循经温通刮痧联合艾灸在脑卒中后压疮患者中的应用

陶晓虹; 樊莉; 胡叶明

doi:10.16766/j.cnki.issn.1674-4152.003809

循经温通刮痧联合艾灸在脑卒中后压疮患者中的应用

doi: 10.16766/j.cnki.issn.1674-4152.003809

浙江省立同德医院护理部，浙江杭州 310012

基金项目:

浙江省中医药科技计划项目 2023ZL306

详细信息

通讯作者:
胡叶明，E-mail：13600539586@163.com

中图分类号: R743.3 R244.4
计量
- 文章访问数: 16
- HTML全文浏览量: 9
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2024-05-19
- 网络出版日期: 2025-01-20

Application of meridian warming and scraping therapy combined with moxibustion in patients with pressure sore after stroke

Department of Nursing, Zhejiang Provincial Tongde Hospital, Hangzhou, Zhejiang 310012, China

摘要

摘要: 目的探讨循经温通刮痧联合艾灸在脑卒中后压疮患者中的应用效果，为临床中医防治压疮提供理论依据。方法选择2022年3月—2024年3月在浙江省立同德医院就诊的脑卒中后压疮患者91例，采用随机数字表法分为对照组(45例)和中医组(46例)，均给予常规护理，对照组采用水胶体敷料外敷，中医组在对照组基础上给予循经温通刮痧联合艾灸干预，持续2周。比较2组压力性损伤愈合量表(PUSH)和疼痛(VAS)评分、肉芽组织出现及创面愈合时间、创面血流灌注量、肿瘤坏死因子-α(TNF-α)和血管内皮生长因子(VEGF)水平。结果中医组干预后PUSH评分为(2.81±0.55)分，VAS评分为(1.67±0.43)分，均低于对照组的(5.63±1.24)分、(2.58±0.88)分(P＜0.05)。中医组肉芽组织出现时间[(4.09±1.27)d]、创面愈合时间[(19.28±4.10)d]均短于对照组[(6.12±1.34)d、(24.34±3.18)d, P＜0.05]，创面血流灌注量多于对照组(P＜0.05)；TNF-α低于对照组，VEGF水平高于对照组(P＜0.05)。结论循经温通刮痧联合艾灸可缓解脑卒中后压疮患者创面疼痛，加快创面愈合，其作用机制可能与增加创面局部血流灌注量，调节TNF-α和VEGF水平有关。
- 脑卒中 /
- 压疮 /
- 中医适宜技术 /
- 刮痧 /
- 艾灸 /
- 创面愈合时间
Abstract: Objective Exploring the application effect of meridian warming and scraping therapy combined with moxibustion in patients with post-stroke pressure ulcers, aiming to provide a theoretical basis for the clinical prevention and treatment of pressure ulcers in traditional Chinese medicine (TCM). Methods A total of 91 patients with post-stroke pressure ulcers treated in Zhejiang Provincial Tongde Hospital from March 2022 to March 2024 were selected and divided into a control group (45 cases) and a traditional Chinese medicine group (46 cases) by random number table method, both of which were given routine care. The control group was given hydrocolloid dressing for external application, and the traditional Chinese medicine group was given the combined intervention of meridian warming and scraping therapy combined with moxibustion on the basis of the control group for 2 weeks. The scores of stress wound healing scale (PUSH) and pain VAS, granulation and wound healing time, wound blood perfusion volume, tumor necrosis factor-α (TNF-α), and vascular endothelial growth factor (VEGF) levels were compared between the two groups. Results The PUSH scores and VAS scores of the TCM group were (2.81±0.55) points and (1.67±0.43) points, both lower than those of the control group (5.63±1.24) points and (2.58±0.88) points (P < 0.05). The occurrence time of granulation tissue (4.09±1.27) d and wound healing time (19.28±4.10) d were shorter than those of the control group [(6.12±1.34) d and (24.34±3.18) d, P < 0.05]. The blood perfusion volume of wound was higher than that of the control group (P < 0.05). The level of TNF-α was lower than that of the control group (P < 0.05), and the level of VEGF was higher than that of the control group (P < 0.05). Conclusion Meridian warming and scraping therapy combined with moxibustion can relieve wound pain and accelerate wound healing in patients with pressure ulcers after stroke, and its mechanism may be related to accelerating local blood perfusion and regulating the levels of TNF-α and VEGF.
- Stroke /
- Pressure sores /
- Appropriate technology of traditional Chinese medicine /
- Scraping therapy /
- Moxibustion /
- Wound healing time

