肠系膜淋巴结肿大腹痛?儿童慢性腹痛中不可忽视的情志因素与小儿推拿心得

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小儿情志因素绝不能忽视。

 

临床上小儿慢性腹痛比较多。

 

特别是一种叫“肠系膜淋巴结肿大”的病在妈妈圈和中医圈中漫延。

 

过去我们治疗肠系膜淋巴结肿大的常用穴位为:一窝风、内关、膊阳池、清胃经、补脾经、捏脊、运内八卦、揉板门、掐揉四横纹、揉足三里等。但说实话,疗效不太令人满意。

 

“为什么疗效不明显呢?”

 

我想起了我小时候。因为鼻炎、腹泻等,父亲带我去看中医,老专家指着又瘦又小的我对父亲说“这个孩子不仅肺和脾虚,而且凡心肝脾肺肾五脏都虚”。我当时吓得不得了。我想五脏都亏空了,命肯定不长。在相当一段时间内,我生活在恐怖之中,每当身体有了些反应总想到是不是病又严重了。天天念叨着会不会死!天天盼望着强壮。

 

我又想起了父亲带我去看一位阿姨。阿姨死于糖尿病。家属介绍病情说先是头痛,后来身上疹子,最后查出糖尿病,最后就死掉了。不久,我开始头痛,后来面部有了些疹子。父亲带我看了很多中医,也吃了很多西药总不好。最后,我嚷着查血糖。说也奇怪,血糖结果出来的那一天,当医生对父亲说孩子血糖不高的时候,我的头痛就好了,疹子也莫名其妙地消褪了。

 

记得读到过一篇英语文章,叫“一天的等待”,说一个小孩普通感冒,医生测体温是华氏102度。而小孩子的常识是摄氏温度。摄氏37度正常,40度以上叫超高热,会死亡。小孩子想到自己已经远远超过危险的40度,甚至达到了102度,就肯定自己会死亡。因此,他整个一天的言行举止都十分异常,他生活在等待死亡的阴影当中。

 

I took his temperature.
“What is it?”
“Something like a hundred,” I said. It was one hundred and two and
four tenths.
“It was a hundred and two,”he said.
“Who said so?”
“The doctor.”
“Your temperature is all right,” I said. “It's nothing to worry
about.”
“I don't worry,” he said, “but I can't keep from thinking.”
“Don't think,” I said. “Just take it easy.”
“I'm taking it easy,” he said and looked straightly ahead. He was
evidently holding tight onto himself about something.
“Take this with water.”
“Do you think it will do any good?”
“Of course will.”
I sat down and opened the Pirate book and commenced to read but I
could see he was not following, so I stopped.
“About what time do you think I'm going to die?” he asked.
“What?”
“About how long will it be before I die?”
“You aren't going to die. What's the matter with you?”
“Oh, yes, I am. I heard him say a hundred and two.”
“People don't die with a fever of one hundred and two. That's a
silly way to talk.”
“I know they do. At school in France, the boys told me you can't
live with forty-four degrees. I've got a hundred and two.”
He had been waiting to die all day, ever since nine o'clock in the
morning.
“You poor Schatz,” I said. “It's like miles and kilometers. You
know, like how many kilometers we make when we do seventy miles in
the car?”
“Oh,”he said.
But his gaze14 at the foot of the bed relaxed slowly. The hold over
himself relaxed too, finally, and the next day it was very
slack15 and he cried very easily at little things
that were of no importance.

 


 

好在他父亲发现了他理解温度的错觉,即时予以纠正。不仅尽快治好了他的感冒,还医治好了他心灵的创伤。

 

我想:腹痛是一种感觉,感觉就与情志有关。如果腹痛是肠系膜淋巴结肿大,是胃炎引起的话,那理论上只要肠系膜淋巴结不消除,不减小,胃炎不控制住就始终会疼痛。但事实上,这种疼痛都是阵发性的。而且一天的大部份时间不痛。况且,肿大的肠系膜淋巴结和慢性胃炎肯定不是一天形成的,怎么会突然就疼痛起来呢!因此,小儿的腹痛,特别是慢性腹痛一定与情志有关!!

 

我坚信《内经》“诸痛痒疮皆属于心”是正确的。还不清楚吗?所有的疼痛都与心的感应有关!

 

那如何调节小儿的情志呢?如何让孩子彻底地消除掉引起或加重腹痛的心理因素呢?

 

我想了一个好办法---

 

我一手抱着孩子,让他们斜躺在我的怀里。另一手轻轻地摩揉着孩子的腹部。一定要轻啊!让孩子感觉到舒适与快乐。然后,逐渐向压痛点(多为B超确定的淋巴结肿大区域,或胃炎所在部位)集中。

 

确定压痛点,遵循由轻至重的原则。缓缓施力。先按,后点,再点揉。边揉边对孩子说“你的肚子里面居然有两条虫子!”

 

孩子立即显现出惊愕的样子!

 

“不要怕。我问问虫子是怎样进入你的肚子里面的?”

 

这时候,我将耳朵贴在孩子的后背或肚子上做着倾听的样子。

 

然后告诉孩子说“虫子是有一天你吃东西时没洗手,或者手没有洗干净才吞进去的。是吗?”

 

孩子哪有时时洗手的呢?他不得不点头。妈妈有时还在旁边加一句“看!今后要洗手了吧!”

 

“虫子真坏!它让我们宝宝天天肚子痛”

 

“不行!我一定要替宝宝驱除掉虫子”

 

随后,我的手法力度开始加重,待孩子最大忍受度时,又将耳朵贴在肚子上,然后高声说“虫子受不了了。它在喊饶命!”

 

“饶不饶它?饶不饶它??你说饶不饶它???”一句比一句急促。

 

因为力度在孩子最大忍受范围,孩子有些(轻微)痛苦,他是不会说话的。妈妈常常会在旁边接口说“不饶它!坚决不饶它!!”

 

“对!不能饶它。它是坏蛋!绝不能饶它!!”

 

我继续短促用力,多在振颤的基础上突然弹拨。力度可是强大啊。

 

性格弱小的小孩这时可能会哭,坚强的小孩眼里也充满了泪水。

 

很快,我停止手法。我会告诉孩子“你肚子里的虫子被我弄死了,它们再也不会让宝宝肚子疼痛了。等会儿大便就会将化掉的虫子排除了。”

 

“你会健康的!你是好样的。你今天太勇敢了!”

 

大家不妨照着我介绍的方法去试试。

 

说不定真有效呢!

 

你说是我推拿好的呢?还是调节情志调节好了的呢?

 

我想,应该是情志调理与腹部局部处理使疗效得到提高!

 

文章来源 公众号:廖品东教授小儿推拿

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