中医便秘辨证干预性护理对COPD便秘患者的影响分析

Research on the influence of constipation dialectical nursing of traditional Chinese medicine on patients with COPD

目的：研究中医便秘辩证干预性护理对慢性阻塞性肺疾病（ COPD）便秘患者的影响。方法选择我院2013年1月至2014年6月129例急性发作的COPD合并便秘患者,根据患者意愿分为两组,干预组68例采用中医便秘辩证干预性护理,对照组61例采用常规护理,比较入组时、干预后1个月、3个月、12个月便秘症状改善情况及12个月内COPD急性发作次数。结果两组干预后1个月便秘症状评分均低于入组时（ P〈0.05）。干预组干预后3个月、12个月便秘症状评分持续降低,与入组时比较差异有统计学意义（ P〈0.05）。干预组干预后1个月、3个月、12个月便秘症状评分均低于对照组（ P〈0.05）。干预组12个月内急性发作次数0次和1次患者构成比为70.59%,2次及以上占29.41%；对照组分别为39.34%和60.66%；两组12个月内COPD急性发作次数比较差异有统计学意义（ P〈0.05）。干预组患者平均呼吸困难次数为2.62次/月,对照组为9.43次/月（ P〈0.05）。干预组12个月中心力和呼吸衰竭发生率明显低于对照组（ P〈0.05）。结论肺与大肠相表里,中医便秘辩证干预性护理可改善COPD伴便秘患者症状,促进排便通畅,使痰热之邪经大便而下,恢复肺气宣降,从而减少呼吸困难发生次数、COPD急性发作次数及呼吸和心力衰竭发生率。

Objective To study the influence of constipation dialectical nursing of traditional Chinese medi-cine for chronic obstructive pulmonary disease （ COPD） patients with constipation. Methods A total of 129 cases of a-cute COPD patients with constipation from january 2013 to june 2014 were selected and divided into two groups accord-ing to the willingness of the patients. The 68 cases of the intervention group received constipation dialectical nursing of traditional Chinese medicine, while the 61 patients of the control group were treated with normal nursing. The improve-ment of constipation of the two groups at the beginning and 1 month, 3 months and 12 months after intervention were compared and the times of acute onset of COPD in 12 months of the two groups were compared as well. Results The scores of the symptoms of constipation of the two groups 1 month after intervention were lower than that at the beginning （ P〈0. 05 ） . The scores of the symptoms of constipation of the intervention group 3 months and 12 months after interven-tion were consistently decreasing, and the differences were statistically significant （P〈0. 05） . The scores of the symp-toms of constipation of the intervention group 1 month, 3 months and 12 months after intervention were lower than that of the control group （ P〈0. 05 ） . Patients with no acute attack and once acute attack of the intervention group in 12 months accounted for 70. 59%, patients with twice acute attack and above accounted for 29. 41%;while the control group was 39. 34% and 60. 66% respectively. There were statistical significances between the COPD acute episodes of the two groups within 12 months （ P〈0. 05 ） . The average times of breathing difficulties of the patients of the intervention group was 2. 62 times a month, while the control group was 9. 43 times a month （P〈0. 05） . The incidence of heart and re-spiratory failure of the intervention group in 12 months was significantly lower than that of the control group （ P〈0. 05 ） . Conclusions The lung and the large intestine are interior-exteriorl. The traditional Chinese medicine dialectical inter-ventional nursing can improve the symptoms of COPD patients with constipation, promote a smooth defecation, release phlegmy heat by stool, restore the lung, reduce the frequency of breathing difficulties, acute episodes of COPD and the incidence of breathing and heart failure.