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表 1 2组脑卒中后压疮患者一般资料比较

Table 1. Comparison of general data between the two groups of patients with post-stroke pressure ulcer

组别	例数	性别 (男/女，例)	年龄 (x±s, 岁)	BMI (x±s)	脑卒中病程 (x±s, d)	压疮面积 (x±s, cm²)	Ⅱ/Ⅲ期压疮 (例)	NRS2002营养评分(x±s，分)	白蛋白 (x±s, g/L)
对照组	45	25/20	60.09±6.77	22.09±2.34	43.12±7.23	35.23±7.45	21/24	5.45±0.56	30.23±4.12
中医组	46	22/24	60.14±8.24	21.88±3.56	40.88±8.65	35.56±6.44	19/27	5.37±0.77	30.19±5.57
统计量		0.544^a	0.032^b	0.332^b	1.337^b	0.226^b	0.266^a	0.566^b	0.039^b
P值		0.461	0.975	0.741	0.184	0.822	0.606	0.573	0.969
注：^a为χ²值，^b为t值。

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表 2 2组脑卒中后压疮患者干预前后PUSH评分比较(x±s，分)

Table 2. Comparison of PUSH scores between the two groups of patients with post-stroke pressure ulcer before and after intervention (x±s, points)

组别	例数	组织类型		24 h渗出量		压力损伤面积		总分
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
对照组	45	3.11±0.45	1.45±0.47^b	1.88±0.36	1.30±0.27^b	5.10±1.14	2.88±0.76^b	10.09±2.67	5.63±1.24^b
中医组	46	2.98±0.67	0.91±0.23^b	1.90±0.56	0.56±0.14^b	5.02±1.26	1.34±0.47^b	9.90±2.45	2.81±0.55^b
统计量		1.084^a	15.675^c	0.202^a	20.091^c	0.317^a	16.347^c	0.354^a	19.431^c
P值		0.281	＜0.001	0.840	＜0.001	0.752	＜0.001	0.724	＜0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP＜0.05。

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表 3 2组脑卒中后压疮患者干预前后VAS评分比较(x±s，分)

Table 3. Comparison of VAS scores between the two groups of patients with post-stroke pressure ulcer before and after intervention (x±s, points)

组别	例数	干预前	干预后
对照组	45	6.34±1.32	2.58±0.88^b
中医组	46	6.17±1.78	1.67±0.43^b
统计量		0.517^a	17.231^c
P值		0.607	＜0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP＜0.05。

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表 4 2组脑卒中后压疮患者肉芽组织出现及创面愈合时间、创面血流灌注量比较(x±s)

Table 4. Comparison of granulation tissue appearance, wound healing time, and wound blood perfusion between the two groups of patients with post-stroke pressure ulcer (x±s)

组别	例数	肉芽组织出现时间(d)	创面愈合时间(d)	创面血流灌注量(PU)
组别	例数	肉芽组织出现时间(d)	创面愈合时间(d)	干预前	干预后
对照组	45	6.12±1.34	24.34±3.18	2.45±0.67	3.06±0.72^b
中医组	46	4.09±1.27	19.28±4.10	2.33±0.95	3.88±0.51^b
统计量		7.419^a	6.569^a	0.695^a	15.671^c
P值		＜0.001	＜0.001	0.489	＜0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP＜0.05。

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表 5 2组脑卒中后压疮患者干预前后TNF-α和VEGF水平比较(x±s)

Table 5. Comparison of TNF-α and VEGF levels between the two groups of patients with post-stroke pressure ulcer before and after intervention (x±s)

组别	例数	TNF-α(ng/L)		VEGF(pg/mL)
组别	例数	干预前	干预后	干预前	干预后
对照组	45	40.09±8.23	33.68±8.05^b	279.98±20.45	350.01±27.45^b
中医组	46	40.47±7.09	23.45±5.27^b	281.02±30.47	399.67±21.33^b
统计量		0.236^a	19.093^c	0.191^a	24.371^c
P值		0.814	＜0.001	0.849	＜0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP＜0.05。

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