子午流注穴位按摩配合耳穴压豆治疗抗精神病药物所致便秘临床研究
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R256.35;R248

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丽水市科学技术局项目(2019SJZC68)


Clinical Study on Point Massage Based on Midnight-Midday Ebb-Flow Theory Com⁃ bined with Auricular Point Pressing with Beans for Constipation Induced by Antipsy⁃ chotic Medication
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    摘要:

    目的:观察子午流注穴位按摩配合耳穴压豆治疗抗精神病药物所致便秘的临床疗效。方法:选取120 例服用抗精神病药物所致便秘患者,按随机数字表法分为对照组和观察组,每组60 例。对照组给予常规护理干预,观察组在对照组基础上给予子午流注穴位按摩配合耳穴压豆治疗。对比2 组临床疗效,观察2 组干预前后便秘情况、肛肠动力学指标、胃肠激素水平及肠道菌群的变化。结果:观察组总有效率93.33%,对照组总有效率73.33%,2 组比较,差异有统计学意义(P<0.05)。干预后,2 组排便困难程度、排便时间、排便频率、粪便性状、排便不尽感及腹胀评分均较干预前降低(P<0.05);观察组上述6 项症状评分均低于对照组(P<0.05)。与干预前比较,2 组干预后直肠最大容量感觉阈值、肛管最大缩榨压及模拟排便肛管压均改善(P<0.05),观察组上述3 项肛肠动力学指标均比对照组改善更明显(P<0.05)。2 组干预前后直肠静息压比较,差异无统计学意义(P>0.05)。与干预前比较,2 组胃动素(MTL)、血管活性肠肽(VIP) 及胃泌素(GAS) 水平干预后均明显升高(P<0.05),生长抑素(SS) 水平干预后均明显降低(P<0.05)。干预后2 组上述4 项胃肠激素水平比较,差异均有统计学意义(P<0.05)。与干预前比较,2 组乳杆菌和双歧杆菌菌落数干预后均增加(P<0.05),肠杆菌和葡萄球菌菌落数干预后均减少(P<0.05)。干预后组间肠道菌群菌落数比较,差异均有统计学意义(P<0.05)。结论:子午流注穴位按摩联合耳穴压豆可有效改善抗精神病药物所致便秘患者的排便情况、肛肠动力学指标、胃肠激素水平及肠道菌群失调情况。

    Abstract:

    Abstract : Objective : To observe the clinical effect of point massage based on midnight-midday ebb-flow theory combined with auricular point pressing with beans for constipation induced by antipsychotic medication. Methods:A total of 120 cases of patients with constipation induced by the oral administration of antipsychotic medication were selected, and divided into the control group and the observation group according to the random number table method, 60 cases in each group. The control group was given routine nursing intervention,and the observation group was given point massage based on midnight-midday ebb-flow theory combined with auricular point pressing with beans based on the treatment of the control group. The clinical effect was compared between the two groups. The constipation condition, the indexes of anorectal dynamics, the levels of gastrointestinal hormones and the intestinal flora in the two groups were observed. Results: The total effective rate was 93.33% in the observation group and 73.33% in the control group,the difference being significant(P< 0.05). After intervention,the scores of difficulty degree and frequency of defecation,defecation time,fecal character and abdominal distension,as well as the scores of the feeling of endless defecation were decreased when compared with those before intervention(P<0.05). Compared with those in the control group,the above six symptom scores after intervention in the observation group were all lower than those in the control group(P<0.05). Compared with those before intervention, rectal maximum volume at sensory threshold, the maximum anal squeeze pressure and anal pressure during simulated defecation were improved(P<0.05), and the above three indexes of anorectal dynamics in the observation group were improved more significantly than those in the control group(P<0.05). There was no significant difference being found in the comparison of rectal resting pressure before and after intervention in the two groups(P>0.05). Compared with those before intervention, the levels of motilin(MTL), vasoactive intestinal peptide(VIP) and gastrin(GAS) after intervention in the two groups were significantly increased(P<0.05),and the levels of somatostatin(SS) were significantly decreased(P<0.05). After intervention,when compared the above four levels of gastrointestinal hormones between the two groups,differences were significant(P<0.05). Compared with that before intervention, the number of lactobacillus and bifidobacterium after intervention in the two groups were increased(P<0.05), and the number of enterobacteria and staphylococcus were decreased(P<0.05). When compared the number of intestinal flora after intervention among the two groups, differences were significant(P<0.05). Conclusion:The therapy of point massage based on midnight-midday ebb-flow theory combined with auricular point pressing with beans can effectively improve defecation of patients with constipation induced by antipsychotic medication,and improve their indexes of anorectal dynamics,levels of gastrointestinal hormones as well as the intestinal flora imbalance.

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陈菲菲,陈玲,陈晓敏,邓丽云.子午流注穴位按摩配合耳穴压豆治疗抗精神病药物所致便秘临床研究[J].新中医,2020,52(13):183-186

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  • 在线发布日期: 2020-07-10
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