穴位贴敷联合穴位推揉干预老年慢性心力衰竭合并便秘疗效观察

目的 观察穴位贴敷联合穴位推揉对老年慢性心力衰竭合并便秘的疗效。方法 将90例老年慢性心力衰竭合并便秘患者随机分为对照组和观察组，每组45例。对照组采用常规护理措施，观察组在常规护理基础上给予大黄、木香粉贴敷神阙、双侧天枢穴，同时给予大肠经逆向穴位推揉。干预7 d后，观察两组患者Wexner评分、便秘患者生存质量量表(patient assessment of constipation-quality of life,PAC-QOL)评分、首次排便时间、平均排便间隔时间以及临床疗效。结果 与护理干预前比较，两组患者干预后Wexner、PAC-QOL评分均显著降低（P＜0.05）；观察组患者Wexner、PAC-QOL评分降低程度显著大于对照组（P＜0.05），首次排便时间和排便间隔时间较对照组显著缩短（P＜0.05）；观察组临床疗效显著优于对照组（P＜0.05）。结论 神阙、天枢穴贴敷大黄、木香粉联合大肠经逆向穴位推揉，可有效缓解慢性心力衰竭患者的便秘症状。

Efficacy of Acupoint Application Combined with Acupoint Massage in Treatment of Elderly Patients with Chronic Heart Failure and Constipation

A total of 90 elderly patients with chronic heart failure and constipation were randomly divided into control group and observation group, with 45 patients in each group. The patients in the control group received routine nursing, and those in the observation group received acupoint application with Rheum officinale and Saussurea costus powder at Shenque and Tianshu points at both sides combined with reverse acupoint massage along the large intestine meridian. After 7 days of intervention, the two groups were observed in terms of Wexner score, patient assessment of constipation quality of life questionnaire (PAC-QOL) score, time to first defecation, mean defecation interval, and clinical outcome. Results After treatment, both groups had significant reductions in Wexner and PAC-QOL scores (P<0.05), and the observation group had significantly greater reductions in these scores than the control group (P<0.05). Compared with the control group, the observation group had significantly shorter time to first defecation and mean defecation interval (P<0.05) and a significantly better clinical outcome (P<0.05). Conclusion Acupoint application with Rheum officinale and Saussurea costus powder at Shenque and Tianshu points combined with reverse acupoint massage along the large intestine meridian can effectively alleviate the symptoms of constipation in patients with chronic heart failure.