择时穴位贴敷联合热熨法对椎体融合术后患者胃肠功能的影响研究

doi:10.3761/j.issn.0254-1769.2026.18.003

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (18): 2469-2477.DOI: 10.3761/j.issn.0254-1769.2026.18.003

• 中医护理技术推广与应用 • 上一篇下一篇

择时穴位贴敷联合热熨法对椎体融合术后患者胃肠功能的影响研究

刘姝兰¹(), 蒋运兰², 康静², 张越², 周群¹^,^*()

¹ 成都中医药大学护理学院成都市 610075
² 成都中医药大学附属医院护理部成都市 610072

收稿日期:2025-12-03 出版日期:2026-09-20 发布日期:2026-09-23
*通讯作者: *周群，E-mail：zhouqun@cdutcm.edu.cn
作者简介:刘姝兰：女，硕士，护士，E-mail：2947459045@qq.com
第一联系人：作者贡献声明
刘姝兰：实施研究、撰写及修改论文；蒋运兰：研究设计、质量控制、技术支持；康静：实施研究、撰写论文；张越：资料收集、修改论文；周群：研究设计、统筹各项工作、论文审阅与修改、基金支持
基金资助:
四川省中医药管理局中医药科研专项课题面上项目(2021MS372)

Effect of acupoint application combined with hot compresses therapy based on midnight-noon ebb-flow of gastrointestinal function in patients after vertebral fusion surgery

LIU Shulan¹(), JIANG Yunlan², KANG Jing², ZHANG Yue², ZHOU Qun¹^,^*()

¹ College of Nursing， Chengdu University of Traditional Chinese Medicine， Chengdu 610075， China
² Nursing Department， Hospital of Chengdu University of Traditional Chinese Medicine， Chengdu 610072， China

Received:2025-12-03 Online:2026-09-20 Published:2026-09-23
* Corresponding author: *ZHOU Qun，E-mail：zhouqun@cdutcm.edu.cn
Funding program:
General Program of the Special Research Project on Traditional Chinese Medicine，Sichuan Provincial Administration of Traditional Chinese Medicine(2021MS372)

摘要/Abstract

摘要：

目的探讨子午流注择时穴位贴敷联合热熨法对退行性脊柱疾病患者椎体融合术后胃肠功能恢复的影响，为临床护理提供参考。方法采用便利抽样法，选取2023年3月至2024年6月在成都市某三级甲等医院骨科行椎体融合术的99例患者作为研究对象，并使用SPSS 27.0软件生成随机数字表，将患者随机分配至试验组、对照组1和对照组2，每组各33例。在术后常规护理基础上，试验组给予子午流注择时穴位贴敷联合热熨法，对照组1给予其他时辰穴位贴敷联合热熨法，对照组2给予子午流注择时安慰剂贴敷联合热熨法。干预7 d后，比较三组术后肠鸣音恢复时间、首次排气时间、首次排便时间、便秘症状自评量表总分及各维度得分、患者满意度的差异。结果 93例患者按要求完成试验。干预后，试验组肠鸣音恢复时间、首次排气时间、便秘症状自评量表总分、患者满意度均优于对照组1和对照组2（P<0.05）；试验组首次排便时间优于对照组2（P<0.05）；试验组便秘症状自评量表各维度得分均优于对照组2，其中，腹部症状维度和直肠症状维度评分优于对照组1（P<0.05）。结论子午流注择时穴位贴敷联合热熨法能有效促进椎体融合术后患者胃肠功能恢复，提高患者满意度。

关键词: 子午流注法, 穴位贴敷, 热熨法, 椎体融合术, 胃肠功能, 中医护理学

Abstract:

Objective To investigate the effect of acupoint application combined with hot compress therapy guided by the Midnight-Noon Ebb-Flow theory on the recovery of gastrointestinal function in patients with degenerative spinal diseases following spinal fusion，and to provide references for clinical nursing practice. Methods Using convenience sampling，99 patients undergoing spinal fusion in the orthopedics department of a tertiary hospital in Chengdu from March 2023 to June 2024 were enrolled. They were randomly assigned by a random number table generated with SPSS 27.0 into an experimental group，control group 1，and control group 2，with 33 cases in each group. All groups received routine postoperative care. The experimental group received acupoint application combined with hot compress therapy guided by the Midnight-Noon Ebb-Flow theory；control group 1 received acupoint application combined with hot compress therapy but at other times；control group 2 received a placebo acupoint application combined with hot compress therapy guided by the Midnight-Noon Ebb-Flow theory. After 7 days of intervention，bowel sound recovery time，time to first flatus，time to first defecation，total and subscale scores of the Patient Assessment of Constipation Symptoms（PAC-SYM），and patient satisfaction scores were compared among the 3 groups. Results Ultimately，93 patients completed the trial per protocol. Following the intervention，the experimental group demonstrated superior outcomes compared to both control group 1 and control group 2 in terms of time to bowel sound recovery，time to first flatus，PAC-SYM total score，and patient satisfaction（P<0.05）. The experimental group also achieved a shorter time to first bowel movement than control group 2（P<0.05）. The experimental group also demonstrated superior scores across all dimensions of the PAC-SYM scale compared to control group 2. Notably，scores for the abdominal symptoms dimension and rectal symptoms dimension were superior to those in control group 1（P<0.05）. Conclusion Guided by the Midnight-Noon Ebb-Flow theory，acupoint application combined with hot compress therapy can effectively promote gastrointestinal function recovery and enhance patient satisfaction following spinal fusion.

Key words: Midnight-Noon Ebb-Flow Acupoint Selection, Acupoint Application, Hot Compress, Spinal Fusion, Gastrointestinal Function, Traditional Chinese Medicine Nursing

刘姝兰, 蒋运兰, 康静, 张越, 周群. 择时穴位贴敷联合热熨法对椎体融合术后患者胃肠功能的影响研究[J]. 中华护理杂志, 2026, 61(18): 2469-2477.

LIU Shulan, JIANG Yunlan, KANG Jing, ZHANG Yue, ZHOU Qun. Effect of acupoint application combined with hot compresses therapy based on midnight-noon ebb-flow of gastrointestinal function in patients after vertebral fusion surgery[J]. Chinese Journal of Nursing, 2026, 61(18): 2469-2477.

图/表 4

表1 三组穴位贴敷联合热熨法的护理干预方案

Table 1 Nursing intervention protocol of acupoint application combined with hot compress therapy guided among 3 groups

表2 三组一般资料的比较

Table 2 Comparison of baseline characteristics among the 3 groups

表3 三组肠鸣音恢复时间、首次排气时间、首次排便时间的比较[h，M（P25，P75）]

Table 3 Comparison of time to bowel sound recovery， first flatus， and first defecation among the 3 groups[h，M（P25，P75）]

表4 三组便秘症状自评量表总分及各维度得分的比较[分，M（P25，P75）]

Table 4 Comparison of scores on PAC-SYM and its subscales among the 3 groups[score，M（P25，P75）]

