孤獨(dú)癥中醫(yī)診療方案

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5、 strengthe ning Humanitie scare , continuestofostercompany wind clear, andgasare, and heartShun ofcultureatmosphere;strengthe ning love helped trapped,caredifficult employee s;carried outstyle activities,ri ch em ployees life;strengthening hea lth and la bourprote ction,orga nization care er healt h

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7、f"zerori sk".T ostrengthene d business plansmanageme nt,will businessbusi ness planscovertoalllev el,ensure t he busi ness ca n controli n control ;to cl ose concern fina ncial ,and coal ele ctric linkage, ande nergy-savi ngscheduling, nati onal poli cy trends, strengthe ningtra ck,active

8、shoul d;toim plementati on State-owned assetsmethod,furtherspe cificationbusiness financialmanagement; to perfect risktube controlsystem, achieve d riskrecognition,a ndmea sure,a nd assessme nt,and report,and controlfeedback ofclosed ri ng management, improve risk preventionca pacity.To furtherstand

9、ardizetrading ,and strivetoachieve "according to la w, standardizeandfair."Innovationof performance management,toensurethat potentialem ployee s "zerofly". To stre ngthe n performancemanagement,process control, enhanceempl oyeeevaluati on a nd levels ofeffectivecommunication toim

10、 proveperforma nce ma nagement. ofurtherquantifyand refineemployeestandards.Work, fullplay party,and bra nch,and members i n"five type Enterprise"construction inthe of core rol e,and fightingfortress role andpioneerm odelrole;to conti nue stostrengt hening "fourgood"leadershi p c

11、onstruction孤獨(dú)癥中醫(yī)診療方案一、診斷（一）疾病診斷1. 中醫(yī)診斷標(biāo)準(zhǔn)參照參照“中醫(yī)對(duì)孤獨(dú)癥的認(rèn)識(shí)及治療現(xiàn)狀”（郭曉琳，中醫(yī)兒科雜志，2010年）、“中醫(yī)對(duì)孤獨(dú)癥的認(rèn)識(shí)及治療現(xiàn)狀”（劉振寰，中醫(yī)兒科雜志，2009年）擬定。主要癥狀：不同程度的言語(yǔ)發(fā)育障礙（少語(yǔ)，無(wú)語(yǔ)，喃喃自語(yǔ)，語(yǔ)言重復(fù)，發(fā)聲怪異，吐字不清，言語(yǔ)難以理解）；社會(huì)交往障礙（眼不視人，目光回避，不愿交際，孤僻獨(dú)行，自我封閉）；特殊行為表現(xiàn)（動(dòng)作怪異，姿勢(shì)奇特，動(dòng)作刻板重復(fù)，興趣狹窄，迷戀物品，行為定式，感覺(jué)遲鈍）?；虿煌潭鹊闹悄苷系K。次要癥狀：急躁易怒，胡言亂語(yǔ)，夜不成寐；表情淡漠，神志癡呆，喃喃自語(yǔ)，口角流涎；發(fā)育遲緩

12、，身材矮小，囟門(mén)遲閉，骨骼肌肉痿軟，智力低下；數(shù)歲不語(yǔ)，神疲乏力，面色白，肢冷或有自汗。2. 西醫(yī)診斷標(biāo)準(zhǔn)參照兒童孤獨(dú)癥ICD-10 診斷標(biāo)準(zhǔn)。（ 1） 3歲以前就出現(xiàn)發(fā)育異?；驌p害，至少表現(xiàn)在下列領(lǐng)域之一：1）人際溝通時(shí)所需的感受性或表達(dá)性語(yǔ)言；2）選擇性社會(huì)依戀或社會(huì)交往能力的發(fā)展；3）功能性或象征性游戲。（ 2）具有以下1 ）、2）、3）項(xiàng)下至少六種癥狀，且其中1 ）項(xiàng)下至少兩system, achieve d riskrecogniti on,a ndmea sure,a nd assessme nt,and report,and controlfeedback ofclosed ri

