中医护理对脑卒中后便秘患者的便秘改善及生活质量影响的meta分析  

A meta-analysis of the effect of traditional Chinese medicine care on the improvement of constipation and quality of life in patients with post-stroke constipation

作　　者：王莉[1] 顾桦 俞素英[1] 包莹霞 Wang Li;Gu Hua;Yu Suying;Bao Yingxia(Department of Neurology,Changzhou First People's Hospital,Changzhou,Jiangsu 213003)

机构地区：[1]常州市第一人民医院神经内科,江苏常州213003

出　　处：《常州实用医学》2024年第2期107-114,共8页CHANGZHOU PRACTICAL MEDICINE

摘　　要：目的探讨中医护理对脑卒中后便秘患者的便秘改善及生活质量影响。方法采用网上检索的方式收集国内外相关数据库文献,并采用方法质量学对收集到的文献进行严格评价,再以RevMan5.3软件进行分析。结果本研究最终纳入10篇文献,均采用随机对照的方法进行研究,文献发表时间在2014-2023年,样本量共826例,其中对照组进行常规护理,研究组在常规护理基础上进行中医护理,中医护理包括耳部全息铜砭刮痧、耳尖放血、耳穴埋豆、手指点穴、火龙罐、神阙灸法、针刺、药棒穴位按摩、神阙穴贴敷、盆底生物反馈干预、艾灸、闪罐及情志护理等。纳入的文献在随机序列方法、文献结果的盲法、选择性报告方面偏倚发生的风险较低,文献质量等级均评为B级。经Meta分析,两组便秘临床症状积分比较存在明显异质性(I2=99%,P<0.00001),以随机效应模型进行分析,结果为SMD=-2.02,95%CI[-7.22,3.19],P>0.05,差异不明显;两组患者护理干预后疗效存在明显的异质性差异(I2=68%,P<0.001),以随机效应模型进行分析,结果为OR=2.76,95%CI[1.29,5.88],存在明显差异(P<0.05);生活质量比较存在明显的异质性差异(I2=98%,P<0.00001),以随机效应模型进行分析,结果为SMD=10.51,95%CI[-17.09,-3.93],存在明显差异(P<0.05)。根据脑卒中后便秘患者经护理干预后的疗效、便秘临床症状积分及生活质量的情况制作漏斗图,其漏斗图两侧均有较好的对称性,发表偏倚较小。结论中医护理可有效预防脑卒中后便秘,提高脑卒中患者的生活质量水平,该项干预措施可纳入术后常规干预措施。Objective To investigate the effect of Chinese medical care on the improvement of consti⁃pation and quality of life in patients with post-stroke constipation.Method Relevant domestic and for⁃eign database literature was collected by online search,and the collected literature was critically evaluat⁃ed by methodological quality science,and then analyzed by RevMan 5.3 software.Results The study fi⁃nally included 10 literatures,all of which were studied using a randomized controlled approach,with liter⁃ature published in 2014-2023 and a total sample size of 826 cases,in which patients in the control group underwent conventional care,while patients in the study group underwent TCM care on the basis of con⁃ventional care,in which TCM care included ear holographic copper acupuncture scraping,ear tip bloodlet⁃ting,ear point embedding,finger pointing,fire dragon jar,Shen Que moxibustion,acupuncture,medicine stick acupressure,Shenqui acupressure,pelvic floor biofeedback intervention,moxibustion,flash jar and emotional care.The included literature had a low risk of bias in terms of randomized sequential methods,blinding of the literature results,and selective reporting,and the quality grade of the literature was rated B.By Meta-analysis,there was significant heterogeneity in the comparison of clinical symptom scores of constipation between the two groups(I2=99%,P<0.00001),which was analyzed by random effects model with SMD=-2.02,95%CI[-7.22,3.19],P>0.05,which was not significant;there was significant heteroge⁃neity in the efficacy of nursing interventions between the two groups(I2=68%,P<0.001),analyzed with a random-effects model,the results were:OR=2.76,95%CI[1.29,5.88],a significant difference(P<0.05);there was a significant heterogeneous difference in quality of life comparison(I2=98%,P<0.00001),analyzed with a random-effects model,the results were:SMD=10.51,95%CI[-17.09,-3.93],with a significant difference(P<0.05).Funnel plots were made according to the efficacy,clinical symptom scores of constipation an

关 键 词：中医护理 脑卒中后便秘 便秘改善 生活质量 META分析 

分 类 号：R473.5[医药卫生—护理学]