宋玉凡 李媛 邹愉龙

【摘要】 目的：观察卯时综合护理结合耳穴压籽法对脑卒中后便秘的疗效。方法：将60例脑卒中后便秘患者按随机数字表分成对照组和观察组，每组30例。对照组采用常规护理方法，观察组在对照组处理的基础上增加卯时综合护理结合耳穴压籽法进行干预，14 d为1个疗程。观察两组干预后便秘疗效，以及干预前后Bristol粪便性状评分、便秘评分表（CCS）。结果：干预14 d后观察组总有效率86.7%，高于对照组的76.7%，差异有统计学意义（P<0.05）;治疗后两组Bristol粪便评分、便秘评分（CSS）均有所改善（P<0.05），组间比较观察组改善优于对照组（P<0.05）。结论：卯时综合护理结合耳穴压籽法对脑卒中后便秘有良好的效果。

【关键词】 脑卒中 便秘 耳穴 卯时 综合护理

[Abstract] Objective： To observe the effect of Maoshi comprehensive nursing combined with auricular acupoint pressing on constipation after stroke. Method： Sixty patients with constipation after stroke were divided into the control group and the observation group according to the random number table， 30 cases in each group. The control group was given routine nursing method. The observation group was given Maoshi comprehensive nursing combined with auricular acupoint pressing on the basis of the control group. The 14 d was a course of treatment. The efficacy of constipation after intervention and the Brsitol fecal trait score and constipation scoring system （CCS） before and after intervention were observed. Result： After 14 days of intervention， the total effective rate of the observation group was 86.7%， which was higher than 76.7% of the control group （P<0.05）. After treatment， the scores of Bristol and CSS were improved in both groups （P<0.05）. The comparison between the groups， the observation were better than those of the control group （P<0.05）. Conclusion： The Maoshi comprehensive nursing combined with auricular acupoint pressing method has a good effect on constipation after stroke.

脑卒中已成为我国第一大死因的疾病[1]。便秘为脑卒中后的常见并发症之一，脑卒中后便秘总发生率为30%～60%[2]。便秘不仅严重影响患者的生活质量，而且会影响疾病的康复，增加脑卒中的复发率和死亡率。因此，保持大便通畅对于脑卒中的恢复至关重要。治疗便秘的口服药物众多，疗效不等，长期用药易使肠道功能紊乱产生依赖性，甚至造成严重不良反应。耳穴贴压籽为中医外治法，安全、无副作用，通过对耳穴的刺激，可达到促进肠道功能的效果。中医子午流注学说指出卯时大肠经气旺盛，在此时通过排便训练、按摩、饮水等手段可激发肠道的功能，促进排便，笔者所在科临床运用其治疗卒中后便秘的患者取得良好的效果，现报告如下。

1 资料与方法

1.1 一般资料

选取福建中医药大学附属康复医院脑病科2018年10月-2019年5月收治的60例脑卒中后便秘患者为研究对象。纳入标準：（1）选取符合脑卒中诊断标准中脑出血和脑梗死诊断的病例，且都经CT、MRI检查确诊;（2）年龄不超过80岁;（3）脑卒中后出现便秘，发病前无便秘;（4）意识清醒，无认知障碍，能够配合治疗。……