13、 ng management, improverisk preventionca pacit y.To furtherstandardizetrading,and strivetoachieve "accordingtola w, standardizeandfair."Innovationofperformance management,toensurethatpotentialemployee s "zerofly". To stre ngthe n performan cemanageme nt, pr ocess control, enhance

14、empl oyeeevaluati on a nd levels ofeffectivecommunication toim proveperforma nce ma nagement. ofurtherquantifyand refineemployeestandards.Work, fullplay party,andbra nch,and members i n"five type Enterprise"construction intheof core rol e,and fightingfortress role andpioneerm odelrole;to c

15、onti nue stostrengt hening "fourgood"leadershi p construction種，2）、3）兩項(xiàng)下各至少一種：1）在下列至少兩個(gè)方面表現(xiàn)出社會(huì)交往能力實(shí)質(zhì)性異常：不能恰當(dāng)?shù)貞?yīng)用眼對(duì)眼注視、面部表情、姿勢(shì)和手勢(shì)來(lái)調(diào)節(jié)社會(huì)交往；（盡管有充分的機(jī)會(huì)）不能發(fā)展與其智齡相適應(yīng)的同伴關(guān)系，用來(lái)共同分享興趣、活動(dòng)與情感；缺乏社會(huì)性情感的相互交流，表現(xiàn)為對(duì)他人情緒的反應(yīng)偏頗或有缺損；或不能依據(jù)社交場(chǎng)合調(diào)整自身行為；或社交、情感與交往行為的整合能力弱；不能自發(fā)地尋求與他人分享歡樂(lè)、興趣或成就（如不向旁人顯示、表達(dá)或指出自己感興趣的事物）。2）交流能

16、力有實(shí)質(zhì)性異常，表現(xiàn)在下列至少一個(gè)方面：口語(yǔ)發(fā)育延遲或缺如，不伴有以手勢(shì)或模仿等替代形式補(bǔ)償溝通的企圖（此前常沒(méi)有呀呀學(xué)語(yǔ)的溝通）；在對(duì)方對(duì)交談具有應(yīng)答性反應(yīng)的情況下，相對(duì)地不能主動(dòng)與人交談或使交談持續(xù)下去（在任何語(yǔ)言技能水平上都可以發(fā)生）；刻板和重復(fù)地使用語(yǔ)言，或別出心裁地使用某些詞句；缺乏各種自發(fā)的假扮性游戲，或（幼年時(shí)）不能進(jìn)行社會(huì)模仿性游戲。3）局限、重復(fù)、刻板的興趣、活動(dòng)和行為模式，表現(xiàn)在下列至少一個(gè)方面：專(zhuān)注于一種或多種刻板、局限的興趣之中，感興趣的內(nèi)容異?；蚧純簩?duì)它異常地關(guān)注；或者盡管內(nèi)容或患兒關(guān)注的形式無(wú)異常，但其關(guān)注的強(qiáng)度和局限性仍然異常；強(qiáng)迫性地明顯固著于特殊而無(wú)用的常規(guī)或

17、儀式；system, achieved riskrecogniti on,a ndmea sure,a nd assessme nt,and report,and controlfeedback ofclosed ri ng management, improve risk preventionca pacit y.To furtherstandardizetrading ,and strivetoachieve "according to la w, standardizeandfair."Innovationof performance management,toens

18、urethat potentialem ployee s "zerofly". To strengthe n performancemanagement, pr ocess control,enhanceempl oyeeevaluation a nd level sofeffectivecommunication toim proveperformance ma nagement.ofurtherquantifyand refineemployeestandards.Work, fullplay party,and bra nch,and members in"

19、five type Enterprise"construction intheof core role,and fightingfortress roleand pi oneerm odelrole;toconti nuestostrengt heni ng "fourgood"leadershi p construction刻板與重復(fù)的怪異動(dòng)作，如拍打、揉搓手或手指，或涉及全身的復(fù)雜運(yùn)動(dòng)；迷戀物體的一部分或玩具的沒(méi)有功能的性質(zhì)（如氣味、質(zhì)感或所發(fā)出的噪音或振動(dòng)）。（ 3）臨床表現(xiàn)不能歸因于以下情況：其他類(lèi)型的廣泛性發(fā)育障礙；特定性感受性語(yǔ)言發(fā)育障礙及繼發(fā)的社會(huì)情

