目的了解妇幼保健机构妇幼中医适宜技术服务开展情况。方法依托妇幼健康研究会妇幼保健学科发展专业委员会和出生缺陷防控专业委员会,向专业委员会成员单位中的妇幼保健机构发放调查问卷,由机构自愿填报,对机构的0～3岁儿童、4～6岁儿童、女性人群中医适宜技术服务开展情况进行问卷调查。结果 79.35%的机构(73/92)有从事妇幼中医服务的人员,省、市、县级机构从事妇幼中医服务的人数中位数分别为14(8,52)人、10(7,18)人、4(2,7)人,差异有统计学意义(P <0.05)。开展调查表中涉及的相关中医服务机构的比例为71.74%,省、市、县级差异无统计学意义(P> 0.05)。开展至少1项0～3岁儿童、4～6岁儿童及女性人群中医服务的机构比例分别为66.30%、54.35%、53.26%。从详细的中医服务开展情况来看,开展了0～3岁小儿推拿、穴位敷贴、中医药浴+推拿、刺四缝服务的机构比例分别为63.04%、54.35%、26.09%、32.61%,省、市、县三级仅在小儿推拿服务方面的年平均服务人次数上差异有统计学意义(P <0.05);开展了4～6岁小儿推拿、穴位敷贴、中医药浴+推拿、刺四缝服务的机构比例分别为48.91%、47.83%、26.09%、29.35%,省、市、县三级仅在刺四缝服务方面的年平均服务人次数上差异有统计学意义(P <0.05);开展了女性人群穴位敷贴、灸疗罐疗法、刮痧技术、隔物灸法、耳穴压豆、督脉中药熏蒸法、温针灸、隔物灸+脐疗的机构比例分别为44.57%、36.96%、22.83%、25.00%、33.70%、21.74%、22.83%、11.96%,省、市、县三级在各项服务的年平均服务人次数上差异均无统计学意义(P> 0.05)。各机构开展的其他项目主要为灸(包括针灸、艾灸、雷火灸等)、中药外用、拔罐等。结论各级妇幼保健机构妇幼中医服务人员配备、妇幼中医服务项目开展均不足,县级尤为明显,针对女性人群的中医服务最为薄弱,开展的中医适宜技术主要以小儿推拿等技术难度较低的服务为主,故应加强各级妇幼保健机构妇幼中医服务学科体系建设,强化中医人员配备,拓展中医技术服务,促进各级妇幼保健机构妇幼中医服务的稳步发展。

Objective To describe the statue of the development of suitable technical services of traditional Chinese medicine( TCM) for women and children in maternal and child health care( MCH) institutions. Methods A questionnaire was distributed to the MCH institutions in the members of MCH Discipline Development Professional Committee and the Birth Defect Prevention and Control Professional Committee of MCH Research Association,and filled voluntarily. The questionnaire was about the TCM services for children aged 0-3 and 4-6 years old and females in the MCH institutions. Results 79. 35% of the institutions( 73/92) had the doctors who were engaged in TCM services for women and children. the median of the doctors in the institutions at the provincial,municipal,and county levels was 14( 8,52),10( 7,18),and 4( 2,7),respectively. There was statistically significant difference among different levels institutions( P < 0. 05). The proportion of the institutions which provide relevant TMC service was 71. 74%,and there were no statistically significant difference among different levels institutions( P > 0. 05). The proportions of institutions that provide TCM services for children aged 0-3,and 4-6 years old,and women was 66. 30%,54. 35%,and 53. 26%,respectively. The proportion of institutions that carried out massage,acupoint application,TCM bath + massage,and Puncture four-seam services for children age 0-3 years old was 63. 04%,54. 35%,26. 09%,32. 61%,respectively. There was statistically significant difference in the average number of infantile massage services visits among different levels institutions( P < 0. 05). The proportion of institutions that carried out infantile massage,acupoint application,Chinese medicine bath + massage,and Puncture four-seam services for 4-6 years old children was 48. 91%,47. 83%,26. 09%,and 29. 35%,respectively. There was statistically significant difference in the average number of Puncture four-seam services visits among different levels institutions( P < 0. 05). The proportion of institutions that carried out acupuncture point application,moxibustion therapy pot therapy,scraping technique,spacer moxibustion,ear acupoint pressure,Dumai TCM fumigation,warm acupuncture,spacer moxibustion + navel therapy for women were 44. 57%,36. 96%,22. 83%,25. 00%,33. 70%,21. 74%,22. 83%,11. 96%,respectively. There was no statistical difference in the average number of each service visits among different level institutions( P > 0. 05). The other services carried out by institutions were moxibustion( including acupuncture,moxibustion,thunder-fire moxibustion,etc.),external use of Chinese herbs and cupping,etc. Conclusion The developments of suitable technical services of TCM for women and children in the different levels MCH institutions and the TCM service personnel are insufficient,especially in the county level institutions. The TCM service for women is the weakest. The programs are mainly based on services which are relatively simple such as infantile massage. In order to promote the steady development of TCM services in the MCH institutions,the construction of the TCM system should be strengthened,the number of professional doctors should be increased,and the services should be expanded.