目的 探讨大黄穴位贴联合直肠指力刺激在脑卒中后便秘患者的应用效果。方法 本研究选择2019年1月—2019年12月间我院收治的脑卒中后便秘患者90例,随机分成A组(大黄穴位贴组),B组(直肠指力刺激组),C组(大黄穴位贴联合直肠指力刺激组)三组,每组30例。记录三组患者便秘治疗有效率,采用Wexner便秘评分系统评估三组患者治疗前后的便秘程度并进行自身前后对比。结果 三组干预前后Wexner评分采用自身配对非参数秩和检验,差异有统计学意义(P＜0.05)。三组干预前后差值采用Kruskal-Wallis H检验结果差异有统计学意义(H=26.211,P＜0.05),经过两两对比,差异有统计学意义(P＜0.05)。值得注意的是,干预后C组Wexner评分下降。干预后C组患者的有效率高于其他两组,有效率结果为C组(90%)＞B组(80%)＞A组(53.5%),差异有统计学意义(P＜0.05)。结论 相较于单一应用大黄穴位贴或直肠指力刺激,大黄穴位贴联合直肠指力刺激治疗效果更好,可有效降低便秘发生率,提高病人生活质量。

Objective To explore the effect of rhubarb acupoint application combined with rectal finger force stimulation in patients with constipation after stroke. Methods In this study, 90 patients with post-stroke constipation admitted to our hospital from January 2019 to December 2019 were randomly divided into group A (rhubarb acupoint application group), group B (rectal finger force stimulation group) and group C (rhubarb acupoint application combined with rectal finger force stimulation group), 30 cases in each group. The effective rates of constipation treatment in the three groups were recorded, and the Wexner constipation scoring system was used to evaluate the degree of constipation before and after treatment among three groups. Results The Wexner scores of the three groups before and after treatment were analyzed by self-paired non-parametric rank sum test, and the differences were statistically significant (all P<0.05). The difference among the three groups before and after treatment using Kruskal-Wallis H test was statistically significant (H=26.211, P<0.05), and after pairwise comparison, the differences were statistically significant (P<0.05). It was worth noting that the Wexner score of group C dropped significantly after treatment. The effective rate of treatment in group C was significantly higher that those in the other two groups. The result showed effective rate of group C (90%)＞ group B (80%)＞group A (53.5%), the difference was statistically significant (P<0.05). Conclusion Compared with the single treatment of rhubarb acupoint application or rectal finger force stimulation, the combined treatment had better efficacy, which reduced incidence of constipation and improved the quality of life of patients.

目的 观察应用济川煎加减结合贴穴治疗帕金森病患者便秘的临床疗效。方法 选取帕金森病合并便秘患者64例,随机分为对照组和观察组,各32例。入选患者均进行帕金森病常规治疗,对照组服用莫沙必利;观察组在对照组治疗基础上加服济川煎加减,并选穴敷贴。疗程结束后对两组患者便秘改善程度、生活活动能力、中医证候积分等项目进行比较。结果 观察组患者便秘改善程度、生活活动能力、中医证候改善均优于对照组,两者比较差异有统计学意义(P<0.05)。结论 应用济川煎加减结合贴穴能有效治疗帕金森病患者便秘,并对帕金森病其他症状有正向调节作用,能提高该类患者生存质量。

Objective To investigate the clinical effect of Jichuanjian decoction and acupoint application on the treatment of constipation in Parkinson's disease. Methods 64 patients with constipation in Parkinson's disease were randomly divided into two groups. 32 patients were treated with Mosapride in control group. 32 patients were treated with Jichuanjian decoction and acupoint application in treatment group.The clinical effects were compared in the two groups. Results The clinical effects of the treatment group were better and the differences were statistical significance (P<0.05). Conclusion The treatment of constipation in Parkinson's disease with Jichuanjian decoction and acupoint application had a significant effect.