20、感問(wèn)題；伴發(fā)情緒/ 行為障礙的精神發(fā)育遲滯；兒童少年精神分裂癥和Rett綜合征。（二）證候診斷1. 心肝火旺證：少語(yǔ)或不語(yǔ)，語(yǔ)則重復(fù)，刻板動(dòng)作，或行為孤僻；伴有急躁易怒，多動(dòng)、注意力不集中，情緒不寧，跑跳無(wú)常，不易管教，夜不成寐，時(shí)有便秘溲黃。舌質(zhì)紅或舌尖邊紅，苔薄黃，脈弦或數(shù)。2. 痰蒙心竅證：喃喃自語(yǔ)，行為孤僻，刻板動(dòng)作；伴有表情淡漠，神情呆滯，對(duì)指令充耳不聞，言語(yǔ)不清。舌質(zhì)淡，體胖大，苔膩，脈滑或濡。3. 腎精虧虛證：語(yǔ)言遲緩，少語(yǔ)，行為孤僻，反應(yīng)遲鈍，刻板動(dòng)作；伴有運(yùn)動(dòng)發(fā)育遲緩，身材矮小，筋骨痿軟。舌淡紅，苔薄白，脈細(xì)弱。4. 心脾兩虛證：少語(yǔ)或不語(yǔ)，氣怯，行為孤僻，反應(yīng)遲鈍，刻板動(dòng)作

21、；伴有面色少華，神疲乏力，肢冷或有自汗，夜寐不安，口角流涎，納差。舌淡紅，苔薄白，脈細(xì)弱。二、治療方法（一）康復(fù)療法1. 功能訓(xùn)練system, achieve d riskrecogniti on,a ndmea sure,a nd assessme nt,and report,and controlfeedback ofclosed ri ng management, improverisk preventionca pacit y.Tofurtherstandardizetrading,and strivetoachieve "accordingtolaw,standardiz

22、eandfair."Innovationofperformancemanagement,toensurethatpotentialemployee s "zerofly". To stre ngthe n performan cemanageme nt, pr ocess control, enhanceempl oyeeevaluati on a nd levels ofeffectivecommunicationtoimproveperformance ma nagement. ofurtherquantifyand refineemployeestandar

23、ds.Work, fullplay party,andbranch,andmembers i n"five type Enterprise"construction intheof core rol e,and fightingfortress role andpioneermodelrole;tocontinuestostrengt hening "fourgood"leadershipconstruction依據(jù)患者的語(yǔ)言、行為、智力等功能障礙，經(jīng)過(guò)康復(fù)師評(píng)定其功能現(xiàn)狀，結(jié)合現(xiàn)代康復(fù)理念使用現(xiàn)代康復(fù)手段，針對(duì)性的選擇語(yǔ)言訓(xùn)練、感覺(jué)統(tǒng)合訓(xùn)練、特殊教育等

24、治療方法。（ 1）語(yǔ)言訓(xùn)練：根據(jù)孤獨(dú)癥患兒存在的語(yǔ)言問(wèn)題（認(rèn)知理解障礙、語(yǔ)言表達(dá)障礙、交流溝通障礙、異常行為等）選擇側(cè)重點(diǎn)。1）認(rèn)知障礙訓(xùn)練實(shí)物認(rèn)知：以日常用品、動(dòng)物、食物、交通工具為主；名詞、動(dòng)詞認(rèn)知訓(xùn)練：實(shí)物-一圖片（匹配）圖片選擇顏色視覺(jué)訓(xùn)練：順序紅、黃、藍(lán)、綠先配對(duì)，再指認(rèn)，后命名整體知覺(jué)和部分知覺(jué)訓(xùn)練形狀知覺(jué)：先識(shí)圓形、方形、三角形，匹配一選擇一命名大小、高低、長(zhǎng)短比較認(rèn)知空間方位詞認(rèn)知訓(xùn)練：順序上下、后前、里外、中間、旁邊、左右形容詞認(rèn)知訓(xùn)練：根據(jù)顏色形容詞、味覺(jué)形容詞、本體覺(jué)形容詞、情感形容詞分別匹配訓(xùn)練。時(shí)間感知概念：上午、下午、早上等人稱(chēng)代詞學(xué)習(xí)：你、我、他匹配訓(xùn)練（11）量

