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Medicine

穴位应用联合穴位按摩治疗慢性阻塞性肺疾病患者便秘

Published: August 18, 2023
doi:
10.3791/64900
, , ,
1Department of Respiratory Medicine,Hospital of Chengdu University of Traditional Chinese Medicine

Summary

在这里，我们展示了穴位应用与穴位按摩相结合治疗慢性阻塞性肺疾病 （COPD） 患者便秘的方法。

Abstract

慢性阻塞性肺疾病（COPD）是老年患者常见且常见的疾病，有进行性加重的趋势。便秘会降低生活质量并引发疾病风险，是慢性阻塞性肺病患者的常见伴随症状。目前，西医治疗对患者来说并没有达到预期的效果。随之而来的是高复发率，而中医在治疗慢性病方面有着悠久的历史和丰富的经验。穴位敷和穴位按摩都是中医的特色疗法，副作用小，安全性高，操作简单，优点突出。它们可有效治疗慢性阻塞性肺病患者的便秘，被认为是慢性便秘患者的理想替代疗法。本文旨在介绍穴位应用结合穴位按摩治疗COPD患者便秘的方法，包括穴位选择、项目选择、治疗时间、操作流程等。

Introduction

慢性呼吸系统疾病是全球第三大死因，慢性阻塞性肺病是慢性呼吸系统疾病死亡的主要原因，给个人和社会带来沉重的负担1。中国是全球COPD患者数量最多的国家：约9900万，患病率为8.6%2。便秘是慢性阻塞性肺病患者的常见并发症，与高水平的多药治疗有关3。有证据表明，超过 39% 的 COPD 患者会出现便秘，且便秘与呼吸困难的严重程度、加重时间和 COPD 的并发症呈正相关4.高度怀疑便秘与慢性阻塞性肺疾病 （AECOPD） 急性加重有关。AECOPD 加速了 COPD 患者的疾病进展，是 COPD 患者死亡的主要原因5.因此，是时候关注COPD患者便秘的治疗了。

大多数患者自行控制便秘，主要使用饮食调整和泻药。研究表明，渗透性泻药通常是便秘患者的首选药物6.然而，使用药物有时不能有效改善便秘症状。它与不良反应或耐受性差有关。多达 50% 的便秘患者对他们目前的治疗结果不完全满意 7,8.因此，有必要寻找疗效好、安全性高的替代疗法。在慢性便秘的治疗中，穴位刺激疗法开始显示出一些优势9.在中医整体论、辨证论治的理念和经络穴位理论的指导下，通过刺激体表的特定穴位来治疗疾病10,11。穴位应用可使药物直接被局部皮肤吸收。它通过刺激穴位达到通路经络、调气和血的效果，从而改善便秘症状10。穴位按摩刺激骶神经，通过增加间质细胞数量来调节排便，并通过激活排便来控制节律性收缩或蠕动12.许多药理学和临床研究已经证实了草药（如大黄）在治疗便秘方面的明显功效13,14。本文介绍了穴位应用联合穴位按摩治疗慢性阻塞性肺疾病患者便秘的示范。

Protocol

该临床研究方案经成都中医药大学附属医院呼吸内科临床研究审批委员会审批（备案号.KY2022014）。 1、操作前的准备工作 项目准备：准备 大黄、生理盐水、碘伏特拭子、医用胶带、医用纱布、医用弯曲板、手部消毒液和医用橡胶手套（材料表）等物品。 使用超微粉碎机将100克 大 黄预先制成粉末，密封在塑料袋中?…

Representative Results

慢性阻塞性肺病患者根据 2023 年发布的“慢性阻塞性肺病全球倡议”进行诊断和治疗16.便秘的诊断标准参考中华医学会结直肠外科分会、中华医学会、中华医学会于2022年发布的《中国成人慢性便秘评估与管理临床实践指南》17.根据患者治疗前后完成的患者便秘症状评估 （PAC-SYM） 表格评估疗效18。选取成都中医药大学附属医院呼吸内科符合要?…

Discussion

老年人群是慢性阻塞性肺病的高危人群。老年人会出现不同程度的胃肠道衰退，而慢性阻塞性肺病患者的缺氧和活动减少会增加便秘的风险。此外，慢性阻塞性肺病患者容易产生紧张、焦虑、抑郁、抑郁、烦躁等负面心理情绪，可导致盆底肌张力增高，导致排便时直肠与管间矛盾运动，抑制肠道蠕动3,23。慢性阻塞性肺病属于中医“肺胀”的范畴。肺在?…

Disclosures

The authors have nothing to disclose.

Acknowledgements

感谢国家中医药临床卓越培养计划（国家中医药人教函〔2022〕1号）、成都中医药大学医院“百人计划”工程（院办〔2021〕42）、四川省中医药管理局科技攻关计划（2021MS093， 2021MS539、2023MS608）。

Materials

Chinese herbal decoction piece rhubarb Sichuan Guoqiang Chinese Medicine Decoction Pieces Co., Ltd 21120104
Gauze swab Shandong Angyang Medical Technology Co., Ltd 2022060201
Hand disinfectant Gamma Disinfection Products (Foshan) Co., Ltd. Sichuan Branch CNSQV3180322A
Iodine volts swab Zhejiang Baigar Health Technology Co., Ltd 20220301
Medical adhesive tape Minnesota Mining Manufacturing Medical Equipment (Shanghai) Co., Ltd 2105NF8
Medical bending plate Shanghai Medical Instrument (Group) Co., Ltd. Surgical Instrument Factory 181001
Medical rubber glove Shanghai Kebang Medical Latex Equipment Co., Ltd 2112019S
Normal saline Sichuan Kelun Pharmaceutical Co., Ltd N22061906
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Tags

Acupoint ApplicationAcupoint MassageConstipationChronic Obstructive Pulmonary Disease (COPD)Rheum Officinale BaillShenqueTianzhuAcupressureAbdominal Massage
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Yuan, F., Lu, F., Guo, Y., Zhang, C. Acupoint Application Combined with Acupoint Massage for Treating Constipation in a Patient with Chronic Obstructive Pulmonary Disease. J. Vis. Exp. (198), e64900, doi:10.3791/64900 (2023).
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