腹部穴位按摩配合贴敷疗法治疗胸腰椎骨折后便秘的临床应用效果观察

Observation on the clinical effect of abdominal acupoint massage combined with application therapy for constipation after thoracolumbar fracture

目的:对胸腰椎骨折后便秘患者分别采取常规西医治疗方案及腹部穴位按摩+贴敷疗法治疗,对比两种治疗方案的应用效果,分析腹部穴位按摩、贴敷等中医治疗方法的应用价值。方法:选取2017年1月-2018年12月,到我院进行治疗的88例胸腰椎骨折后便秘患者,将患者分为两组。对照组患者(44例)使用酚酞片治疗,每日1次,每次1片。观察组患者(44例)使用腹部穴位按摩+贴敷疗法治疗,穴位按摩选取中脘、大横、天枢等穴位进行按摩,每个穴位按摩1 min并顺时针按摩患者腹部;穴位贴敷使用厚朴、大黄等药物,按照1∶1的比例配比并使用蜂蜜调制,选取神阙穴贴敷。两组患者均治疗7 d。结果:观察组患者总有效率为93.18%,对照组患者总有效率为77.27%,差异明显(χ^2=4.42,P <0.05);观察组患者排便顺畅(77.27%VS40.91%)、大便质软比例(88.64%VS61.36%)明显高于对照组,差异明显(χ^2=12.03、8.73,P <0.05);观察组患者干预后48 h、72 h的排便次数、矢气次数均明显多于对照组(P <0.05)。结论:对胸腰椎骨折后便秘患者采取腹部穴位按摩+贴敷疗法治疗能够有效改善患者便秘症状,改善大便性状及患者排便感觉,增加排便次数及矢气次数,应用效果优于常规西药治疗。

Objective: Patients with constipation after thoracolumbar fracture were treated with conventional western medicine and abdominal acupoint massage combined with application therapy, and the application effects of the two treatment schemes were compared, and the application value of traditional Chinese medicine such as abdominal acupoint massage and application therapy was analyzed. Methods: 88 patients with constipation after thoracolumbar fracture who were admitted to our hospital for treatment from January 2017 to December 2018 were selected and divided into two groups. Patients in the control group(44 cases) were treated with phenolphthalein tablets, once a day and one tablet a day. Patients in the observation group(44 cases) were treated with abdominal acupoint massage combined with application therapy. Acupoint massage selected Zhongwan( 中脘), Daheng( 大横), Tianshu( 天枢) and other acupoints for massage, and each acupoint was massaged for 1 minute and then massaged the patients’ abdomen clockwise. Acupoint application use magnolia officinalis, rhubarb and other drugs, in accordance with the ratio of 1:1 and the use of honey modulation, select Shenque acupoint application. Patients in both groups were treated for 7 days. Results: The total effective rate was 93.18% in the observation group and 77.27% in the control group, which was with a significant difference(χ~2=4.42,P < 0.05). In the observation group, the defecation was smooth(77.27% VS 40.91%) and the proportion of soft stool(88.64% VS 61.36%) was significantly higher than that in the control group(χ~2 =12.03,8.73,P < 0.05). The number of defecation and sagittal gas in the observation group was significantly higher than that in the control group 48 h and 72 h after intervention(P < 0.05). Conclusion: The abdominal acupoint massage combined with application therapy can effectively relieve the symptoms of constipation, improve the stool characteristics and defecation sensation of patients, and increase the frequency of defecation and sagittal qi in the treatment of constipation after thoracolumbar fracture. The application effect is superior to conventional western medicine treatment.