加味增液承氣湯足浴預(yù)防腎陰虧虛型經(jīng)尿道前列腺等離子切除術(shù)后患者便秘的臨床研究
發(fā)布時(shí)間：2018-10-31 14:16
【摘要】：[目的]本研究通過歸納總結(jié)經(jīng)尿道前列腺等離子切除術(shù)后患者發(fā)生便秘的常見證型,探索運(yùn)用中醫(yī)足浴的方法預(yù)防經(jīng)尿道前列腺等離子切除術(shù)后患者便秘的可行性,通過觀察術(shù)后患者首次排便時(shí)間,便秘癥狀評(píng)分結(jié)果,預(yù)防便秘有效率,常見中醫(yī)癥狀積分,舒適度及滿意度的結(jié)果確定療效。旨在為前列腺等離子切除術(shù)后患者尋找安全有效、耐受性好的促進(jìn)術(shù)后排便的輔助治療方法,同時(shí)推廣中藥足浴這項(xiàng)傳統(tǒng)中醫(yī)外治法技術(shù)。[方法]本研究通過回顧研究206例良性前列腺增生型經(jīng)尿道前列腺等離子切除術(shù)后患者發(fā)生便秘與中醫(yī)證型的關(guān)系,得出結(jié)論,腎陰虧虛型患者術(shù)后便秘發(fā)生率較高。根據(jù)隨機(jī)對(duì)照原則設(shè)計(jì),采用方便抽樣的方法,抽取江蘇省中醫(yī)院泌尿外科2013年12月-2014年9月90名行經(jīng)尿道前列腺等離子切除術(shù),中醫(yī)證屬腎陰虧虛型的患者,采用隨機(jī)方法將患者分為常規(guī)護(hù)理組、溫水足浴組和中藥足浴組。常規(guī)護(hù)理組按照術(shù)后一般護(hù)理常規(guī),內(nèi)容包括術(shù)后6小時(shí)進(jìn)食流質(zhì),保持膀胱沖洗通暢,排尿通暢,緩解疼痛、飲食宣教等；溫水足浴組在常規(guī)護(hù)理組基礎(chǔ)上在術(shù)后24h對(duì)患者采取溫水足浴,早晚各一次,共治療3天；中藥足浴組在常規(guī)護(hù)理組基礎(chǔ)上在術(shù)后24h對(duì)患者采取加味增液承氣湯足浴,早晚各一次,共治療3天。觀察患者術(shù)后首次排便時(shí)間、便秘癥狀評(píng)分、預(yù)防便秘有效率來確定中藥足浴對(duì)預(yù)防前列腺術(shù)后患者便秘的效果。采用中文SPSS15.0 for windows統(tǒng)計(jì)軟件對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析,計(jì)量數(shù)據(jù)采用均數(shù)±標(biāo)準(zhǔn)差描述。兩組對(duì)比分析,定性資料采用卡方檢驗(yàn),有序資料采用Ridit分析。定量資料符合正態(tài)分布用t檢驗(yàn),以P0.05作為有統(tǒng)計(jì)學(xué)意義,以P0.01作為有高度統(tǒng)計(jì)學(xué)意義。[結(jié)果]三組病例既往排便情況、手術(shù)持續(xù)時(shí)間、病情分期等方面比較差異無統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。通過在常規(guī)護(hù)理組常規(guī)護(hù)理方式基礎(chǔ)上分別采取溫水足浴和中藥足浴的方法,中藥足浴組術(shù)后首次排便時(shí)間(57.86±15.37h),明顯提前于常規(guī)護(hù)理組(67.78±15.30h)和溫水足浴組(68.10±9.06h)；三組術(shù)后24-48h便秘癥狀評(píng)分結(jié)果顯示,常規(guī)護(hù)理組5.70±1.62,溫水足浴組5.57±1.63,中藥足浴組4.68±1.19,術(shù)后48-72h便秘癥狀評(píng)分結(jié)果顯示,常規(guī)護(hù)理組4.87±1.78,溫水足浴組5.03±1.99,中藥足浴組2.68±0.81,中藥足浴組評(píng)分結(jié)果顯著低于常規(guī)護(hù)理組和溫水足浴組,中藥足浴組與常規(guī)護(hù)理組和溫水足浴組分別比較,具有統(tǒng)計(jì)學(xué)差異；三組預(yù)防便秘有效率結(jié)果顯示,常規(guī)護(hù)理組、溫水足浴組和中藥足浴組的總有效率分別為：53%,62%和90%,中藥足浴組與常規(guī)護(hù)理組和溫水足浴組相比,具有統(tǒng)計(jì)學(xué)差異。[結(jié)論]中藥足浴可促進(jìn)前列腺等離子切除術(shù)后患者排便；減少術(shù)后便秘發(fā)生率；改善腎陰虧虛型良性前列腺增生患者常見中醫(yī)癥狀,提高患者術(shù)后舒適度和滿意度。
[Abstract]:[objective] to summarize the common syndromes of constipation after transurethral prostatectomy (TURP), and to explore the feasibility of using traditional Chinese medicine (TCM) foot bath to prevent constipation after transurethral prostatectomy. The curative effect was determined by observing the first defecation time, the score of constipation symptom, the effective rate of preventing constipation, the score of common TCM symptoms, the degree of comfort and satisfaction. The aim of this paper is to find a safe, effective and tolerant method to promote postoperative defecation for patients after prostatectomy, and to promote the traditional Chinese medicine foot bath. [methods] the relationship between constipation and TCM syndromes in 206 patients with benign prostatic hyperplasia after transurethral prostatectomy was studied retrospectively. The conclusion is that the incidence of constipation is higher in patients with deficiency of kidney yin after operation. According to the principle of random control, 90 patients who underwent transurethral prostatectomy in urology department of Jiangsu Provincial Hospital of traditional Chinese Medicine from December 2013 to September 2014 were selected by the method of convenient sampling. Patients were randomly divided into routine nursing group, warm water foot bath group and traditional Chinese medicine foot bath group. Routine nursing group according to postoperative general nursing routine, including 6 hours after the operation, including eating fluid, bladder washing unobstructed, urination unobstructed, pain relief, diet education and so on; In the warm water foot bath group, the patients were treated with warm water foot bath 24 hours after operation on the basis