25、詞學(xué)習(xí)：不同量詞匹配學(xué)習(xí)（12）句子理解：兩詞句、三詞句根據(jù)個(gè)體進(jìn)度逐步學(xué)習(xí)（13）閱讀理解：故事情景匹配2）言語(yǔ)表達(dá)障礙訓(xùn)練包括口面部按摩、輔助口型，改善口、舌、下頜運(yùn)動(dòng)能力及靈活性，音system, achieve d riskrecogniti on,a ndmea sure,a nd assessme nt,and report,and controlfeedback ofclosed ri ng management, im prove risk preventionca pacit y.To furtherstandardizetrading,and strivetoachieve

26、 "according to la w, standardizeandfair."Innovation of performance manage ment,toensurethat potentialem ployee s "zerofly". To stre ngthe n performancemanageme nt, pr ocess control, enhanceempl oyeeevaluati on a nd level sofeffectivecommunicati on toim proveperforma nce ma nageme

27、nt. ofurtherquantifyand refineemploy eestandards.Work, fullplay party,a nd bra nch,and members i n"five type Enterprise"construction i nthe of core rol e,and fightingfortress ro leand pi oneerm odelrole;to conti nue stostrengt heni ng "fourgood"leader shi p construction素水平、音節(jié)水平、單

28、詞水平、句子水平訓(xùn)練。從被動(dòng)發(fā)聲一模仿口型發(fā)聲一自主發(fā)聲逐步訓(xùn)練。3）交流障礙訓(xùn)練無(wú)口語(yǔ)期：訓(xùn)練重點(diǎn)以注視人與物、聽(tīng)指令練習(xí)、動(dòng)作模仿、互動(dòng)游戲、手勢(shì)符號(hào)表達(dá)等訓(xùn)練。仿說(shuō)期：從聽(tīng)聲音、分辨聲音并模仿發(fā)聲、模仿發(fā)音交流、引導(dǎo)下用固定模式的句子進(jìn)行簡(jiǎn)單短句交流。不善交流期：包括逼患兒說(shuō)話(huà)，強(qiáng)化有需求一說(shuō)話(huà)表達(dá)-滿(mǎn)足需求模式；多設(shè)置說(shuō)話(huà)的情景、制造環(huán)境，引導(dǎo)患兒在適合的場(chǎng)景下主動(dòng)表達(dá)；互動(dòng)游戲，強(qiáng)調(diào)讓患兒主動(dòng)參與，與他人合作、分享；交流內(nèi)容適合患兒目前能力，多鼓勵(lì)，引導(dǎo)患兒參加集體活動(dòng)，增加社交機(jī)會(huì)。4）異常行為矯治包括正負(fù)強(qiáng)化、系統(tǒng)脫敏、消退法、暫時(shí)隔離、懲罰法。正強(qiáng)化正確選擇要強(qiáng)化行為，有效選擇

29、強(qiáng)化物，逐漸脫離強(qiáng)化程序；負(fù)強(qiáng)化應(yīng)明確目標(biāo)行為，選擇適當(dāng)厭惡刺激，選擇警告刺激，盡量減少不良行為產(chǎn)生誘因。（2）感覺(jué)統(tǒng)合訓(xùn)練：先用孤獨(dú)癥兒童發(fā)展評(píng)估表（中國(guó)殘疾人聯(lián)合會(huì)康復(fù)部制）評(píng)定后再制定相應(yīng)的訓(xùn)練計(jì)劃。1）觸覺(jué)系統(tǒng)：以手、腳及全身不同位置接觸不同質(zhì)地的物件刺激進(jìn)行訓(xùn)練。包括尋寶游戲、麻布刷身游戲、大龍球壓滾、玩膠泥、鉆滾筒、鉆陽(yáng)關(guān)隧道、排筆刷癢游戲等。2）前庭覺(jué)系統(tǒng)：包括搖晃和旋轉(zhuǎn)的訓(xùn)練（吊桶、秋千、掉兜）、跳跳床、踩腳踏、滑板活動(dòng)（俯沖滑板、爬滑板、滑板推球、滑板轉(zhuǎn)圈）、走平衡木、system, achieve d riskrecogniti on,a ndmea sure,a nd a

