本文選題：低頻脈沖 + 穴位刺激��； 參考：《福建中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的通過(guò)低頻脈沖穴位刺激對(duì)糖尿病便秘患者進(jìn)行進(jìn)行為期兩周的干預(yù),旨在探究低頻脈沖穴位刺激對(duì)糖尿病便秘患者的首次排便時(shí)間、腸鳴音次數(shù)、血漿NO值、便秘癥狀積分的變化、便秘療效、不良反應(yīng)及隨訪后便秘的復(fù)發(fā)情況的影響,以期為臨床更有效地應(yīng)用低頻脈沖穴位刺激治療糖尿病便秘提供依據(jù)。方法以2015年3月～2015年10月期間入住某三級(jí)甲等醫(yī)院內(nèi)分泌科的糖尿病便秘患者為主要研究對(duì)象,采用隨機(jī)數(shù)字表法將符合納入和排除標(biāo)準(zhǔn)的74例患者隨機(jī)分為試驗(yàn)組37例和對(duì)照組37例。對(duì)照組在基礎(chǔ)治療與護(hù)理的基礎(chǔ)上給予便秘的常規(guī)治療；試驗(yàn)組在對(duì)照組的基礎(chǔ)上給予低頻脈沖穴位刺激。每日一次,每次30min,干預(yù)兩周,隨訪兩周。記錄兩組患者干預(yù)前后首次排便時(shí)間、腸鳴音次數(shù)、血清NO值、便秘癥狀積分、不良反應(yīng)及隨訪兩周后便秘復(fù)發(fā)情況。結(jié)果1.基線比較試驗(yàn)前兩組患者一般情況(年齡、性別、病程、用藥情況、空腹血糖值、糖化血紅蛋白值等),評(píng)價(jià)指標(biāo)基線情況(首次排便時(shí)間、腸鳴音次數(shù)、NO值、中醫(yī)癥狀積分)比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。2.首次排便時(shí)間兩組患者的首次排便時(shí)間比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。3.腸鳴音次數(shù)試驗(yàn)結(jié)束后,兩組患者腸鳴音次數(shù)與自身試驗(yàn)前比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；試驗(yàn)組與對(duì)照組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。4.血清NO值試驗(yàn)結(jié)束后,兩組患者血清NO值與自身試驗(yàn)前比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；兩組間比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。5.便秘癥狀積分試驗(yàn)1周后,試驗(yàn)組便秘各項(xiàng)癥狀積分與試驗(yàn)前比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05)；對(duì)照組便秘各項(xiàng)癥狀積分與試驗(yàn)前比較,除排便性狀差異有統(tǒng)計(jì)學(xué)意義(P0.05)外其他均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；試驗(yàn)組與對(duì)照組比較,排便時(shí)間和排便性狀差異有統(tǒng)計(jì)學(xué)意義(P0.05),其他差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。試驗(yàn)2周后,試驗(yàn)組各單項(xiàng)癥狀積分與試驗(yàn)前比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05),對(duì)照組各單項(xiàng)癥狀積分與試驗(yàn)前比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)；試驗(yàn)組與對(duì)照組比較,除便意和兼證差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)外,其他單項(xiàng)癥狀積分比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。6.便秘療效試驗(yàn)2周后,試驗(yàn)組痊愈5例,顯效9例,有效15例,無(wú)效5例,總有效率為85.29%；對(duì)照組痊愈2例,顯效5例,有效13例,無(wú)效15例,總有效率57.15%；兩組患者有效率比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。7.不良反應(yīng)情況試驗(yàn)2周后,試驗(yàn)組不良反應(yīng)發(fā)生率為2.94%,低于對(duì)照組的14.29%,兩組不良反應(yīng)發(fā)生情況比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),即低頻脈沖穴位刺激不會(huì)增加患者的不良反應(yīng)的發(fā)生。8.復(fù)發(fā)情況試驗(yàn)結(jié)束兩周后,試驗(yàn)組有5例復(fù)發(fā)便秘,復(fù)發(fā)率為17.24%；對(duì)照組有12例復(fù)發(fā),復(fù)發(fā)率為60%,高于試驗(yàn)組,且兩組患者復(fù)發(fā)率比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),說(shuō)明低頻脈沖穴位刺激較對(duì)照組有更好的遠(yuǎn)期效果。結(jié)論低頻脈沖穴位電刺激能有效改善糖尿病便秘患者的便秘情況,且不會(huì)增加患者的不良反應(yīng)發(fā)生率,同時(shí)具有一定的遠(yuǎn)期效果,因此,低頻脈沖穴位刺激是改善糖尿病便秘患者便秘效果的簡(jiǎn)便、有效的護(hù)理方法。
[Abstract]:Objective to investigate the effect of low frequency pulse acupoint stimulation on the patients with diabetes constipation for two weeks. The aim is to explore the effect of low frequency pulse acupoint stimulation on the time of first defecation, the number of bowel sounds, the change of the NO value of plasma, the integral of constipation symptoms, the effect of constipation, the adverse reaction and the recurrence of constipation after follow-up. In order to provide the basis for the treatment of diabetic constipation more effectively with low frequency pulse acupoint stimulation (LF pulse acupoint stimulation). Methods the patients with diabetes constipation in the Department of endocrinology of a three grade class a hospital from March 2015 to October 2015 were used as the main research object. The randomized digital table method was used to randomly divide the patients with the inclusion and exclusion criteria into the patients. 