias evaluation were carried out.The literature evidence grade evaluation was based on the evaluation standard of modern acupuncture disease spectrum by Professor Du Yuanhao and the "new five level" evidence of literature type by the evidence-based medicine(EBM)center of Oxford University According to the standard and New York State University’s "new nine level" evidence standard,the self-made grade standard is adopted,following the principle of evidence-based evidence grade.The literature quality bias was evaluated by using the improved Jadad evaluation(7-point method)and the Cochrane manual(version 5.1.0)RCT bias risk assessment tool.In order to distinguish high frequency disease spectrum from low frequency disease spectrum,price law was used to determine the number of frequency disease spectrum.All studies were strictly screened by two researchers according to the criteria of inclusion and exclusion,and relevant information was extracted.In case of disagreement,the third researcher was introduced to negotiate.Result:1.Survey resultsIn terms of basic information,according to the actual population of this questionnaire survey,junior undergraduates of Tianjin University of traditional Chinese medicine participated in this questionnaire to a high degree(88.88%),and 81.53% of the respondents were female students,75.44% of the respondents were medical students.In terms of popularity,96.86% of the respondents knew about infantile Tuina,"Internet"(47.46%)and "TV program"(47.06%)were the main sources of respondents’ knowledge about children’s massage,and the information source of "school influence"(12.17%)could not be ignored.In terms of cognitive level,specific cognition is insufficient and cognitive bias exists.99.61% of the respondents recognized that infantile Tuina had therapeutic effect,but they could not recognize its specific therapeutic value;they had vague cognition about the scope of treatment,and they supported the treatment of spleen and stomach diseases(87.23%);they did not understand the specific treatment of infantile massage,and recognized that infantile Tuina had "fewer side effects than antibiotics"(87.62%)and "long-term preventive effect of disease"(73.8%)At the same time,they were worried about the adverse reactions of "delayed illness"(52.65%)and "skin damage"(47.35%).In terms of promotion methods,the most recognized by the respondents were "the promotion influence of doctors"(92.34%)and "free clinic activities"(88.61%),but they did not know enough about "basic medical research"(64.44%)and "evidence-based medical research"(55.6%).2.Bibliometric research on modern infantile TuinaThrough Wanfang medical thesaurus,Mesh keywords in Pub Med and presearch,25 Chinese keywords and 4 foreign keywords were identified.Eight databases were searched,including CNKI 16222,vip207,Wang Fang 20075,cbm1978,Pub Med 190,Cochrane 29,web of science 85,EMBASE 21,Chinese database38482,foreign database 315,a total of 38797.The abstracts of this paper were imported into Note Express 3.3,and the literatures were obtained by duplicate checking,and the literatures were eliminated by manual screening.Finally,8119 clinical literatures with clear classification and 279 disease spectrums were obtained.109 literatures were eliminated by the principle of "isolated syndrome not established",and 8010 literatures were obtained.A total of170 disease spectrums were included in the final study,and 170 modern pediatric Tuina diseases were finally selected There were 133 disease names of Western Medicine(78.24%),22 symptoms or signs of Western Medicine(12.94%)and 15 disease names of traditional Chinese medicine(8.82%).Among the 15 disease categories,the top three categories of disease spectrum were 41(24.12%)diseases of digestive system,3327(41.54%),37(21.76%)diseases of musculoskeletal system and connective tissue,1099(13.72%),16(9.41%)diseases of respiratory system,1293(16.14%)29%,accounting for 71.40% of the total disease spectrum literature.In single disease,the number of diarrhea literature was the most,accounting for1756(21.92%).3.Study on the disease spectrum of modern infantile TuinaAccording to the screening of evidence-based disease spectrum,there are 14 grade Ⅰ disease spectrum(Ⅰ)and 68 grade Ⅱ disease spectrum(Ⅱ),including 7 grade ⅡA disease spectrum,10 grade ⅡB disease spectrum,51 grade ⅡC disease spectrum and 88 grade Ⅲ disease spectrum(Ⅲ),so as to construct the evidence-based grade disease spectrum of infantile massage.Price’s law of literature is used in the disease spectrum of frequency grade.The frequency limit value m = 31.39 is calculated by formula,and the integer is 32.There are 34 high frequency spectrum(HFS,Grade A)and 136 low frequency spectrum(LFS,Grade B)in170 disease spectrum,34 disease spectrum disease literature total more than 50%(86.05%),basically in line with price’s law,high frequency disease spectrum(Grade A)mainly exists in the digestive system(26.47%),respiratory system(17.65%)and musculoskeletal system(17.65%),which is more consistent with the former evidence-based disease spectrum research method.The statistical results of the two grades of disease spectrum were combined and sorted according to the principle of evidence-based classification of literature to construct the disease spectrum classification table of infantile Tuina.According to the statistics of the disease spectrum of seven children’s massage monographs from different academic schools and sources,64 disease spectrum of children’s massage monographs were obtained,accounting for 37.64% of the total 170 disease spectrum.The total coverage rate of disease spectrum of monographs was 92.18%.Among the 64 disease spectrum,14 were grade Ⅰ,24 were grade Ⅱ,6 were ⅡA,6 were ⅡB,12 were ⅡC,21 were Ⅲ,among which 14 were grade Ⅰ disease spectrum.Among the 64 items,27(42.19%)had high frequency disease spectrum(Grade A).At the same time,by drawing word cloud(WC)to compare the disease spectrum of monographs with that of infantile Tuina,it is found that the disease spectrum of children’s massage basically contains the disease spectrum of monographs,and the content range is wider and richer.Conclusion1.The questionnaire survey can better represent the understanding level of junior students,female students and medical students of Tianjin University of traditional Chinese medicine on infantile Tuina.The results show that the awareness of infantile Tuina among college students in Tianjin University of traditional Chinese medicine is high,but the cognition of treatment scope and treatment method is insufficient.It shows that it is necessary to strengthen the propaganda of infantile Tuina combined with physicians,and strengthen the research and promotion of basic medicine and evidence-based medicine of infantile massage.2.Through bibliometric research,170 disease spectrum of modern infantile Tuina were selected,including 133 disease names of Western medicine,22 symptoms or signs of Western medicine and 15 disease names of traditional Chinese medicine.3.Based on the evidence-based evaluation method,14 grade Ⅰ disease spectrum(Ⅰ)and68 grade Ⅱ disease spectrum(Ⅱ)were screened,including 7 grade ⅡA disease spectrum,10 grade ⅡB disease spectrum,51 grade ⅡC disease spectrum and 88 grade Ⅲ disease spectrum(Ⅲ).Through literature research,34 high frequency disease spectrum and 136 low frequency disease spectrum were screened.Finally,we build a modern pediatric massage grade disease spectrum including evidence-based grade disease spectrum and frequency disease spectrum,which is basically in line with the trend of modern disease spectrum research scope. |
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