of routine nursing. In the traditional Chinese medicine foot bath group, on the basis of routine nursing, the patients were treated with modified Zengye Chengqi decoction at 24 hours after operation, once in the morning and evening, and treated for 3 days. The first defecation time, constipation symptom score and effective rate of preventing constipation were observed to determine the effect of traditional Chinese medicine foot bath on the prevention of constipation after prostatic surgery. Chinese SPSS15.0 for windows statistical software was used to analyze the data, and the mean 鹵standard deviation was used to describe the measurement data. The qualitative data were analyzed by chi-square test and the ordered data were analyzed by Ridit. The quantitative data were consistent with normal distribution with t test, P0.05 as statistical significance, P0.01 as highly statistically significant. [results] there were no significant differences in the past defecation, operation duration and disease stages among the three groups (P0.05). The first defecation time of the traditional Chinese medicine foot bath group was (57.86 鹵15.37 h) after operation by adopting warm water foot bath and traditional Chinese medicine foot bath on the basis of routine nursing mode. Compared with routine nursing group (67.78 鹵15.30 h) and warm water foot bath group (68.10 鹵9.06 h); The scores of constipation symptoms in the three groups were 5.70 鹵1.62 in routine nursing group, 5.57 鹵1.63 in warm water foot bath group, 4.68 鹵1.19 in traditional Chinese medicine foot bath group. Routine nursing group (4.87 鹵1.78), warm water foot bath group (5.03 鹵1.99) and traditional Chinese medicine foot bath group (2.68 鹵0.81). The score of traditional Chinese medicine foot bath group was significantly lower than that of routine nursing group and warm water foot bath group. The traditional Chinese medicine foot bath group was compared with the routine nursing group and the warm water foot bath group, the difference was statistically significant. The effective rate of preventing constipation in the three groups showed that the total effective rates of routine nursing group, warm water foot bath group and traditional Chinese medicine foot bath group were 53% and 90%, respectively. There was statistical difference between the traditional Chinese medicine foot bath group and the routine nursing group and the warm water foot bath group. [conclusion] traditional Chinese medicine foot bath can promote the defecation of patients after prostatic plasma resection, reduce the incidence of constipation after operation, improve the common symptoms of traditional Chinese medicine in patients with benign prostatic hyperplasia with deficiency of kidney yin, and improve the postoperative comfort and satisfaction of the patients.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R473.6
[Abstract]:[objective] to summarize the common syndromes of constipation after transurethral prostatectomy (TURP), and to explore the feasibility of using traditional Chinese medicine (TCM) foot bath to prevent constipation after transurethral prostatectomy. The curative effect was determined by observing the first defecation time, the score of constipation symptom, the effective rate of preventing constipation, the score of common TCM symptoms, the degree of comfort and satisfaction. The aim of this paper is to find a safe, effective and tolerant method to promote postoperative defecation for patients after prostatectomy, and to promote the traditional Chinese medicine foot bath. [methods] the relationship between constipation and TCM syndromes in 206 patients with benign prostatic hyperplasia after transurethral prostatectomy was studied retrospectively. The conclusion is that the incidence