循经温通刮痧联合艾灸在脑卒中后压疮患者中的应用  

Application of meridian warming and scraping therapy combined with moxibustion in patients with pressure sore after stroke

作　　者：陶晓虹[1] 樊莉 胡叶明[1] TAO Xiaohong;FAN Li;HU Yeming(Department of Nursing,Zhejiang Provincial Tongde Hospital,Hangzhou,Zhejiang 310012,China)

机构地区：[1]浙江省立同德医院护理部,浙江杭州310012

出　　处：《中华全科医学》2024年第12期2108-2111,共4页Chinese Journal of General Practice

基　　金：浙江省中医药科技计划项目(2023ZL306)。

摘　　要：目的探讨循经温通刮痧联合艾灸在脑卒中后压疮患者中的应用效果,为临床中医防治压疮提供理论依据。方法选择2022年3月—2024年3月在浙江省立同德医院就诊的脑卒中后压疮患者91例,采用随机数字表法分为对照组(45例)和中医组(46例),均给予常规护理,对照组采用水胶体敷料外敷,中医组在对照组基础上给予循经温通刮痧联合艾灸干预,持续2周。比较2组压力性损伤愈合量表(PUSH)和疼痛(VAS)评分、肉芽组织出现及创面愈合时间、创面血流灌注量、肿瘤坏死因子-α(TNF-α)和血管内皮生长因子(VEGF)水平。结果中医组干预后PUSH评分为(2.81±0.55)分,VAS评分为(1.67±0.43)分,均低于对照组的(5.63±1.24)分、(2.58±0.88)分(P<0.05)。中医组肉芽组织出现时间[(4.09±1.27)d]、创面愈合时间[(19.28±4.10)d]均短于对照组[(6.12±1.34)d、(24.34±3.18)d,P<0.05],创面血流灌注量多于对照组(P<0.05);TNF-α低于对照组,VEGF水平高于对照组(P<0.05)。结论循经温通刮痧联合艾灸可缓解脑卒中后压疮患者创面疼痛,加快创面愈合,其作用机制可能与增加创面局部血流灌注量,调节TNF-α和VEGF水平有关。Objective Exploring the application effect of meridian warming and scraping therapy combined with moxibustion in patients with post-stroke pressure ulcers,aiming to provide a theoretical basis for the clinical prevention and treatment of pressure ulcers in traditional Chinese medicine(TCM).Methods A total of 91 patients with post-stroke pressure ulcers treated in Zhejiang Provincial Tongde Hospital from March 2022 to March 2024 were selected and divided into a control group(45 cases)and a traditional Chinese medicine group(46 cases)by random number table method,both of which were given routine care.The control group was given hydrocolloid dressing for external application,and the traditional Chinese medicine group was given the combined intervention of meridian warming and scraping therapy combined with moxibustion on the basis of the control group for 2 weeks.The scores of stress wound healing scale(PUSH)and pain VAS,granulation and wound healing time,wound blood perfusion volume,tumor necrosis factor-α(TNF-α),and vascular endothelial growth factor(VEGF)levels were compared between the two groups.Results The PUSH scores and VAS scores of the TCM group were(2.81±0.55)points and(1.67±0.43)points,both lower than those of the control group(5.63±1.24)points and(2.58±0.88)points(P<0.05).The occurrence time of granulation tissue(4.09±1.27)d and wound healing time(19.28±4.10)d were shorter than those of the control group[(6.12±1.34)d and(24.34±3.18)d,P<0.05].The blood perfusion volume of wound was higher than that of the control group(P<0.05).The level of TNF-αwas lower than that of the control group(P<0.05),and the level of VEGF was higher than that of the control group(P<0.05).Conclusion Meridian warming and scraping therapy combined with moxibustion can relieve wound pain and accelerate wound healing in patients with pressure ulcers after stroke,and its mechanism may be related to accelerating local blood perfusion and regulating the levels of TNF-αand VEGF.

关 键 词：脑卒中 压疮 中医适宜技术 刮痧 艾灸 创面愈合时间 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R244.4[医药卫生—临床医学]