耳穴压豆、按摩辅助治疗慢传输型便秘临床研究

Clinical Study on Auricular Point Pressing with Beans and Auricular Massage Combined with Routine Medical Measures for Slow Transit Constipation

目的:观察在常规医护措施基础上加用耳穴压豆、按摩治疗慢传输型便秘(STC)的临床疗效。方法:将120例患者按随机数字表法分为对照组和观察组各60例。2组均予莫沙必利片、聚乙二醇4000散剂治疗,并给予调整生活方式、心理护理、运动指导和建立良好的排便习惯等综合护理措施进行干预。观察组加予耳穴压豆、按摩。2组疗程均为4周。治疗前、治疗4周后评价便秘主要症状评分、便秘患者症状自评量表(PAC-SYM)评分,记录2组患者排便恢复正常时间、治疗前后的平均每周自发完全排便(SCBM)次数,并进行12周的随访,统计复发率。结果:治疗后,2组粪便性状、排便费力等6项便秘主要症状评分及总分均较治疗前下降(P<0.01),观察组6项症状评分及总分均低于对照组(P<0.01)。2组SCBM次数均较治疗前增加(P<0.01),PAC-SYM评分均较治疗前下降(P<0.01)。观察组SCBM次数多于对照组(P<0.01),PAC-SYM评分低于对照组(P<0.01)。对照组排便恢复正常时间较对照组加快(P<0.01)。观察组排便恢复正常率为91.67%,高于对照组的78.33%(P<0.05)。观察组复发率25.45%,对照组复发率46.81%,2组比较,差异有统计学意义(P<0.05)。结论:在现代医学常规治疗和护理的基础上加予耳穴压豆和按摩治疗STC患者,可进一步减轻便秘主要症状,缩短病程,提高临床疗效与患者的生活质量,减少复发。

Objective:To observe the clinical effect of auricular point pressing with beans and auricular massage based on routine medical measures for slow transit constipation(STC). Methods:A total of 120 cases of patients were divided into the control group and the observation group according to the random number table method,60 cases in each group. Both groups were treated with mosapride tablets and polyethylene glycol 4000 powder, and given comprehensive nursing measures including lifestyle modification,psychological nursing,exercise instruction and establishment of good defecation habits. The observation group was additionally treated with auricular point pressing with beans and auricular massage. Both groups were treated for four weeks. Before treatment and after four-week treatment,the scores of main symptoms of constipation and Patient Assessment of Constipation Symptoms(PAC-SYM) were evaluated. The average times of weekly spontaneous complete bowel movement(SCBM) before and after treatment and the time for defecation to return to normal in the two groups were recorded. A 12-week follow-up was performed to count the recurrence rate. Results:After treatment,the six scores of main symptoms of constipation including fecal character and difficulty of defecation as well as the total scores in the two groups were decreased when compared with those before treatment(P<0.01),and the above scores in the observation group were lower than those in the control group(P<0.01). The SCBM times in the two groups were increased when compared with those before treatment(P<0.01),and the PAC-SYM scores were decreased(P<0.01). The SCBM time in the observation group was more than that in the control group(P<0.01),and the PAC-SYM score was fewer(P<0.01). The time for defecation to return to normal in the observation group was accelerated when compared with that in the control group(P<0.01). The recovery rate of defecation was 91.67%,higher than that of 78.33% in the control group(P<0.05). The recurrence rate was 25.45% in the observation group and 46.81% in the control group, the difference being significant(P<0.05).Conclusion:Based on routine treatment and nursing measures of modern medicine,the additional application of auricular point pressing with beans and auricular massage for STC patients can further relieve the main symptoms of constipation,shorten the disease course,improve clinical effect and quality of life and reduce recurrence.