of constipation is higher in patients with deficiency of kidney yin after operation. According to the principle of random control, 90 patients who underwent transurethral prostatectomy in urology department of Jiangsu Provincial Hospital of traditional Chinese Medicine from December 2013 to September 2014 were selected by the method of convenient sampling. Patients were randomly divided into routine nursing group, warm water foot bath group and traditional Chinese medicine foot bath group. Routine nursing group according to postoperative general nursing routine, including 6 hours after the operation, including eating fluid, bladder washing unobstructed, urination unobstructed, pain relief, diet education and so on; In the warm water foot bath group, the patients were treated with warm water foot bath 24 hours after operation on the basis of routine nursing. In the traditional Chinese medicine foot bath group, on the basis of routine nursing, the patients were treated with modified Zengye Chengqi decoction at 24 hours after operation, once in the morning and evening, and treated for 3 days. The first defecation time, constipation symptom score and effective rate of preventing constipation were observed to determine the effect of traditional Chinese medicine foot bath on the prevention of constipation after prostatic surgery. Chinese SPSS15.0 for windows statistical software was used to analyze the data, and the mean 鹵standard deviation was used to describe the measurement data. The qualitative data were analyzed by chi-square test and the ordered data were analyzed by Ridit. The quantitative data were consistent with normal distribution with t test, P0.05 as statistical significance, P0.01 as highly statistically significant. [results] there were no significant differences in the past defecation, operation duration and disease stages among the three groups (P0.05). The first defecation time of the traditional Chinese medicine foot bath group was (57.86 鹵15.37 h) after operation by adopting warm water foot bath and traditional Chinese medicine foot bath on the basis of routine nursing mode. Compared with routine nursing group (67.78 鹵15.30 h) and warm water foot bath group (68.10 鹵9.06 h); The scores of constipation symptoms in the three groups were 5.70 鹵1.62 in routine nursing group, 5.57 鹵1.63 in warm water foot bath group, 4.68 鹵1.19 in traditional Chinese medicine foot bath group. Routine nursing group (4.87 鹵1.78), warm water foot bath group (5.03 鹵1.99) and traditional Chinese medicine foot bath group (2.68 鹵0.81). The score of traditional Chinese medicine foot bath group was significantly lower than that of routine nursing group and warm water foot bath group. The traditional Chinese medicine foot bath group was compared with the routine nursing group and the warm water foot bath group, the difference was statistically significant. The effective rate of preventing constipation in the three groups showed that the total effective rates of routine nursing group, warm water foot bath group and traditional Chinese medicine foot bath group were 53% and 90%, respectively. There was statistical difference between the traditional Chinese medicine foot bath group and the routine nursing group and the warm water foot bath group. [conclusion] traditional Chinese medicine foot bath can promote the defecation of patients after prostatic plasma resection, reduce the incidence of constipation after operation, improve the common symptoms of traditional Chinese medicine in patients with benign prostatic hyperplasia with deficiency of kidney yin, and improve the postoperative comfort and satisfaction of the patients.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R473.6
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