30、ssessme nt,and report,and controlfeedback ofclosed ri ng management, improverisk preventionca pacit y.To furtherstandardizetrading ,and strivetoachieve "according to la w, standardizeandfair."Innovationof performance management,toensurethat potentialem ployee s "zerofly". To stre

31、 ngthe n performan cemanagement, pr ocess control, enhanceempl oyeeevaluati on a nd levels ofeffectivecommunication toimproveperformance ma nagement.ofurtherquantifyand refineemployeestandards.Work, fullplay party,and bra nch,and members i n"five type Enterprise"construction intheof core r

32、ole,and fightingfortress role andpioneerm odelrole;to conti nue stostrengthening "fourgood"leadershi p construction平衡臺(tái)等。3）本體覺(jué)系統(tǒng)：包括關(guān)節(jié)按壓、推小車(chē)、推重物、攀巖、拋接球活動(dòng)、跳球跳床、拉單杠、翻跟斗、壓大龍球、雙人轉(zhuǎn)大龍球等。4）聽(tīng)覺(jué)系統(tǒng)：包括尋找聲源、配對(duì)聲音、打擊樂(lè)器等。5）視覺(jué)系統(tǒng)：包括鉆小桶、吹肥皂、玩陀螺、暗室手電筒照射、躲貓貓、不同燈光刺激等。（ 3）特殊教育：包括行為治療、音樂(lè)游戲、言語(yǔ)訓(xùn)練、生活自理（采用順向鏈鎖和逆向鏈鎖）、社會(huì)

33、適應(yīng)、融合教育，采用生活環(huán)境模擬改變、目光接觸訓(xùn)練，指令聽(tīng)從訓(xùn)練、模仿能力訓(xùn)練、表達(dá)能力訓(xùn)練。異常行為矯治采用正負(fù)強(qiáng)化、系統(tǒng)脫敏、消退法、暫時(shí)隔離、懲罰法。正強(qiáng)化正確選擇要強(qiáng)化行為，有效選擇強(qiáng)化物，逐漸脫離強(qiáng)化程序；負(fù)強(qiáng)化應(yīng)明確目標(biāo)行為，選擇適當(dāng)厭惡刺激，選擇警告刺激，盡量減少不良行為產(chǎn)生誘因。2. 針刺療法頭針：百會(huì)、四神針、語(yǔ)言一區(qū)、二區(qū)、三區(qū)、智三針。體針：內(nèi)關(guān)、神門(mén)、勞宮。辨證取穴：心肝火旺型加心俞、肝俞、風(fēng)池；痰蒙心竅型加脾俞、豐隆、內(nèi)關(guān)；腎精虧虛型加腎俞、太溪、涌泉；心脾兩虛型加心俞、脾俞、三陰交。對(duì)癥取穴：語(yǔ)言不利、發(fā)音困難、吐字不清加舌三針、啞門(mén)、廉泉等；病程較長(zhǎng)、癥狀較重、5

34、歲以上的患兒可加足智針。刺法：頭針平刺進(jìn)針，沿皮刺入帽狀腱膜下11.5寸，百會(huì)、智三針（神system, achieve d riskrecogniti on,a ndmea sure,a nd assessme nt,and report,and controlfeedback ofclosed ri ng management, im prove risk preventionca pacit y.To furtherstandardizetrading,and strivetoachieve "accordingtolaw, standardizeandfair."I

35、nnovationof performance management,toensurethat potentialem ployee s "zerofly". To stre ngthe n performancemanagement, pr ocess control, enhanceempl oyeeevaluati on a nd level sofeffectivecommunication toim proveperforma nce ma nagement. ofurtherquantifyand refineemployeestandards.Work, fu

