砭石穴位按摩联合参苓白术散对老年胸腰椎压缩骨折术后便秘症状及胃肠道功能恢复的影响  

Effects of stone needle acupoint massage combined with Shenling Baizhu powder on postoperative constipation symptoms and gastrointestinal function recovery in elderly patients with thoracolumbar compression fracture

作　　者：叶爽 谢添[1] 顾晞[1] YE Shuang;XIE Tian;GU Xi(Department of Orthopedics and Traumatology,Wuhan Traditional Chinese Medicine Hospital,Wuhan Hubei 430000,China)

机构地区：[1]武汉市中医医院骨伤科,湖北武汉430000

出　　处：《临床和实验医学杂志》2025年第2期164-168,共5页Journal of Clinical and Experimental Medicine

基　　金：湖北省中医药管理局中医药科研项目(编号:ZY2023Z011);武汉市中医药科研项目(编号:WZ22B12)。

摘　　要：目的探究砭石穴位按摩联合参苓白术散对老年胸腰椎压缩骨折(TVCF)术后便秘症状及胃肠道功能恢复的影响。方法将2022年9月至2023年8月武汉市中医医院收治的老年TVCF术后出现便秘的患者纳入本次前瞻性研究,按照随机数字表法将其分为对照组(n=40)和联合组(n=40)。对照组患者接受参苓白术散治疗,联合组患者接受砭石穴位按摩+参苓白术散治疗,两组治疗时间均为7 d。比较两组的临床疗效、治疗前及治疗7 d后的症状自评量表(PAC-SYM)评分(腹部症状、直肠症状及大便症状评分和PAC-SYM总分)、术后胃肠功能恢复指标(肠鸣音、首次排便时间和腹痛、腹胀缓解时间)、治疗前及治疗7 d后的血清胃肠道激素(胃动素、胃泌素和生长抑素)水平和治疗结束后3个月的复发情况。结果联合组的总有效率为97.50%,显著高于对照组(80.00%),差异有统计学意义(P<0.05)。治疗7 d后,两组的腹部症状、直肠症状、大便症状和PAC-SYM总分均较治疗前显著下降,且联合组的腹部症状、直肠症状、大便症状和PAC-SYM总分分别为(2.25±0.43)、(8.17±1.55)、(0.76±0.30)、(10.29±2.01)分,均显著低于对照组[(3.32±0.59)、(10.28±2.05)、(1.20±0.41)和(15.12±3.16)分],差异均有统计学意义(P<0.05)。联合组术后肠鸣音次数为(4.53±0.37)次/min,显著高于对照组[(2.46±0.44)次/min],首次排便时间和腹痛、腹胀缓解时间分别为(18.83±3.28)、(18.20±3.04)h,均显著短于对照组[(30.74±5.96)、(30.12±3.79)h],差异均有统计学意义(P<0.05)。治疗7 d后,两组的胃动素均较治疗前显著升高,胃泌素和生长抑素均较治疗前显著降低,联合组的血清胃动素为(76.19±9.87)ng/L,显著高于对照组[(71.53±9.21)ng/L],而胃泌素和生长抑素分别为(62.36±5.83)、(20.69±3.90)ng/L,均明显低于对照组[(66.24±5.19)、(23.74±3.65)ng/L],差异均有统计学意义(P<0.05)。联合组治疗结束后3个月的复发率为32.50Objective To explore the effect of stone needle acupoint massage combined with Shenling Baizhu powder on postoperative constipation symptoms and gastrointestinal function recovery in elderly patients with thoracolumbar compression fracture(TVCF).Methods A total of 80 patients who developed constipation after receiving TVCF surgery at Wuhan Traditional Chinese Medicine Hospital from September 2022 to August 2023 were included in this prospective study and were randomly divided into the control group(n=40)and the combination group(n=40)according to the random number table method.The control group received treatment with Shenling Baizhu powder,while the combination group received treatment with stone needle acupoint massage and Shenling Baizhu powder.The treatment time of the two groups was 7 days.The clinical efficacy,patient assessment of constipation symptom(PAC-SYM)scores(including abdominal,rectal,and fecal symptom scores and PAC-SYM total score)before and 7 days after treatment,postoperative gastrointestinal function recovery indicators(including time of first defecation time,bowel sounds and abdominal pain and abdominal distension relief time),serum gastrointestinal hormones(including motilin,gastrin and somatostatin)before and 7 days after treatment and recurrence 3 months after treatment were compared.Results The total effective rate of the combined group was 97.50%,which was significantly higher than that of the control group(80.00%),the difference was statistically significant(P<0.05).After 7 days of treatment,the abdominal symptoms,rectal symptoms,stool symptoms and PAC-SYM total scores of the two groups were significantly lower than those before treatment,and the abdominal symptoms,rectal symptoms,stool symptoms,and PAC-SYM total score of the combination group were(2.25±0.43),(8.17±1.55),(0.76±0.30),and(10.29±2.01)pionts,respectively,significantly lower than those of the control group[(3.32±0.59),(10.28±2.05),(1.20±0.41),and(15.12±3.16)points],the differences were statistically significant(P<0.0

关 键 词：砭石穴位按摩 参苓白术散 老年人 胸腰椎压缩骨折 便秘 胃肠道功能 

分 类 号：R24[医药卫生—中医临床基础]