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奉水华, 涂丽, 蔡喆燚, 刘康, 林奕, 文贞艳.耳部刮痧-放血-压豆序贯疗法干预老年功能性便秘肠道实热证患者的临床疗效观察[J].湖南中医药大学学报英文版,2026,46(8):1645-1651.[Click to copy
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| 耳部刮痧-放血-压豆序贯疗法干预老年功能性便秘肠道实热证患者的临床疗效观察 |
| 奉水华,涂丽,蔡喆燚,刘康,林奕,文贞艳 |
| (湖南中医药大学第一附属医院, 湖南 长沙 410007) |
| 摘要: |
| 目的 评价耳部刮痧-放血-压豆序贯疗法对老年功能性便秘（FC）肠道实热证患者的临床疗效。方法 选取2025年1月至2025年9月在湖南中医药大学第一附属医院肛肠科住院治疗的126例老年FC肠道实热证患者作为研究对象。采用类实验研究设计，依据收治病区对研究对象进行分组。其中，肛肠一病区收治的患者为对照组，肛肠二病区收治的患者为观察组，每组63例。对照组患者予以FC常规治疗联合专科护理干预，观察组患者在对照组的基础上，给予耳部刮痧-放血-压豆序贯疗法，两组疗程均为4周。治疗4周后，对比两组患者便秘患者症状自评量表（PAC-SYM）评分、便秘患者生活质量量表（PAC-QOL）评分及Bristol粪便形状量表（BSFS）评分；测定患者直肠肛管容量感觉阈值，包括直肠扩张时的初始感觉阈值（FSV）、初始排便阈值（DSV）和最大耐受阈值（MTV）；检测患者血清胃动素（MTL）、P物质、一氧化氮（NO）、丙二醛（MDA）和超氧化物歧化酶（SOD）水平；计算不良反应发生率以评估治疗安全性。结果 治疗后，两组患者PAC-SYM、PAC-QOL评分和直肠肛管容量感觉阈值FSV、DSV、MTV及血清NO、MDA水平均较治疗前降低（P＜0.05），且观察组低于对照组（P＜0.05）；BSFS评分及血清MTL、P物质、SOD水平均较治疗前升高（P＜0.05），且观察组高于对照组（P＜0.05）。治疗期间，两组患者均耐受性良好，未出现不良反应。结论 耳部刮痧-放血-压豆序贯疗法可缓解老年FC肠道实热证患者的临床症状，降低排便障碍程度，改善胃肠激素及氧化应激指标，提高患者生活质量。 |
| 关键词: 功能性便秘|肠道实热证|耳部刮痧|耳尖放血|耳穴压豆 |
| DOI：10.3969/j.issn.1674-070X.2026.08.015 |
| Received:June 10, 2026 |
| 基金项目:湖南省自然科学基金项目（2026JJ81470）；湖南省护理学会青苗计划资助项目（湘护会字〔2024〕184号）。 |
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| Clinical efficacy of sequential auricular scraping, bloodletting, and seed-pressing therapy in elderly functional constipation with intestinal excess heat pattern |
| FENG Shuihua, TU Li, CAI Zheyi, LIU Kang, LIN Yi, WEN Zhenyan |
| (The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| Objective To assess the clinical efficacy of sequential auricular scraping, bloodletting, and seed-pressing for elderly patients with functional constipation (FC) of intestinal excess-heat pattern. Methods A quasi-experimental study design was adopted. A total of 126 elderly patients with FC of intestinal excess heat pattern, hospitalized in the Department of Proctology at the First Hospital of Hunan University of Chinese Medicine from January 2025 to September 2025, were enrolled and assigned to two groups according to the wards to which they were admitted. Patients admitted to Ward 1 of the Department of Proctology served as the control group, and those admitted to Ward 2 served as the observation group, with 63 cases in each group. The control group received routine FC treatment combined with specialized nursing care, while the observation group received sequential auricular scraping, bloodletting, and seed-pressing therapy in addition to the control group regimen. The treatment course was four weeks for both groups. After four weeks of treatment, scores of the Patient Assessment of Constipation Symptoms (PAC-SYM), Patient Assessment of Constipation Quality of Life (PAC-QOL), and Bristol Stool Form Scale (BSFS) were compared between the two groups. Anorectal capacity sensory thresholds were measured, including the first sensation volume (FSV), defecating sensation volume (DSV), and maximum tolerated volume (MTV) during rectal distension. Serum levels of motilin (MTL), substance P, nitric oxide (NO), malondialdehyde (MDA), and superoxide dismutase (SOD) were measured. The incidence of adverse reactions was calculated to evaluate treatment safety. Results After treatment, the PAC-SYM and PAC-QOL scores, anorectal sensory thresholds (FSV, DSV, MTV), and serum levels of NO and MDA significantly decreased in both groups compared with baseline (P<0.05), with the observation group showing lower values than the control group (P<0.05). The BSFS scores, serum MTL, substance P, and SOD levels significantly increased in both groups compared with baseline (P<0.05), with the observation group showing higher values than the control group (P<0.05). During the treatment period, both groups tolerated the interventions well, and no adverse reactions were observed. Conclusion The sequential auricular scraping, bloodletting, and seed-pressing therapy can alleviate clinical symptoms, reduce the degree of defecation difficulty, regulate gastrointestinal hormones and makers of oxidative stress, and enhance the quality of life in elderly FC patients of the intestinal excess heat pattern. |
| Key words: functional constipation|intestinal excess heat pattern|ear scraping|ear tip bloodletting|auricular seed-pressing |
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