36、llplay party,andbra nch,and members i n"five type Enterprise"construction intheof core rol e,and fightingfortress roleandpioneerm odelrole;to conti nue stostrengt heni ng "fourgood"leader shi p construction庭、雙本神）語(yǔ)言二區(qū)、三區(qū)由前向后沿皮刺入，語(yǔ)言一區(qū)由下向上沿皮刺入，四神針針尖向外平刺，緊貼骨膜行針，針深近 25 mm以抽氣法運(yùn)針10次,行強(qiáng)刺

37、激，以針下有向內(nèi)吸附感為度，留針2 小時(shí)，留針期間堅(jiān)持帶針功能訓(xùn)練，行針3次。內(nèi)關(guān)、神門(mén)、勞宮直刺0.51寸，留針30分鐘，期間行針2次，平補(bǔ)平瀉，每天治療1次，每周 6次。3. 推拿療法頭面部：施開(kāi)天門(mén)手法、分推額陰陽(yáng)、叩擊語(yǔ)言一區(qū)、二區(qū)、三區(qū)各1 分鐘，對(duì)口周和頭面部穴位水溝、地倉(cāng)、下關(guān)、翳風(fēng)、頰車(chē)、承漿、印堂、腦戶(hù)、啞門(mén)、大椎進(jìn)行順時(shí)針?lè)较虬慈?，每? 分鐘。四肢部：施以清肝經(jīng)、清心經(jīng)、補(bǔ)脾經(jīng)、補(bǔ)腎經(jīng)、清天河水各1分鐘，按揉少海、血海、足三里、豐隆穴1 分鐘，揉雙合谷、雙太沖各1分鐘。背部：順經(jīng)推膀胱經(jīng)第一線(xiàn)、第二線(xiàn)各5次，順經(jīng)推督脈5次，叩擊華佗夾脊 5次，捏脊 5次，從第 2次開(kāi)始，

38、術(shù)者根據(jù)患兒出現(xiàn)的不同癥狀，采用提捏的手法，有針對(duì)性的刺激相關(guān)背俞穴，加強(qiáng)治療。捏脊結(jié)束后，醫(yī)者用雙手拇指按揉腎俞穴5分鐘。4. 耳穴療法取心、肝、腎、腦、交感、神門(mén)穴等，3天更換1次，休息 1天，貼壓期間每日手按壓3次，每次10 分鐘。（二）辨證選擇口服中藥湯劑、中成藥1. 心肝火旺證治法：清心平肝，安神定志。推薦方藥：安神定志丸加減。遠(yuǎn)志、石菖蒲、茯神、茯苓、龍齒、黨參system, achieved riskrecognition,a ndmea sure,a nd assessme nt,and report,and controlfeedback ofclosed ri ng man

39、agement, improverisk preventionca pacit y.To furtherstandardizetrading,and strivetoachieve "according to la w, standardizeandfair."Innovationof performance management,toensurethat potentialem ployee s "zerofly". To stre ngthe n performan cemanageme nt, pr ocess control, enhanceem

40、pl oyeeevaluati on a nd levels ofeffectivecommunication toim proveperforma nce ma nagement. ofurtherquantifyand refineemployeestandards.Work, fullplay party,and bra nch,and members in"five type Enterprise"construction inthe of core role,and fightingfortress role andpioneerm odelrole;to con

41、ti nue stostrengt hening "fourgood"leadershi p construction等。中成藥：朱砂安神丸、龍膽瀉肝丸等。2. 痰蒙心竅證治法：豁痰寧心，醒腦開(kāi)竅。推薦方藥：滌痰湯加減。茯苓、人參、甘草、橘紅、膽星、半夏、竹茹、枳實(shí)、菖蒲等。中成藥：蘇合香丸等。3. 腎精虧虛證治法：滋補(bǔ)肝腎，填精益髓。推薦方藥：六味地黃湯合菖蒲丸加減。生地黃、山藥、山茱萸、枸杞、澤瀉、丹皮、人參、石菖蒲、麥門(mén)冬、遠(yuǎn)志、川芎、當(dāng)歸等。中成藥：六味地黃丸、左歸丸等。4. 心脾兩虛證治法：健脾益氣，養(yǎng)心安神。推薦方藥：歸脾湯與養(yǎng)心湯加減。白術(shù)、當(dāng)歸、茯苓、龍眼肉

