卯时穴位按摩联合神阙穴贴敷防治混合痔术后便秘的临床效果

Maoshi Acupoint Massage Combined with Shenque Acupoint Application in Prevention and Treatment of Constipation after Mixed Hemorrhoids Operation

目的:探讨卯时腹部穴位按摩联合神阙穴贴敷防治混合痔术后便秘的临床疗效。方法:选取2017年8月—2020年8月沧州中西医结合医院肛肠科收治的接受混合痔外剥内扎手术患者96例作为研究对象。按照随机数字表法分为2组,每组48例。对照组术后给予饮食指导,第1~3天半流质饮食,第4天开始普通饮食,多食新鲜蔬菜、瓜果及粗纤维食品,忌食辛辣、油腻食品,多饮水。治疗组在对照组治疗基础上予以卯时腹部穴位按摩联合神阙穴贴敷。比较两组术后首次排便时间及便秘发生率,比较两组术后首次排便时、第3天、第5天、第7天排便困难程度、粪便性状评分,比较两组干预前后肛肠动力学指标,包括直肠静息压(RRP)、肛管静息压(ARP)及肛管高压区长度(HPZ)。结果:治疗组首次排便时间短于对照组[(35.72±8.07)h vs(41.64±7.85)h,P<0.05],术后第1~3天便秘发生率低于对于对照组(31%vs 68%,P<0.05);术后首次排便时、术后第3天、第5天,治疗组排便困难程度评分分别为(3.63±0.89)分、(3.47±0.84)分、(2.21±0.53)分,分别低于对照组的(4.46±1.07)分、(4.22±1.03)分、(2.74±0.61)分,差异均有统计学意义(P<0.05);术后首次排便时、术后第3天、第5天治疗组粪便性状评分分别为(3.58±1.03)分、(3.36±0.88)分、(2.41±0.65)分,分别低于对照组的(4.23±1.11)分、(4.04±1.00)分、(2.90±0.76)分,差异均有统计学意义(P<0.05);治疗后,治疗组RRP[(2.94±0.66)kPa vs(2.45±0.61)kPa]、ARP[(37.21±5.74)kPa vs(32.19±5.70)kPa]、HPZ[(4.44±0.46)cm vs(3.70±0.39)cm]均高于对照组,差异均有统计学意义(P<0.05)。结论:卯时腹部穴位按摩联合神阙穴贴敷有利于改善粪便性状,促进粪便排出,促进肛门排便功能恢复,减少了便秘的发生。

Objective To investigate the curative effect of acupoint massage at Maoshi combined with Shenque acupoint application in the prevention and treatment of postoperative constipation of mixed hemorrhoids.Methods 96 patients with mixed hemorrhoids were selected and divided into two groups according to the digital random table method,with 48 cases in each group.The control group were given diet guidance after operation,half liquid diet from the first to the third day,and the ordinary diet on the fourth day.They ate more fresh vegetables,fruits and crude fiber food,avoid spicy and greasy food,and drank more water.The treatment group were given Maoshi abdominal acupoint massage combined with Shenque acupoint sticking on the basis of the treatment of the control group.The first defecation time and incidence of constipation were compared between the two groups.The difficulty in defecating and fecal characteristics scores at the first defecation time,the third day,the fifth day and the seventh day after the operation were compared between the two groups.The anorectal motility indexes including rectal resting pressure(RRP),anal resting pressure(ARP)and anal canal high pressure zone length(HPZ)were compared between the two groups before and after intervention.Results The first defecation time of the treatment group was shorter than that of the control group[(35.72±8.07)h vs(41.64±7.85)h,P<0.05],and the incidence of constipation in the first 3 days after operation was lower than that of the control group(31%vs 68%,P<0.05).The defecation difficulty scores of the treatment group were(3.63±0.89),(3.47±0.84)and(2.21±0.53)respectively.They were lower than(4.23±1.11),(4.04±1.00),(2.90±0.76)in the control group,which the differences were statistically significant(P<0.05).The scores of fecal characteristics in the treatment group were(3.58±1.03),(3.36±0.88)and(2.41±0.65)at the first defecation,the third day and the fifth day after operation respectively.They were lower than(4.23±1.11),(4.04±1.00),(2.90±0.76)in the control group,which the differences were statistically significant(P<0.05).The RRP[(2.94±0.66)kPa vs(2.45±0.61)kPa],ARP[(37.21±5.74)kPa vs(32.19±5.70)kPa]and HPZ[(4.44±0.46)cm vs(3.70±0.39)cm]of the treatment group were higher than those of the control group(P<0.05),which the differences were statistically significant.Conclusion Maoshi abdominal acupoint massage combined with Shenque acupoint application is beneficial to improve fecal properties,promote fecal excretion,promote the recovery of anal defecation function and reduce the occurrence of constipation.