| ObjectiveThe first part explores the curative effect of touch and acupoint massage combined with blue light irradiation in the treatment of neonatal jaundice through meta-analysis,and provides evidence-based basis for the second part of clinical trials.The second part is to study the effect of touching,acupoint massage and combined application of them with blue light irradiation on neonatal jaundice by carrying out clinical trials,so as to provide basis for clinical medical and nursing work.MethodsIn the first part,Search literature databases such as PubMed,EMbase,Web of science,Cochrane,CBM,CNKI,WF,VIP,etc.According to the Cochrane Handbook evaluation system,randomized controlled trials of nursing care and acupoint massage therapy for neonatal jaundice were performed.After data extraction and quality evaluation,meta-analysis was performed using Revman 5.3 software.In the second part,neonatal pathological jaundice patients as research objects.According to inclusion and exclusion criteria,the subjects were divided into experimental group 1(touching group),experimental group 2(acupoint massage group),experimental group 3(touching combined acupoint massage group)and control group.Each group was given different intervention measures.The control group was given routine nursing and blue light irradiation,the experimental group 1 was given touch nursing on the basis of the control group,the experimental group 2 was given acupoint massage on the basis of the control group,and the experimental group3 was given acupoint massage on the basis of the experimental group 1.The total effective rate of jaundice treatment,daily transcutaneous bilirubin value,serum bilirubin level,daily sleep time,daily defecation times and jaundice subsidence time were compared among the four groups.The data were analyzed by SPSS19.0.ResultMeta analysis results:A total of 19 articles were included,with a total of 2064 patients.(1)The results of meta-analysis showed that there was a statistically significant differencein the treatment efficiency of jaundice with touching care combined with blue light therapy[RR=1.16,95%CI=1.08-1.26,P=0.0002],and serum total bilirubin levels after treatment with jaundice in neonates were a statistical difference [MD=-29.52,95%CI=-39.56--19.47,P <0.00001],and there was a statistically significant difference in the time of jaundice regression after treatment[MD=-1.89,95%CI=-2.50--1.29,P < 0.00001].(2)Acupoint massage combined with blue light could increase the treatment efficiency after treatment of jaundice in neonates[RR=1.14,95%CI=1.01-1.28,P=0.04],reduce serum total bilirubin levels after treatment of jaundice in neonates [MD=-27.10,95%CI=-30.71--23.50,P <0.00001],there was a statistical difference between the the time of jaundice regression [MD=-1.40,95%CI=-1.99--0.80,P < 0.00001].Clinical trial results:(1)A total of 124 children completed clinical trials,of which 31 were in group 1(touching group),32 were in group 2(acupoint massage group),31 were in group 3(touching combined acupoint massage group),and 30 were in control group.There was no significant difference in gender,age and weight between the four groups(P > 0.05).(2)The total effective rate of jaundice treatment in the first group,the second group,the third group and the control group were 90.3%,93.8%,96.8% and 73.3%,respectively.There were significant differences among the four groups(P < 0.05).(3)There was no significant difference in the transdermal bilirubin values between the four groups on the day of admission(P > 0.05).After taking intervention measures,the daily transcutaneous bilirubin values of children in group 1,group 2 and group 3 were significantly different from those of the control group(P < 0.01).(4)After treatment,the levels of serum bilirubin and serum direct bilirubin in the four groups were significantly lower than those before treatment(P < 0.01),and there was a significant difference between the experimental group 1,the experimental group 2 and the experimental group 3(P < 0.01).There was no difference between the experimental group 1 and the experimental group 2(P > 0.05).(5)There was no significant difference in sleep time between the four groups on the first day of hospitalization(P > 0.05).From the 2nd day to the 5th day of hospitalization,there were significant differences in the daily sleep time between the experimental group 1,the experimental group 2 and the experimental group 3 and the control group(P < 0.05).(6)After treatment,the number of defecation per day,body weight gain and jaundice subsidence time of the children in test 1,test 2 and test 3 groups were significantly different from those of the control group(P < 0.05).ConclusionMeta-analysis conclusion:(1)Touching combined with blue light irradiation can increase the total effective rate of jaundice treatment,significantly reduce the level of serum total bilirubin in children after jaundice treatment,and shorten the time of jaundice subsidence.(2)Acupoint massage combined with blue light irradiation can increase the total effective rate of jaundice treatment,reduce the level of serum total bilirubin in children after jaundice treatment,and shorten the time of jaundice subsidence.Clinical trial conclusion:(1)Touching and acupoint massage combined with blue light irradiation can improve the total effective rate of jaundice treatment,significantly reduce the percutaneous bilirubin value,serum total bilirubin level and serum binding bilirubin level,and shorten the jaundice subsidence time.Among them,touching combined with acupoint massage decreased the level of serum total bilirubin faster than touching alone and acupoint massage,which showed that this method had better effect in treating neonatal jaundice.(2)Touching and acupoint massage combined with blue light irradiation prolonged the daily sleeping time of children,thus increasing the compliance of blue light irradiation.(3)Touching and acupoint massage combined with blue light irradiation can promote the weight growth and growth of children.(4)Touching and acupoint massage are simple and easy to implement,and have significant effect on reducing serum bilirubin level,which is worthy of clinical application. |
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