37 cases in the experimental group and 37 cases in the control group. The control group was given the routine treatment of constipation on the basis of basic treatment and nursing. The experimental group was given low frequency pulse acupoint stimulation on the basis of the control group. Once a day, 30min, intervention for two weeks, followed up for two weeks. The first defecation time, the number of bowel sounds, and the serum NO value of the two groups were recorded. Constipation symptom score, adverse reaction and recurrence of constipation after two weeks of follow-up. Results 1. baseline comparison between the two groups of patients (age, sex, course of disease, medication, fasting blood sugar, glycosylated hemoglobin), the baseline of the evaluation index (the first defecation time, the number of bowel sounds, NO value, TCM symptom score), the difference, the difference, the difference, the difference, the difference, the difference, the difference, the difference Statistical significance (P0.05), compared with the first defecation time of.2. for the first defecation time of the two groups, the difference was statistically significant (P0.05) after the end of the.3. bowel sound frequency test, the number of bowel sounds in the two groups was compared with that before the test, the difference was statistically significant (P0.05), and the difference was statistically significant compared with the control group. After the P0.05.4. serum NO test, the serum NO value of the two groups was compared with that before the test, the difference was statistically significant (P0.05); the difference between the two groups was statistically significant (P0.05) after 1 weeks of the.5. constipation symptom integral test, the difference of the constipation symptom score of the experimental group was statistically significant (P0.05) and the comparison before the test (P0.05). The symptom scores of constipation were compared with those before the test. There was no statistical significance (P0.05) except for the difference of defecation characters (P0.05). Compared with the control group, there were significant differences in defecation time and defecation characteristics (P0.05), and there was no significant difference in other differences (P0.05). After 2 weeks of trial, the individual symptoms of the experimental group were different. The difference was statistically significant (P0.05) compared with that before the test, and the difference in the score of single symptom in the control group was statistically significant (P0.05) compared with that before the test (P0.05). In comparison with the control group, there was no statistical significance (P0.05) of the difference in the scores of other single symptoms (P0.05) compared with the control group (P0.05). After 2 weeks of constipation test, the test group recovered 5 cases, effective 9 cases, effective 15 cases, invalid 5 cases, the total effective rate was 85.29%, the control group cured 2 cases, 5 cases, effective 13 cases, 15 cases, total effective rate 57.15%. The difference has statistical significance (P0.05).7. adverse reaction test after 2 weeks, adverse reaction occurred in the experimental group. The rate was 2.94%, lower than 14.29% of the control group. There was no significant difference in the occurrence of adverse reactions between the two groups (P0.05), that is, the low frequency pulse acupoint stimulation did not increase the adverse reaction of the patients with the occurrence of.8. recurrence test after two weeks, 5 cases in the experimental group had recurrent constipation, the recurrence rate was 17.24%, 12 cases in the control group had relapse and the recurrence rate was 6. 0%, higher than the test group, and the recurrence rate of the two groups, the difference is statistically significant (P0.05), indicating that low frequency pulse acupoint stimulation has a better long-term effect than the control group. Conclusion low frequency pulse acupoint electrical stimulation can effectively improve the constipation of patients with diabetic constipation, and will not increase the incidence of adverse reactions in patients, at the same time it has a certain extent. Therefore, low frequency pulse acupoint stimulation is a simple and effective nursing method to improve constipation effect in diabetic constipation patients.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R248.1

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