中药封包热敷配合穴位按摩治疗早产儿便秘的疗效观察

Observation of Curative Effect on Constipation in Premature Infants Treated by Heated Chinese Medicine Package Application Combined with Acupoint Massage

[目的]探讨中药封包热敷配合穴位按摩治疗早产儿便秘的临床疗效.[方法]将86例便秘早产儿随机分为试验组和对照组,每组各43例.对照组给予一般早产儿常规护理和穴位按摩,试验组在对照组基础上给予中药封包热敷治疗,共治疗14 d.比较2组患儿首次排胎粪时间、每日排便量、胎便转黄时间、喂养不耐受(呕吐、反流、腹胀、胃潴留)发生率和新生儿高胆红素血症发生率,观察2组患儿血中胃泌素(GAS)和胃动素(MTL)水平的变化情况.[结果](1)试验组的首次胎粪时间和胎粪转黄时间均早于对照组,差异均有统计学意义(P<0.01).(2)试验组从治疗的第2天开始,每日排便量呈逐渐增多趋势,且每日排便量均高于对照组.(3)治疗14 d后,2组患儿的GAS和MTL水平均较开始治疗时明显降低(P<0.05),且试验组在治疗14 d后的GAS和MTL水平均明显低于对照组(P<0.05).(4)试验组的喂养不耐受发生率和高胆红素血症发生率均明显低于对照组(P<0.05或P<0.01).[结论]在治疗早产儿便秘的过程中,采用中药封包热敷配合穴位按摩可显著改善患儿胃肠功能,促进患儿排便,并且能够降低喂养不耐受和高胆红素血症的发生率.

Objective To investigate the curative effect of heated Chinese medicine package application combined with acupoint massage in the treatment of constipation in premature infants.Methods A total of 86 cases of constipation premature infants were randomized into trial group and control group,43 cases in each group.The control group was given conventional nursing for premature infants plus acupoint massage,and the trial group was treated with heated Chinese medicine package application based on the treatment for the control group.The treatment for the two groups covered 14 days.The time for the first defection of meconium,daily defecation volume,time for the meconium turning yellow,incidence of feeding intolerance(vomiting,reflux,abdominal distension,gastric retention),and incidence of neonatal hyperbilirubinemia in the two groups were observed.And the changes of blood gastrin(GAS)and motilin(MTL)levels were compared between the two groups.Results(1)The time for the first defection of meconium and time for the meconium turning yellow in the trial group were significantly shorter than those in the control group,the difference being significant(P<0.01).(2)The daily defecation volume in the trial group tended to increase from the second day of treatment,and the volume was larger than that in the control group.(3)After treatment for 14 days,the GAS and MTL levels in the two groups were obviously decreased(P<0.05 compared with those before treatment),and the levels in the trial group were much lower than those in the control group(P<0.05).(4)The incidence of feeding intolerance and the incidence of hyperbilirubinemia in the trial group were much lower than those in the control group(P<0.05 or P<0.01).Conclusion In the treatment of premature infants with constipation,the application of heated Chinese medicine package combined with acupoint massage can significantly improve the gastrointestinal function,promote the defecation,and reduce the incidence of feeding intolerance and hyperbilirubinemia.