“子午流注”指导下大黄穴位贴敷治疗危重患者便秘的临床研究

发布时间：2018-03-26 03:50

本文选题：子午流注　切入点：大黄穴位贴敷　出处：《山东大学》2017年硕士论文

【摘要】：研究目的探索"子午流注"理论指导下大黄穴位贴敷治疗危重患者便秘的有效性及安全性,继而为该治疗方案在临床治疗工作中推广使用提供理论依据。以期向危重患者提供更加优质的临床医疗服务,促使其病情得到控制,在较短时间内改善便秘症状。研究方法选取2015年3月至2016年3月入住莱芜市中医院ICU的危重患者60例,利用随机数字表法分为对照组和观察组各30例。对照组采取口服莫沙必利治疗,1片/次,3次/d。观察组给予"子午流注"理论指导下大黄穴位贴敷治疗,每日6:00,用生理盐水清理穴位,将药贴固定于神阙穴,每日1次,每次6 h。两组患者均持续治疗4个疗程,7 d为一个疗程。比较两组患者临床治疗总有效率、不良反应发生率、便秘症状积分、肛管运动功能、直肠肛管协调运动功能、直肠感觉功能等。结果1.观察组治疗总有效率93.3%,同期对照组治疗总有效率80%。观察组临床疗效优于对照组,差异有统计学意义(P0.05)。2.治疗后,观察组排便间隔时间(0.64±0.15)分,排便速度(1.23±0.78)分,排便性状(1.01 ±0.50)分,排便难度(0.92士0.35)分,便意(0-85±0.70)分。同期对照组排便间隔时间(1-15±0.13)分,排便速度(2.02±0.80)分,排便性状(1.75±0.48)分,排便难度(1.53±0.34)分,便意(1.51±0.67)分。观察组各指标均明显优于对照组,差异有统计学意义(P0.05)。3.治疗后,观察组 RP(65.38±1.52)mmHg,HPZ(4.47±0.32)cm,MSP(194.37±1.50)mmHg,DSS(14.10±1.25)s。同期对照组RP(61.20±1.45)mmHg,HPZ(4.22±0.30)cm,MSP(185.69±1.41)mmHg,DSS(12.65±1.24)s。观察组各指标均明显优于对照组,差异有统计学意义(P0.05)。4.治疗后,观察组IRP(35.79±1.11)mmHg,RAP(46.90±1.41)mmHg,ARR(33.85±1.3)%,RAPG(-11.44±1.33)mmHg。同期对照组 IRP(33.08±1.20)mmHg,RAP(53.33± 1.45)mmHg,ARR(29.48± 1.35)%,RAPG(—15.24± 1.26)mmHg。观察组各指标均明显优于对照组,差异有统计学意义(P0.05)。5.治疗后,观察组直肠初始感觉阈值(25.10±0.85)ml,直肠初始排便感觉阈值(52.10±1.35)ml,直肠最大耐受量(141.73±4.25)ml。同期对照组直肠初始感觉阈值(22.37±0.90)ml,直肠初始排便感觉阈值(46.48±1.32)ml,直肠最大耐受量(134.99±4.11)ml。观察组各指标均明显优于对照组,差异有统计学意义(P0.05)。结论1."子午流注"理论指导下大黄穴位贴敷治疗危重患者便秘效果更佳、安全性更高,可满足当前患者临床治疗需求。2.在缓解便秘症状、改善肛管运动功能、直肠肛管协调运动功能、直肠感觉功能方面,"子午流注"理论指导下大黄穴位贴敷取得的效果更加明显。3."子午流注"理论指导下大黄穴位贴敷治疗可作为临床治疗危重患者便秘的优选方案推广使用。
[Abstract]:Objective to explore the efficacy and safety of rhubarb acupoint application in the treatment of severe constipation under the guidance of "Meridian flow" theory. Then it provides a theoretical basis for popularizing and using the treatment scheme in clinical treatment, in order to provide more high-quality clinical medical services to critically ill patients and to bring their condition under control. To improve constipation symptoms in a short period of time. Methods 60 critically ill patients admitted to ICU in Laiwu traditional Chinese Medicine Hospital from March 2015 to March 2016 were selected. The control group was divided into control group (n = 30) and observation group (n = 30). The control group was treated with oral mosapride for 3 times / d. The observation group was treated with "meridian flow" theory under the guidance of "rhubarb" acupoint application. At 6: 00 daily, the acupoints were cleaned with normal saline, and the drug was fixed at Shenque point once a day for 6 hours. The patients in both groups were treated continuously for 4 courses and 7 days as a course of treatment. The total effective rate of clinical treatment and the incidence of adverse reactions were compared between the two groups. Results 1. The total effective rate of treatment in the observation group was 93.3, and the total effective rate in the control group was 80 percent. The clinical efficacy of the observation group was better than that of the control group, and the clinical efficacy of the observation group was better than that of the control group. After treatment, the defecation interval time was 0.64 卤0.15, the defecation rate was 1.23 卤0.78, the defecation character was 1.01 卤0.50, the defecation difficulty was 0.92 卤0.35), the mean defecation time was 1-15 卤0.13), the defecation velocity was 2.02 卤0.80). The score of defecation character was 1.75 卤0.48, the defecation difficulty was 1.53 卤0.34, the defecation meaning was 1.51 卤0.67). The indexes in the observation group were significantly better than those in the control group, and the difference was statistically significant (P0.05 .3.After the treatment, the RP(65.38 卤1.52 mm HgPZ4.47 卤0.32 cm ~ (-1) HgPZ) in the observation group was significantly higher than that in the control group (14.10 卤1.25 / s). In the same period, the control group's RP(61.20 卤1.45 mm HgHPZL 4.22 卤0.30mm HHPZL was significantly superior to the control group (P < 0.01 卤1.41 卤1.41 mm HgDSS 12.65 卤1.24s-1). After treatment, the IRP(35.79 of the observation group was 46.90 卤1.41 卤1.41 卤1.41 卤1.41 卤1.31 卤1.31 卤3.85 卤1.33 卤1.33 卤11.44 卤1.33 卤1.33 mm Hg / g respectively. After treatment, the IRP(33.08 卤1.20 mm IRP(33.08 of the observation group was 29.48 卤1.35 卤1.35 卤1.26 mm Hg.After the treatment, all the indexes in the observation group were significantly better than those in the control group (P 0.05. 5). In the observation group, the initial rectal sensory threshold was 25.10 卤0.85ml, the rectal initial defecation threshold was 52.10 卤1.35ml, the rectal maximum tolerance dose was 141.73 卤4.25ml. In the control group, the rectal initial sensory threshold was 22.37 卤0.90ml, the rectal initial defecation threshold was 46.48 卤1.32ml, and the maximum rectal tolerance dose was 134.99 卤4.11ml / ml. All of them were significantly superior to the control group. Conclusion 1. Under the guidance of "Meridian flow" theory, the application of rhubarb acupoint to treat severe constipation is more effective and safe, which can meet the current clinical treatment needs of patients with constipation. 2. In relieving constipation symptoms, Improve anal motor function, rectoanal coordination motor function, In rectal sensory function, under the guidance of "Meridian flow" theory, the effect of rhubarb acupoint application was more obvious. 3. Under the guidance of "Meridian flow" theory, rhubarb acupoint application therapy could be used as an excellent scheme for clinical treatment of constipation in critically ill patients.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R248.9

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