穴位按摩联合耳穴压豆对复方聚乙二醇电解质散不良反应的缓解效果研究

Study on the effect of acupressure and ear acupoint pressure bean on alleviating the adverse reac⁃tions of polyethylene glycol electrolyte powder

目的观察穴位按摩联合耳穴压豆治疗对结肠镜检查患者复方聚乙二醇电解质散不良反应的缓解效果,分析该治疗对患者服药依从性和肠道清洁度的影响。方法研究设计为前瞻性、单中心、随机对照临床试验。研究对象选自拟在杭州师范大学附属医院内镜中心行结肠镜检查的患者。纳入患者按随机数字表法分为试验组(50例)和对照组(50例)。对照组患者给予结肠镜检查常规护理,试验组在常规护理基础上加用穴位按摩联合耳穴压豆治疗。比较2组患者复方聚乙二醇电解质散不良反应发生率、服药依从性(8条目Morisky服药依从性量表评分)及肠道清洁度(波士顿肠道准备量表评分)的差异。结果研究初期纳入100例患者,其中8例脱落,最终92例纳入分析(试验组和对照组各46例)。试验组男性26例,女性20例;年龄(47±6)岁,范围35~56岁;对照组男性25例,女性21例;年龄(46±6)岁,范围33~57岁。2组患者年龄、性别、文化程度和婚姻状态方面差异均无统计学意义(P>0.05)。试验组复方聚乙二醇电解质散不良反应总体发生率低于对照组,差异有统计学意义[30.4%(14/46)比65.2%(30/46),χ^(2)=11.152,P=0.001]。试验组不良反应包括恶心11例、饱胀2例、腹痛1例;对照组不良反应包括恶心17例、呕吐2例、饱胀5例、腹痛4例、肛门不适及皮疹各1例。试验组患者8条目Morisky服药依从性量表评分和波士顿肠道准备量表评分均高于对照组[8(7,8)分比6(6,6)分,χ^(2)=-7.711,P<0.001;9(8,9)分比7(7,7)分,χ^(2)=-6.721,P<0.001],差异有统计学意义。结论结肠镜检查常规护理过程中加用穴位按摩联合耳穴压豆法进行干预,能够有效缓解复方聚乙二醇电解质散不良反应,提高患者服药依从性和肠道清洁度。

Objective To observe the effect of acupressure and ear acupoint pressure bean on alleviating the adverse reactions of polyethylene glycol electrolyte powder in patients undergoing colonoscopy,and analyze the effect on patients'medication compliance and intestinal cleanliness.Methods The study was designed as a prospective,single-center,randomized controlled clinical trial.The subjects were selected from patients who planned to undergo colonoscopy in the Endoscopy Center of the Affiliated Hospital of Hangzhou Normal University and were divided into trial group(50 patients)and control group(50 patients)in terms of random number table method.Patients in the control group was given colonoscopy routine nursing,and those in the trial group was treated with acupressure and ear acupoint pressure bean therapy on the basis of routine nursing.The incidence of adverse reactions of polyethylene glycol electrolyte powder,medication compliance(8-item Morisky medication adherence scale),and intestinal cleanliness(Boston bowel prepara‑tion scale)in patients were compared between the 2 groups.Results A total of 100 patients were included initially,8 fell off during the study,and 92 were finally entered in the analysis,including 46 in the trial group and control group respectively.There were 26 males and 20 females in the trial group,aged(47±6)years with a range from 35 to 56 years,and 25 males and 21 females in the control group,aged(46±6)years with a range from 33 to 57 years.Differences in age,gender,education level,and marital status of patients between the 2 groups were not significant(all P>0.05).The overall incidence of adverse reactions of polyethylene glycol electrolyte powder in the trial group was lower than that in the control group[30.4%(14/46)vs.65.2%(30/46),χ^(2)=11.152,P=0.001].Adverse reactions in the trial group included nausea(11 cases),fullness(2 cases),and abdominal pain(1 case),while those in the control group included nausea(17 cases),fullness(5 cases),abdominal pain(4 cases),vomiting(2 cases),anal discomfort and rash(1 case each).The scores of 8-item Morisky medication adherence scale and Boston bowel preparation scale in the trial group were both higher than those in the control group[8(7,8)points vs.6(6,6)points,χ^(2)=-7.711,P<0.001;9(8,9)points vs.7(7,7)points,χ^(2)=-6.721,P<0.001].Conclusion The addition of acupressure and ear acupoint pres‑sure bean to the routine nursing process in colonoscopy can effectively alleviate the adverse reactions of polyethylene glycol electrolyte powder,and improve patients'medication compliance and intestinal cleanliness.