商陆贴敷神阙穴联合常规治疗脑出血后便秘临床研究
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R743.34

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Observation on Curative Effect of Application with Phytolaccae Radix at Shenque Point Combined with Routine Treatment on Constipation After Cerebral Hemorrhage
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    摘要:

    目的:观察商陆贴敷神阙穴联合常规治疗脑出血后便秘患者的临床疗效,及对排便情况、生活质 量的影响。方法:选取脑出血后便秘患者94 例,采用随机数字表法分为对照组和观察组各47 例。所有患者均 进行脑内血肿清除去骨瓣术治疗,对照组术后予以常规治疗,观察组在对照组基础上联合商陆贴敷神阙穴进行 综合干预。2 组均治疗7 d 后,比较2 组临床疗效,以及治疗前后便秘症状评分、肛肠动力学[肛管最大收缩 压(MSP)、肛管静息压(ARP) ]水平、容量感觉阈值[初始排便感觉阈值(DSV)、(DSV) 和最大耐受阈 值(MTV) ]、粪便肠道短链脂肪酸水平及便秘患者生活质量自评量表评分。结果:治疗7 d 后,观察组总有效 率为91.49%,高于对照组72.34%,2 组比较,差异有统计学意义(P<0.05)。治疗后,2 组便秘症状各项评分 均较治疗前降低(P<0.05);观察组排便困难、粪便性状、排便频率、腹胀评分均低于对照组(P<0.05), 2 组排便时间、下坠不尽胀感评分比较,差异无统计学意义(P>0.05)。治疗后,2 组MSP、ARP 水平均较治 疗前升高(P<0.05),且观察组MSP、ARP 水平均高于对照组(P<0.05)。治疗后,2 组DSV、MTV 水平均较 治疗前降低(P<0.05),且观察组DSV、MTV 水平均低于对照组(P<0.05)。治疗后,2 组丁酸水平均较治疗 前升高(P<0.05),且观察组丁酸水平高于对照组(P<0.05);2 组乙酸、丙酸水平治疗前后均变化不大(P> 0.05)。治疗后,2 组生活质量自评量表中生理、忧虑、满意度、社会心理评分均较治疗前降低(P<0.05),且 观察组上述各项评分均低于对照组(P<0.05)。结论:商陆贴敷神阙穴联合常规治疗可有效改善脑出血后便秘 患者便秘症状,改善肛门括约肌的收缩力及肠道功能,有效调节肠道短链脂肪酸水平,提高患者生活质量,具 有较好的临床效果。

    Abstract:

    Abstract:Objective:To observe the clinical effect of the therapy of application with Phytolaccae Radix at Shenque Point (RN 8) combined with routine treatment on constipation after cerebral hemorrhage. Methods:A total of 94 patients with constipation after cerebral hemorrhage were selected and divided into the control group and the observation group according to the random number table method,with 47 cases in each group. All included patients were given decompressive craniectomy for clearing intracranial hematoma; the control group was given routine treatment, and the observation group was additionally treated with application with Phytolaccae Radix at Shenque Point (RN 8) based on the treatment of the control group. After 7 days of treatment,the clinical effects,scores of constipation symptoms,levels of anorectal dynamics indexes, including maximum anal squeeze pressure (MSP) and anal resting pressure (ARP),levels of volume perception threshold indexes,including initial defecation sensory value (DSV) and maximum tolerance value (MTV), levels of intestinal short chain fatty acid of stool and scores of Patient Assessment of Constipation Quality of Life Scale (PAC-QOL) were compared before and after treatment between the two groups. Results: The total effective rate was 91.49% in the observation group and 72.34% in the control group, the difference being significant (P<0.05). After treatment, the scores of defecation difficulty, stool characters, defecation frequency, abdominal distension, defecation time, distending sensation of incomplete defection in the two groups were decreased when compared with those before treatment (P<0.05);the scores of defecation difficulty,stool characters,defecation frequency and abdominal distension in the observation group were lower than those in the control group (P<0.05), and there was no significant difference being found in the comparisons of scores of defecation time and distending sensation of incomplete defection between the two groups (P>0.05). After treatment, the levels of MSP and ARP in the two groups were increased when compared with those before treatment (P< 0.05),and the above two levels in the observation group were higher than those in the control group (P< 0.05). After treatment,the levels of DSV and MTV in the two groups were decreased when compared with those before treatment (P<0.05),and the above two levels in the observation group were lower than those in the control group (P<0.05). After treatment,the levels of butyric acid in the two groups were increased when compared with those before treatment (P<0.05), and level of butyric acid in the observation group was higher than that in the control group (P<0.05);there were no great changes before and after treatment in the levels of acetic acid and propionic acid in the two groups (P>0.05). After treatment, the scores of physiology, anxiety, satisfaction degree and social psychology in the PAC-QOL in the two groups were decreased when compared with those before treatment (P<0.05), and the above four scores in the observation group were lower than those in the control group (P<0.05). Conclusion: The therapy of application with Phytolaccae Radix at Shenque Point (RN 8) combined with routine treatment can effectively improve the symptoms of patients with constipation after cerebral hemorrhage, enhance the contraction force of anal sphincter and the intestinal function, regulate the level of intestinal short chain fatty acid of stool,and improve the quality of life of patients with a better clinical effect.

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李燕,江露,叶芬.商陆贴敷神阙穴联合常规治疗脑出血后便秘临床研究[J].新中医,2024,56(6):151-156

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  • 在线发布日期: 2024-03-26
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