揿针联合腹部按摩治疗慢性阻塞性肺疾病伴发便秘临床研究

Clinical Study on Thumb-tack Needle Combined with Abdominal Massage for COPD Accompanied by Constipation

目的:观察揿针联合腹部按摩治疗慢性阻塞性肺疾病伴发便秘的临床疗效。方法:将90例慢性阻塞性肺疾病伴发便秘的肺脾气虚证患者按随机数字表法分为对照组和观察组各45例。对照组口服乳果糖口服液,连续6天。观察组采用揿针联合腹部按摩治疗,连续6天。记录治疗前7天、治疗期间(6天)及治疗结束后1周的周排便次数。治疗前后评价便秘患者症状自评量表(PAC-SYM)和便秘患者生活质量自评量表(PAC-QOL)评分。比较2组的疗效。结果:治疗后,观察组疗效优于对照组,差异有统计学意义(P<0.05)。2组治疗前1周的排便次数比较,差异无统计学意义(P>0.05)。治疗期间,观察组的排便次数多于对照组(P<0.05)。治疗结束后1周,观察组的排便次数多于对照组(P<0.05)。2组PAC-SYM腹部症状、直肠症状和大便症状3个维度的评分及总分均较治疗前下降(P<0.01),观察组各维度评分和总分均低于对照组(P<0.01)。2组PAC-QOL生理、社会心理、担忧、满意度4个维度的评分和PAC-QOL总分均较治疗前下降(P<0.01),观察组各维度评分和总分均低于对照组(P<0.01)。结论:与口服乳果糖口服液相比,揿针联合腹部按摩治疗慢性阻塞性肺疾病伴发便秘可更有效地减轻便秘程度、增加排便次数、提高患者的生活质量,有较好的临床疗效。

Objective:To observe the clinical effect of thumb-tack needle combined with abdominal massage for chronic obstructive pulmonary disease(COPD) accompanied by constipation.Methods:Divided 90 cases of patients with COPD accompanied by constipation who had lung-spleen qi deficiency syndrome into the control group and the observation group randomly,45 cases in each group.The control group received the oral administration of lactulose oral solution for 6 days continuously,while the observation group received thumb-tack needle combined with abdominal massage for 6 days continuously.Recorded the weekly defecation frequency 7 days before treatment,during treatment(6 days) and one week after treatment;evaluated scores of the patient assessment of constipation symptoms(PAC-SYM) and the patient assessment of constipation quality of life questionnaire(PAC-QOL) before and after treatment.Compared the curative effect in the two groups.Results:After treatment,the clinical effect in the observation group was better than that in the control group,difference being significant(P <0.05).Comparing the defecation frequency one week before treatment in both groups,there was no significant difference being found(P> 0.05).During treatment,the defecation frequency in the observation group was higher than that in the control group(P <0.05).One week after treatment,the defecation frequency in the observation group was higher than that in the control group(P <0.05).The total score and scores of such three dimensions as abdominal symptoms,rectal symptoms and defecation symptoms in PAC-SYM in both groups were respectively lower than those before treatment(P <0.01).The total score and scores of each dimension in the observation group were respectively lower than those in the control group(P <0.01).The total score and scores of such four dimensions as physiology,social psychology,worry and satisfaction in PAC-QOL in both groups were respectively lower than those before treatment(P <0.01),the total score and scores of each dimension in the observation group were respectively lower than those in the control group(P <0.01).Conclusion:In comparison with the oral administration of lactulose oral solution,thumb-tack needle combined with abdominal massage has relatively good clinical effect in treating COPD accompanied by constipation,which can effectively relieve constipation,increase defecation frequency and promote the quality of life of patients.