大承气汤加减方神阙穴贴敷联合吐纳法预防老年股骨粗隆间骨折便秘的疗效观察

Observation on the curative effect of Dachengqi Decoction plus Shenque acupoint application combined with inhalation method on preventing constipation of femoral intertrochanteric fracture in the elderly

目的观察大承气汤加减方神阙穴贴敷联合吐纳法预防老年股骨粗隆间骨折便秘的效果。方法选取2021年1月至2023年1月于南昌市洪都中医院住院的90例老年股骨粗隆间骨折患者作为研究对象,采用随机数字表法将其分为常规组、吐纳组、联合组,每组各30例。常规组实施常规护理及按摩干预,吐纳组在常规组的基础上实施吐纳法,联合组在常规组的基础上实施吐纳法+大承气汤加减神阙穴贴敷干预。比较三组的便秘症状、每分钟肠鸣音次数、首次排便时间、大便性状、生活质量。结果三组治疗后的Wexner便秘评分低于治疗前,且治疗后联合组的Wexner便秘评分低于吐纳组、常规组,吐纳组的Wexner便秘评分低于常规组,差异有统计学意义(P<0.05)。联合组每分钟肠鸣音次数多于吐纳组、常规组,首次排便时间短于吐纳组、常规组,且吐纳组每分钟肠鸣音次数多于常规组,首次排便时间短于常规组,差异有统计学意义(P<0.05)。联合组大便正常率高于吐纳组、常规组,差异有统计学意义(P<0.017)。三组治疗后的心理、生理、环境、社会关系评分高于治疗前,且治疗后联合组的心理、生理、环境、社会关系评分高于常规组,差异有统计学意义(P<0.05)。结论大承气汤加减方神阙穴贴敷联合吐纳法可改善老年股骨粗隆间骨折患者大便性状及排便状况,缩短首次排便时间,预防便秘的发生。

Objective To observe the effect of Dachengqi Decoction plus Shenque acupoint application combined with inhalation method on preventing constipation of femoral intertrochanteric fracture in the elderly.Methods A total of 90 elderly patients with intertrochanteric fracture of femur hospitalized in Hongdu Hospital of Traditional Chinese Medicine of Nanchang City from January 2021 to January 2023 were selected as the study objects,and were divided into routine group,inhalation group and combined group by random number table method,with 30 cases in each group.The routine group was subjected to routine nursing and massage intervention,the inhalation group was subjected to the inhalation method on the basis of the routine group,and the combined group was subjected to the intervention of the inhalation method+Dachengqi Decoction plus Shenque acupoint application on the basis of the routine.The symptoms of constipation,the number of bowel sounds per minute,the time of first defecation,the characteristics of stool and the quality of life of the three groups were compared.Results The Wexner constipation score of the three groups after treatment were lower than those before treatment,and the Wexner constipation score of the combined group after treatment was lower than that of the inhalation group and the routine group,and the Wexner constipation score of the inhalation group was lower than that of the routine group,with statistical significances(P<0.05).The frequency of bowel sounds per minute in the combined group was more than that in the inhalation group and the routine group,the first defecation time was shorter than that in the inhalation group and the routine group,and the frequency of bowel sounds per minute in the inhalation group was more than that in the routine group,the first defecation time was shorter than that in the routine group,the differences were statistically significant(P<0.05).The normal rate of stool in the combined group was higher than that in the inhalation group and the routine group,and the difference was statistically significant(P<0.017).The scores of psychological,physiological,environmental and social relations of the three groups after treatment were higher than those before treatment,and the scores of psychological,physiological,environmental and social relations of the combined group after treatment were higher than those of the routine group,with statistical significances(P<0.05).Conclusion Dachengqi Decoction plus Shenque acupoint application combined with inhalation method can improve the defecation characteristics and status of elderly patients with intertrochanteric fracture of the femur,shorten the first defecation time,and prevent constipation.