目的 运用网络药理学方法预测生白术活性成分、作用靶点及生物学意义,探讨其防治便秘的作用机制,并结合导师临床应用取得的疗效进行进一步的验证。方法 借助TCMSP在线数据库查找白术的药效成份并选择其生物利用度(OB)>30%且类药性(DL)>0.18的化合物,并查询每种成分所对应的靶标。通过Gene Cards、OMIM共2个疾病相关靶点的数据库检索便秘相关靶点信息。将二者靶基因相映射获得交集靶点。借助 cytoscape 3.7.1 软件对查询结果进行可视化。所得到的基因通过相互作用数据库(STRING)进行相互作用蛋白查询并构建蛋白质相互作用(PPI)网络。使用R语言对关键靶点行GO和KEGG富集分析,以构建“成分-靶点-信号通路”的网络。结果 共得到白术人源靶蛋白7个,便秘相关的人源基因2 859个。发现其主要通过干预PGR、CHRM3、CHRM1、ACHE、CHRM2五个基因并参与胆碱能突触、钙信号通路、肌动蛋白细胞骨架的调控、神经活性配体-受体相互作用、cAMP信号通路、PI3K-AKT信号通路共6条信号通路以达到防治便秘的效果。结论 应用网络药理学方法分析预测得到重用生白术防治便秘的潜在药效成分、作用靶点及其信号通路,为临床应用提供了理论依据。

Objective To predict the active ingredients, targets and biological significance of Atractylodes macrocephala by network pharmacology, to explore the mechanism of its prevention and treatment of constipation, and to further verify its efficacy in combination with the clinical application of tutors. Methods The constituents of Atractylodes macrocephala were searched by TCMSP database and the compounds with bioavailability (OB) > 30% and drug-like property (DL) > 0.18 were screened, and the corresponding targets of each constituent were queried. Constipation-related target information was retrieved from two disease-related target databases of GeneCards and OMIM, mapping the two target genes to obtain intersecting targets, by visualization of query results with cytoscape 3.7.1. The resulting genes were queried by the interaction database (STRING) and the protein interaction (PPI) network was constructed. GO and KEGG enrichment analysis of key targets was carried out by R language in order to construct the network of “component-target-signal pathway”. Results Seven human target proteins and 2 859 constipation related human genes were obtained from Atractylodes macrocephala. It was found that the effect of prevention and treatment of constipation was mainly achieved by interfering with five genes of PGR, CHRM3, CHRM1, ACHE and CHRM2 and participating in six signaling pathways: cholinergic synapse, calcium signaling pathway, regulation of actin cytoskeleton, neuroactive ligand-receptor interaction, cAMP signaling pathway and PI3K-AKT signaling pathway. Conclusion The potential pharmacodynamic components, targets and signaling pathways of reuse Rhizoma atractylodis macrocephalae in the prevention and treatment of constipation can be predicted by network pharmacological method, which provides a theoretical basis for clinical application.

目的 探讨健康教育路径联合集束化护理模式在预防脑卒中患者便秘的效果观察。方法 随机选择神经外科收治的脑卒中患者120例,分为实验组与对照组,各60例,其中对照组给予常规护理,而实验组在常规护理基础上应用健康教育路径联合集束化护理模式。比较两组患者便秘发生率、便秘措施落实率、患者满意度、及患者入院前后的健康教育知识知晓率的比较。结果 实验组便秘发生率明显低于对照组,便秘护理评估率,护理措施落实率,病人满意度明显高于观察组,患者入院后的健康教育知识知晓率明显升高(P<0.05),具有统计学意义。结论 健康教育路径联合集束化护理模式能有效的降低脑卒中患者便秘发生率,提高预防便秘发生护理措施落实率,提高患者满意度,提高患者舒适度。

目的 探讨品管圈活动在提高神经外科卧床患者便秘预防措施落实率中的的应用效果。方法 成立品管圈,确定以“提高神经外科卧床患者便秘预防措施落实率”为主题,进行现状调查,设定目标,进行要因分析,制定并实施措施,比较品管圈活动前后护士落实便秘预防措施情况。结果 实施品管圈活动后,神经外科卧床患者便秘预防措施落实率从活动前的41.59%上升至活动后85.6%,差异有统计学意义(P＜0.05)。结论 品管圈活动可以有效提高神经外科卧床患者便秘预防措施落实率,降低便秘的发生率,减轻患者痛苦,改善患者生活质量。