穴位按摩联合热奄包热熨治疗缺血性脑卒中后便秘疗效观察  

Observation on Curative Effect of Acupoint Massage Combined with Hot Medicated Compress with Hot Package on Constipation After Ischemic Stroke

作　　者：陈小红 杨霞 许小青 CHEN Xiaohong;YANG Xia;XU Xiaoqing(Emergency Department,Cangnan Hospital of Traditional Chinese Medicine,Cangnan Zhejiang 325800,China)

机构地区：[1]苍南县中医院急诊科,浙江苍南325800

出　　处：《新中医》2025年第4期106-110,共5页New Chinese Medicine

基　　金：苍南县2023年科技项目(2023S03)。

摘　　要：目的:观察穴位按摩联合热奄包热熨治疗缺血性脑卒中后便秘的临床疗效。方法:纳入2023年1月—2024年1月苍南县中医院收治的68例脑卒中后便秘患者,按随机数字表法分为试验组和对照组各34例。试验组采用穴位按摩联合热奄包热熨治疗,对照组采用乳果糖浓溶液治疗。治疗1周后,比较2组治疗前后中医证候评分、便秘症状评分、便秘生活质量量表(PAC-QOL)评分、小肠传输时间、结肠传输时间、直肠静息压、肛门静息压、肛门收缩压,评价2组临床疗效。结果:治疗后,试验组总有效率为94.12%(32/34),高于对照组为70.59%(24/34),2组比较,差异有统计学意义(P<0.05)。治疗后,2组大便干结、腹满胀痛、肠鸣矢气等中医证候评分均较治疗前降低(P<0.05);且试验组各项评分均低于对照组(P<0.05)。治疗后,2组排便困难、粪便性状、排便时间、排便频率、腹胀及排便时下坠、不尽、胀感等便秘症状评分及总分均较治疗前降低(P<0.05),且试验组各项评分均低于对照组(P<0.05)。治疗后,2组PAC-QOL量表中各项评分均较治疗前降低(P<0.05),且试验组各项评分均低于对照组(P<0.05)。治疗后,2组小肠传输时间、结肠传输时间均较治疗前缩短(P<0.05),且试验组小肠传输时间、结肠传输时间均短于对照组(P<0.05)。治疗后2组直肠静息压、肛门静息压、肛门收缩压均较治疗前降低(P<0.05),且试验组3项指标均低于对照组(P<0.05)。结论:穴位按摩联合热奄包热熨治疗缺血性脑卒中后便秘疗效肯定,可显著改善患者临床症状,缩短肠道传输时间、降低直肠肛门压力,提高患者生活质量。Objective:To observe the clinical efficacy of acupoint massage combined with hot medicated compress with hot package on constipation after ischemic stroke.Methods:A total of 68 patients with constipation after stroke treated in the Cangnan Hospital of Traditional Chinese Medicine from January 2023 to January 2024 were selected and divided into the trial group and the control group according to the random number table method,with 34 cases in each group.The trial group received acupoint massage combined with hot medicated compress with hot package,and the control group was treated with the Lactulose Concentrate.After one week of treatment,traditional Chinese medicine(TCM)syndrome scores,constipation symptom scores,Patient Assessment of Constipation Quality of Life(PAC-QOL)scores,small intestine transit time,colon transit time,rectal resting pressure,anal resting pressure,and anal contraction pressure were compared between the two groups;the clinical effects were evaluated in the two groups.Results:After treatment,the total effective rate was 94.12%(32/34)in the trial group,higher than that of 70.59%(24/34)in the control group,with a significant difference between the two groups(P<0.05).After treatment,both groups showed significant reductions in TCM syndrome scores for dry stools,abdominal distension and pain,and bowel sounds with flatulence compared to those before treatment(P<0.05),with the trial group scoring lower than the control group(P<0.05).After treatment,the constipation symptom scores for defecation difficulties,stool form,defecation time,defecation frequency,abdominal distension,and sensations of incomplete evacuation and straining during defecation,as well as the total scores,in the two groups were significantly reduced when compared with those before treatment(P<0.05),with the trial group scoring lower than the control group(P<0.05).After treatment,PAC-QOL scores in the two groups were decreased when compared with those before treatment(P<0.05),with the trial group scoring lower than the control group

关 键 词：脑卒中后便秘 穴位按摩 热奄包热熨 便秘生活质量量表 肠道传输时间 直肠肛门压力 

分 类 号：R244[医药卫生—针灸推拿学]