参考文献 32

[1]	覃海兵, 李春蓉, 邹爱元, 等. 出院关键任务计划在腰椎椎间融合手术患者中的应用[J]. 中华现代护理杂志, 2021, 27(30):4139-4143.
	Qin HB, Li CR, Zou AY, et al. Application of discharge key task plan in patients undergoing lumbar intervertebral fusion surgery[J]. Chin J Mod Nurs, 2021, 27(30):4139-4143.
[2]	邹亚琪, 李大鹏, 曹文炳, 等. 单侧双通道内镜腰椎融合治疗腰椎退行性疾病[J]. 中国矫形外科杂志, 2025, 33(2):176-179.
	Zou YQ, Li DP, Cao WB, et al. Unilateral biportal endoscopic lumbar interbody fusion for lumbar degenerative diseases[J]. Orthop J China, 2025, 33(2):176-179.
[3]	马建华, 王庆雷, 毕靓, 等. 超声中频穴位导药技术对腰椎手术患者术后胃肠功能恢复作用的研究[J]. 中国医师进修杂志, 2023, 46(6):507-511.
	Ma JH, Wang QL, Bi L, et al. Study on the effect of ultrasound intermediate frequency acupoint drug guiding technology on the recovery of gastrointestinal function in patients undergoing lumbar spine surgery[J]. Chin J Postgrad Med, 2023, 46(6):507-511.
[4]	陶星燃, 鲁月, 平苹, 等. 经皮穴位电刺激对腰段脊柱手术患者术后胃肠功能的影响[J]. 中华麻醉学杂志, 2023, 43(9):1103-1107.
	Tao XR, Lu Y, Ping P, et al. Effect of transcutaneous electrical acupoint stimulation on postoperative gastrointestinal function in patients undergoing lumbar spinal surgery[J]. Chin J Anesthesiol, 2023, 43(9):1103-1107.
[5]	李偲, 刘克玄, 邓小明, 等. 术后胃肠功能障碍防治专家共识[J]. 国际麻醉学与复苏杂志, 2021, 42(11):1133-1142.
	Li S, Liu KX, Deng XM, et al. Expert consensus on prevention and treatment of postoperative gastrointestinal dysfunction[J]. Int J Anesthesiol Resusc, 2021, 42(11):1133-1142.
[6]	Bahk JH, Kim YH, Park HY, et al. Incidence and risk factors of gastrointestinal and hepatobiliary complications after spinal fusion surgery:a retrospective cohort study[J]. J Korean Med Sci, 2020, 35(40):e345. DOI URL
[7]	郑旭, 顾小萍, 王琛. 胸腰椎融合术患者术后胃肠功能障碍的危险因素分析[J]. 中华医学杂志, 2024, 104(3):186-191.
	Zheng X, Gu XP, Wang C. Analysis of risk factors for postoperative gastrointestinal disorders in patients undergoing thoracolumbar fusion[J]. Natl Med J China, 2024, 104(3):186-191.
[8]	薛建军, 徐紫清, 侯怀晶, 等. 中西医结合防治术后胃肠功能紊乱临床实践指南(2023版)[J]. 北京医学, 2024, 46(11):905-919.
	Xue JJ, Xu ZQ, Hou HJ, et al. Clinical practice guideline for prevention and treatment of postoperative gastrointestinal disorder with integrated traditional Chinese and Western medicine(2023 edition)[J]. Beijing Med J, 2024, 46(11):905-919.
[9]	曾海平, 曹立幸, 陈其城, 等. 中医药促进术后胃肠功能恢复研究进展[J]. 中国中西医结合杂志, 2022, 42(1):117-122.
	Zeng HP, Cao LX, Chen QC, et al. Research progress of tradi-tional Chinese medicine in promoting postoperative gastrointestinal function recovery[J]. Chin J Integr Tradit West Med, 2022, 42(1):117-122.
[10]	于王子. 中医药治疗腹部术后胃肠功能障碍研究进展[J]. 辽宁中医杂志, 2021, 48(9):218-220.
	Yu WZ. Research progress of traditional Chinese medicine in treatment of gastrointestinal dysfunction after abdominal surgery[J]. Liaoning J Tradit Chin Med, 2021, 48(9):218-220.
[11]	刘家豪, 黄凤. 中医时间医学研究综述[J]. 中华中医药杂志, 2022, 37(10):5880-5882.
	Liu JH, Huang F. Review of TCM time medicine research[J]. China J Tradit Chin Med Pharm, 2022, 37(10):5880-5882.
[12]	桂屏, 叶淑华, 谢玉英, 等. 子午流注择时穴位贴敷对妇科腹腔镜术后患者胃肠功能的影响[J]. 中华护理杂志, 2020, 55(9):1376-1380. DOI