42、、遠(yuǎn)志、酸棗仁、柏子仁、五味子、木香、炙甘草、人參等。中成藥：歸脾丸等。（三）其他療法1. 穴位注射復(fù)方丹參注射液等穴位注射每日取兩穴，每穴位注射藥物0.5ml ，根據(jù)辨證選穴，每日1 次。2. 穴位埋線(xiàn)system, achieve d riskrecognition,a ndmea sure,a nd assessme nt,and report,and controlfeedback ofclosed ri ng management, im prove risk preventionca pacit y.To furtherstandardizetrading ,and strivet

43、oachieve "according to la w, standardizeandfair."Innovationof performance management,toensurethat potentialem ployee s "zerofly". To stre ngthe n performancemanagement, pr ocess control, enhanceempl oyeeevaluati on a nd level sofeffectivecommunication toim proveperforma nce ma na

44、gement. ofurtherquantifyand refineemployeestandards.Work, fullplay party,and bra nch,and members i n"five type Enterprise"construction inthe of core rol e,and fightingfortress roleand pi oneerm odelrole;to conti nue stostrengt heni ng "fourgood"leader shi p construction針對(duì)不同證型辨證選取

45、穴位，將可吸收羊腸線(xiàn)埋入穴位，持續(xù)刺激，每次取兩穴，兩周1次。3. 刮痧1）刮頭頂前部：一手扶持患兒頭部，另一手握刮痧板，從百會(huì)穴沿督脈向前額方向刮拭10次，點(diǎn)按百會(huì)、神庭穴；然后與頭正中線(xiàn)平行，循膀胱經(jīng)刮拭頭頂部雙側(cè)，刮拭力量以患兒耐受為度，刮拭10次。每日治療1次。2）刮背腰部：患者取俯臥位，先在背部常規(guī)消毒，涂抹潤(rùn)滑油，從上到下依次推刮督脈、足太陽(yáng)膀胱經(jīng)和夾脊穴，見(jiàn)痧即止，每周治療2次。注意事項(xiàng)：刮痧時(shí)注意避開(kāi)癤腫、包塊；頭部刮痧不需涂抹刮痧介質(zhì)。4. 物理因子療法根據(jù)病情需要，可選用經(jīng)絡(luò)導(dǎo)平儀等治療。（四）護(hù)理調(diào)攝1. 護(hù)理常規(guī)：按照中醫(yī)兒科一般護(hù)理常規(guī)護(hù)理。2. 安全護(hù)理：清除患兒周

46、圍環(huán)境中的危險(xiǎn)物品，防止?fàn)C傷、墜床、跌倒、碰傷等意外傷害，防止自傷的發(fā)生；下床活動(dòng)、如廁時(shí)，應(yīng)有專(zhuān)人陪護(hù)。3. 情志護(hù)理：護(hù)理人員主動(dòng)關(guān)心患兒，因人而異地通過(guò)解釋、勸導(dǎo)、鼓勵(lì)、引導(dǎo)等措施達(dá)到緩解患兒的心理問(wèn)題。4. 健康指導(dǎo)：（1）早期發(fā)現(xiàn)，早期療育，減少其不適應(yīng)、破壞性行為的出現(xiàn)，發(fā)揮潛能，對(duì)其病癥的改善愈有幫助。（2）在教育或訓(xùn)練過(guò)程中有三個(gè)原則：對(duì)孩子行為寬容和理解；異常行為的改變和變更；特別能力的發(fā)現(xiàn)、培養(yǎng)和轉(zhuǎn)化。（3）康復(fù)訓(xùn)練以家庭為中心，本病病程長(zhǎng)，非進(jìn)行性發(fā)展，需要父母協(xié)助患兒規(guī)范治療。三、療效評(píng)價(jià)laylevels cadres in e nterprisedevel opme

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