针刺联合济川煎敷脐治疗老年卒中后患者便秘的临床观察

Clinical observation of acupuncture combined with Jichuan decoction umbilical compress in treatment of constipation in elderly patients after stroke

中文关键词: 老年  便秘  卒中  针刺  脐敷贴  康复

英文关键词: elderly  constipation  stroke  acupuncture  umbilical compress  rehabilitation

中文摘要:

      目的 观察针刺联合济川煎治疗卒中后便秘的疗效,为寻求温和、效果明确、不良反应小的治疗手段提供依据.方法 选取2021年9月-2022年3在松江区泗泾医院等医疗机构就诊的老年卒中后便秘患者90例,随机分为对照组(n=30,采用常规护理及康复治疗)、敷贴组(n=30,采用常规护理及康复联合敷贴治疗)、针刺+敷贴组(n=30,采用常规护理及康复加用针刺和敷贴治疗).3组疗程均为2周.观察并比较3组康复疗效、完全自主排便次数、自主排便次数、便秘生活质量及肛门外括约肌肌电图等指标值.结果 针刺+敷贴组完全自主排便有效率(47.0％)高于贴敷组(24.6％)和对照组(3.4％),差异均有统计学意义(均P＜0.01).3组在康复及治疗前,肛周神经传导潜伏期均异常(轻度到中度延长),在施行不同的治疗方案后,潜伏期均有缩短;针刺+敷贴组肛神经的潜伏期的治疗前后差值[(17.46±9.63)ms]均大于贴敷组[(9.23±5.76)ms]、对照组[(5.22±2.69)ms]),差异均有统计学意义(均P＜0.01).结论 3种疗法对卒中后患者的便秘症状具有改善作用;敷贴组和针刺+敷贴组均能显著增加自主排便次数,而针灸联合济川煎敷脐较敷脐更能增加排便力度.

英文摘要:

      Objective To observe the therapeutic effects of acupuncture combined with Jichuan decoction on post-stroke constipation,and provide a basis for seeking mild,effective,and minimally adverse treatment methods.Methods 90 elderly patients with post-stroke constipation who were treated in medical institutions including Sijing Hospital in Songjiang District from September 2021 to March 2022 were selected.They were randomly divided into control group(n=30,receiving routine nursing and rehabilitation treatment),umbilical compress group(n=30,receiving routine nursing and rehabilitation combined with umbilical compress treatment),acupuncture+umbilical compress group(n=30,receiving routine nursing and rehabilita-tion combined with acupuncture and umbilical compress treatment).The treatment course of the three groups was 2 weeks.The rehabilitation efficacy,frequency of completely autonomous defecation,frequency of autonomous defecation,quality of life for constipation,and electromyography(EMG)of the external anal sphincter were observed and compared among three groups.Results The effective rate of complete autonomous defecation in the acupuncture+umbilical compress group(47.0％)was higher than those in the umbilical compress group(24.6％)and the control group(3.4％),and the differences were statistically significant(all P＜0.01).Before rehabilitation and treatment,the latency period of perianal nerve conduction was abnormal in all three groups(mildly to moderately prolong).After receiving different treatment,the latency period of all three groups was shortened.The difference in latency period of perianal nerve conduction before and after treatment in the acupuncture+umbilical compress group[(17.46±9.63)ms]was greater than those in the umbilical compress group[(9.23±5.76)ms]and the con-trol group[(5.22±2.69)ms],and the differences were statistically significant(all P＜0.01).Conclusion The three kinds of treatment can improve the constipation symptoms of the patients after stroke.Both the umbilical compress group and the acupunc-ture+umbilical compress group can significantly increase the frequency of autonomous defecation,while acupuncture combined with Jichuan decoction umbilical compress can increase defecation force more than umbilical compress alone.