Orem自护理论在中药保留灌肠治疗大肠湿热证溃疡性结肠炎患者中的应用

Application of Orem’s Self-Care theory in nursing of patients with ulcerative colitis of colon damp-heat syndrome treated with retention enema of Traditional Chinese Medicine

目的探讨Orem自护理论运在中药保留灌肠治疗大肠湿热证溃疡性结肠炎患者中的应用效果。方法选取2020年2月—2023年2月医院肛肠科住院接受治疗的84例大肠湿热证溃疡性结肠炎患者为研究对象,采用随机数字表法将其分为研究组和对照组,各42例。两组患者均采用保留灌肠治疗,在此基础上,对照组采用常规护理干预,研究组在常规护理基础上增加Orem自护理论干预。对比两组患者临床症状、炎性反应指标和生存质量。结果干预后两组患者溃疡性结肠炎疾病活动指数(UCDAI)中的便血、腹泻、内镜表现、医师评定的评分相较于干预前均有降低,且研究组低于对照组(P<0.01)。干预后两组患者的TNF-α、IL-6、IL-8的水平相较于干预前均有降低,且研究组低于对照组(P<0.01)。干预后两组患者炎症性肠病患者生活质量量表(IBDQ)评分中的肠道症状、全身症状、情感功能及社会功能的评分相较于干预前降低,且研究组低于对照组(P<0.01)。结论在中药保留灌肠治疗大肠湿热证溃疡性结肠炎患者护理中,基于Orem自护理论指导护理能够有效改善患者临床症状和炎性反应,提高患者的生活质量。

Objective To evaluate the application of Orem’s Self-Care theory in nursing of patients with ulcerative colitis of colon damp-heat syndrome treated with retention enema of Traditional Chinese Medicine.Methods Eighty-four patients with ulcerative colitis of colon damp-heat syndrome were selected as the study subjects,and were randomly divided into the experimental group(n=42)and the control group(n=42).Patients in both groups were treated with Chinese herbal medicine retention enema and conventional nursing interventions,and patients in the experimental group were given Orem's self-care theory-guided interventions.Clinical symptoms,inflammatory indicators and quality of the two groups of patients were compared.Results After intervention,the UCDAI index of both groups of patients showed a decrease in hematochezia,diarrhea,endoscopic manifestations,and physician evaluated scores compared to those before intervention,with the experimental group being lower than the control group(P<0.01).The levels of TNF-α,IL-6 and IL-8 in both two groups had dropped after intervention,and levels of inflammatory index in the experimental group were lower than those in the control group(P<0.01).After intervention,the IBDQ scores of intestinal symptoms,systemic symptoms,emotional function,and social function in both groups of patients decreased compared to those before intervention,and IBDQ scores in the experimental group were lower than those in the control group(P<0.01).Conclusion Nursing interventions based on the Orem's self-care theory are effective to relieve the clinical symptoms and inflammatory reactions of patients with ulcerative colitis of colon damp-heat syndrome,and improve their quality of life.