	Gui P, Ye SH, Xie YY, et al. Effects of acupoint application therapy based on midnight-noon ebb-flow for gastrointestinal function in patients undergoing gynecological laparoscopy[J]. Chin J Nurs, 2020, 55(9):1376-1380. DOI
[13]	中华医学会. 临床诊疗指南-骨科分册[M]. 北京: 人民卫生出版社, 2009.
	Chinese Medical Association. Clinical diagnosis and treatment guide-orthopedics fascicle[M]. Beijing: People’s Medical Publishing House, 2009.
[14]	Slappendel R, Simpson K, Dubois D, et al. Validation of the PAC-SYM questionnaire for opioid-induced constipation in patients with chronic low back pain[J]. Eur J Pain, 2006, 10(3):209. DOI PMID
[15]	叶佳雪, 王诗源. 小承气汤给药途径与现代临床应用的研究进展[J]. 江西中医药, 2023, 54(9):76-80.
	Ye JX, Wang SY. Research progress on administration route and modern clinical application of Xiaochengqi decoction[J]. Jiangxi J Tradit Chin Med, 2023, 54(9):76-80.
[16]	齐琪, 张晴, 胡文均, 等. 小承气汤的古今文献分析[J]. 中国实验方剂学杂志, 2021, 27(15):115-123.
	Qi Q, Zhang Q, Hu WJ, et al. Textual research on ancient and modern literature of Xiao chengqitang[J]. Chin J Exp Tradit Med Formulae, 2021, 27(15):115-123.
[17]	郭凤琴, 位路其, 张锦聪, 等. 穴位按摩、穴位贴敷联合艾灸治疗产后尿潴留:随机对照试验[J]. 中国针灸, 2024, 44(7):803-806,844.
	Guo FQ, Wei LQ, Zhang JC, et al. Acupoint massage,acupoint sticking combined with moxibustion for postpartum urinary retention:a randomized controlled trial[J]. Chin Acupunct Moxibustion, 2024, 44(7):803-806,844.
[18]	林勇, 刘婧, 李佳. 时间针灸疗法对功能性胃肠病作用的研究进展[J]. 中华中医药杂志, 2021, 36(6):3478-3482.
	Lin Y, Liu J, Li J. Research progress on the effects of time acupuncture on functional gastrointestinal diseases[J]. China J Tradit Chin Med Pharm, 2021, 36(6):3478-3482.
[19]	惠宁军, 闫红霞, 辛彩虹. 吴茱萸烫熨结合艾灸脐部对下肢骨折患者术后胃肠功能恢复的影响[J]. 中医外治杂志, 2019, 28(5):26-27.
	Hui NJ, Yan HX, Xin CH. Effect of evodia rutaecarpa ironing combined with moxibustion on recovery of gastrointestinal function in patients with lower limb fracture after operation[J]. J Extern Ther Tradit Chin Med, 2019, 28(5):26-27.
[20]	胡国会, 赵辉, 周江红, 等. 行气消胀艾盐包热熨神阙联合穴位贴敷对胃癌术后胃肠功能恢复的疗效观察[J]. 甘肃医药, 2019, 38(8):710-712.
	Hu GH, Zhao H, Zhou JH, et al. Observation on the therapeutic effect of Xingqi anti-bloating ai-salt pack hot ironing Shenque combined with acupoint application on gastrointestinal function recovery after gastric cancer surgery[J]. Gansu Med J, 2019, 38(8):710-712.
[21]	胡天宏, 毛跃霞, 陈少华, 等. 气交灸结合腹部穴位按摩促进腰椎融合术后胃肠功能恢复的中医护理研究[J]. 军事护理, 2025, 42(7):28-31.
	Hu TH, Mao YX, Chen SH, et al. Effect of qijiao moxibustion combined with abdominal acupoint massage on promoting gastro-intestinal function after lumbar fusion surgery[J]. Mil Nurs, 2025, 42(7):28-31.
[22]	国家药典委员会. 中华人民共和国药典[M]. 北京: 中国医药科技出版社, 2022.
	Pharmacopoeia Commission of the People’s Republic of China. Pharmacopoeia of the People’s Republic of China[M]. Beijing: China Medical Science and Technology Press,2020.
[23]	游海心, 杨晓艳, 罗奕宇, 等. 基于量效关系从“中药-成分-靶点”探讨大黄、枳实和厚朴不同配比的疗效作用机制[J]. 中草药, 2024, 55(20):7021-7032.
