PDCA护理模式联合中药灌肠在溃疡性结肠炎中的应用效果

PDCA nursing mode combined with traditional Chinese medicine enema for patients with ulcerative colitis

目的探讨计划-执行-检查-处理(Plan-Do-Check-Act,PDCA)护理模式联合中药灌肠在溃疡性结肠炎中的应用效果。方法采用前瞻性研究设计,选取2019年4月至2023年3月汉中市中医医院收治的82例溃疡性结肠炎患者,随机数字表法分为两组,各41例。试验组中,男27例、女14例,年龄(41.73±6.18)岁,病程(7.04±1.31)个月,病情程度:轻度22例、中度19例。对照组中,男23例、女18例,年龄(42.59±6.43)岁,病程(6.72±1.53)个月,病情程度:轻度23例、中度18例。对照组给予常规治疗及常规护理干预,试验组在常规治疗、护理的基础上给予PDCA护理模式联合中药灌肠;均持续干预4周。比较两组康复效果、血清炎性因子水平、溃疡性结肠炎疾病活动指数(UCDAI)、炎症性肠病生活质量评价量表(IBDQ)评分。统计学方法采用t检验、χ^(2)检验。结果试验组总有效率[90.24%(37/41)]高于对照组[73.17%(30/41)],差异有统计学意义(χ^(2)=3.998,P=0.046)。干预后试验组CRP、IL-6水平分别为(4.04±0.64)mg/L、(1.67±1.07)ng/L,低于对照组的(6.12±0.73)mg/L、(2.98±1.15)ng/L,差异均有统计学意义(t=13.719、5.340,均P<0.05);试验组便血、腹泻、内镜表现、医生评价评分分别为(1.23±0.29)分、(1.21±0.27)分、(1.06±0.23)分、(1.14±0.31)分,均低于对照组的(1.38±0.31)分、(1.43±0.26)分、(1.16±0.22)分、(1.39±0.28)分,差异均有统计学意义(t=2.263、3.758、2.012、3.832,均P<0.05);试验组肠道症状、全身症状、社会功能、情感功能评分分别为(67.84±4.73)分、(29.71±2.73)分、(27.72±2.31)分、(69.82±5.36)分,均高于对照组的(60.13±4.26)分、(27.36±2.68)分、(24.06±2.08)分、(64.67±4.79分),差异均有统计学意义(t=7.755、3.933、7.539、4.587,均P<0.05)。结论PDCA护理模式联合中药灌肠治疗溃疡性结肠炎中效果显著,并能有效改善患者的生活质量。

Objective To explore the effect of the Plan-Do-Check-Act(PDCA)nursing mode combined with traditional Chinese medicine enema for patients with ulcerative colitis.Methods This was a prospective study.Eighty-two patients with ulcerative colitis treated at Hanzhong Hospital of Traditional Chinese Medicine from April 2019 to March 2023 were divided into an experimental group and a control group using the random number table method,with 41 patients in each group.The experimental group included 27 males and 14 females,with an age of(41.73±6.18)years and a disease duration of(7.04±1.31)months;there were 22 mild cases and 19 moderate cases.The control group included 23 males and 18 females,with an age of(42.59±6.43)years and a disease duration of(6.72±1.53)months;there were 23 mild cases and 18 moderate cases.The control group received conventional treatment and routine nursing intervention,while the experimental group received conventional treatment,PDCA nursing,and traditional Chinese medicine enema,for 4 weeks.The recovery effects,serum levels of inflammatory factors,and scores of Ulcerative Colitis Disease Activity Index(UCDAI)and Inflammatory Bowel Disease Questionnaire(IBDQ)were compared between the two groups by t andχ^(2)tests.Results The total effective rate of the experimental group was higher than that of the control group[90.24%(37/41)vs.73.17%(30/41)],with a statistical difference(x2=3.998;P=0.046).After the intervention,the levels of C-reaction protein(CRP)and interleukin-6(IL-6)in the experimental group were lower than those in the control group[(4.04±0.64)mg/L vs.(6.12±0.73)mg/L and(1.67±1.07)ng/L vs.(2.98±1.15)ng/L],with statistical differences(t=13.719 and 5.340;both P<0.05);the scores of rectal bleeding,diarrhea,endoscopic findings,and physician evaluation in the experimental group were lower than those in the control group[(1.23±0.29)vs.(1.38±0.31),(1.21±0.27)vs.(1.43±0.26),(1.06±0.23)vs.(1.16±0.22),and(1.14±0.31)vs.(1.39±0.28)],with statistical differences(t=2.263,3.758,2.012,and 3.832;all P<0.05);the scores of intestinal symptoms,systemic symptoms,social function,and emotional function in the experimental group were higher than those in the control group[(67.84±4.73)vs.(60.13±4.26),(29.71±2.73)vs.(27.36±2.68),(27.72±2.31)vs.(24.06±2.08),and(69.82±5.36)vs.(64.67±4.79)],with statistical differences(t=7.755,3.933,7.539,and 4.587;all P<0.05).Conclusion PDCA nursing mode combined with traditional Chinese medicine enema has significant advantages in treating patients with ulcerative colitis,and effectively improving the treatment effect and their quality of life.