	You HX, Yang XY, Luo YY, et al. Study on therapeutic mechanism of different ratios of Rhei Radix et Rhizoma,Aurantii Fructus Immaturus and Magnoliae Officinalis Cortex from “traditional Chinese medicine-component-target” based on dose-effect relationship[J]. Chin Tradit Herb Drugs, 2024, 55(20):7021-7032.
[24]	尹东阁, 杜豫吉, 孔佳辉, 等. 经典名方小承气汤对胃黏膜的保护作用及机制研究[J]. 中华中医药杂志, 2024, 39(5):2323-2329.
	Yin DG, Du YJ, Kong JH, et al. Study on the protective effect and mechanism of the classic formula Xiaochengqi Decoction on gastric mucosa[J]. China J Tradit Chin Med Pharm, 2024, 39(5):2323-2329.
[25]	王建斌, 余小勇, 吉涛. 加味小承气汤保留灌肠联合中药封包对急性低位肠梗阻患者肠屏障功能和血炎性因子的影响[J]. 辽宁中医杂志, 2024, 51(11):90-94.
	Wang JB, Yu XY, Ji T. Effects of modified Xiaochengqi decoction retention enema combined with TCM packaging on intestinal barrier function and serum inflammatory factors in patients with acute low intestinal obstruction[J]. Liaoning J Tradit Chin Med, 2024, 51(11):90-94.
[26]	朱千虑, 朱沥钰, 黄沐晗, 等. 基于数据挖掘技术探究穴位刺激改善结直肠癌术后胃肠功能选穴规律[J]. 中国中医药信息杂志, 2024, 31(4):65-71.
	Zhu QL, Zhu LY, Huang MH, et al. Exploration on acupoint selection law for acupoint stimulation to improve gastrointestinal function after colorectal cancer surgery based on data mining technology[J]. Chin J Inf Tradit Chin Med, 2024, 31(4):65-71.
[27]	田从豁, 彭冬青. 中国贴敷治疗学[M]. 3版. 北京: 中国中医药出版社, 2022.
	Tian CH, Peng DQ. China’s plaster therapy[M]. 3rd ed.. Beijing: China Press of Traditional Chinese Medicine, 2022.
[28]	姚斌莲, 徐敏, 毛小培, 等. 砭石中药热熨在造血干细胞移植患者预处理期胃肠道反应中的应用研究[J]. 中华护理杂志, 2025, 60(12):1420-1426. DOI
	Yao BL, Xu M, Mao XP, et al. Study on the effect of Bian-stone-based herbal heat therapy on gastrointestinal reactions during the preconditioning period of hematopoietic stem cell transplantation patients[J]. Chin J Nurs, 2025, 60(12):1420-1426. DOI
[29]	谢睿, 章启秀, 陈丽丽, 等. 择时芳香疗法联合平衡火罐对围绝经期失眠患者的干预效果研究[J]. 中华护理杂志, 2025, 60(21):2654-2661. DOI
	Xie R, Zhang QX, Chen LL, et al. Study on the effect of timing aromatherapy combined with balanced cupping on perimenopausal insomnia patients[J]. Chin J Nurs, 2025, 60(21):2654-2661. DOI
[30]	詹晴晴, 邵明义, 崔鸿雁, 等. 中医时间节律三级干预框架的构建及其在胃肠疾病精准治疗中的应用[J]. 中国中药杂志, 2025, 50(19):5323-5329.
	Zhan QQ, Shao MY, Cui HY, et al. Construction of a three-level intervention framework in traditional Chinese medicine(TCM) chronomedicine and its application in precision treatment of gastrointestinal diseases[J]. China J Chin Mater Med, 2025, 50(19):5323-5329.
[31]	魏腾腾, 杨旭光, 邓云鹏, 等. 基于数据挖掘探究术后胃肠功能紊乱选穴规律[J]. 上海针灸杂志, 2023, 42(9):976-983.
	Wei TT, Yang XG, Deng YP, et al. Based on data mining to explore the law of acupoint selection for postoperative gastrointestinal dysfunction[J]. Shanghai J Acupunct Moxibustion, 2023, 42(9):976-983.
[32]	Bishehsari F, Post Z, Swanson GR, et al. Circadian rhythms in gastroenterology:the biological clock’s impact on gut health[J]. Gastroenterology, 2025, 169(7):1380-1396. DOI URL

择时穴位贴敷联合热熨法对椎体融合术后患者胃肠功能的影响研究

Effect of acupoint application combined with hot compresses therapy based on midnight-noon ebb-flow of gastrointestinal function in patients after vertebral fusion surgery

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