Abstract:

Objective Exploring the effect of Bian-stone-based herbal heat therapy on herbal heat ironing in gastrointestinal reactions during the preconditioning period of hematopoietic stem cell transplantation patients. Methods Convenience sampling method was used to select 68 cases of hematopoietic stem cell transplantation patients who attended the hematology department of a tertiary-level Chinese medicine hospital in Hangzhou from October 2023 to April 2024 as the study subjects，and the SPSS 26.0 statistical software was used to generate a random number for grouping into an experimental and a control group，with 34 cases in each group. On the basis of intravenous antiemetic medication and routine，the experimental group implemented the Bian-stone-based herbal heat therapy on the basis of intravenous antiemetic medication and conventional nursing care. In the control group，intravenous antiemetic drugs and routine care were used，and the intervention duration of both groups was 14 d，of which 7 d was a course of treatment，with a total of 2 courses of treatment. The incidence of gastroin-testinal reactions，Gastrointestinal Symptom Rating Scale（GSRS） score，Pepsin Ⅰ（PG Ⅰ），Pepsin Ⅱ（PG Ⅱ），and the ratio of PG Ⅰ to PG Ⅱ（PGR） before and after the intervention were compared between the 2 groups. Results The final sample of 66 cases was collected in this study，and 1 patient was dislodged from each of the control group and the experimental group. The comparison of the incidence of gastrointestinal reactions between the 2 groups within 14 days showed that the incidences of nausea，vomiting，abdominal distension，and diarrhea were lower in the experimental group than those in the control group（P<0.05）. GSRS scores on days 1，8，and 14 of intervention were compared，and there were effects between groups in both groups（F=5.338，P=0.017）. The levels of PG Ⅰ，PG Ⅱ in the experimental group on day 8 of the intervention were lower than those in the control group.The levels of PGR was higher than that in the control group（all P<0.05）.The safety of the 2 groups after treatment was evaluated，and the results showed that no serious adverse events occurred in the 2 groups. Conclusion Bian-stone-based herbal heat therapy can improve gastrointestinal reactions and reduce the incidence of gastrointestinal reactions during the preconditioning period of hematopoietic stem cell transplantation patients，which provides clinical guidance for the application of Bian-stone-based herbal heat therapy by nursing staff in the future.

Key words: Medicinal Ironing Therapy, Hematopoietic Stem Cell Transplantation, Gastrointestinal Tract, Traditional Chinese Medicine Nursing

摘要： 目的 探讨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效果。方法 采用便利抽样法，选取2023年10月—2024年4月在杭州市某三级甲等中医医院血液科住院的造血干细胞移植患者68例作为研究对象，采用SPSS 26.0软件产生随机数进行分组，分为试验组和对照组，各34例，试验组在静脉止吐用药和常规护理的基础上实施砭石中药热熨；对照组采用静脉止吐用药和常规护理，两组干预时长均为14 d，其中7 d为1个疗程，共2个疗程。比较两组干预前后胃肠道反应发生率、胃肠道症状评定量表（Gastrointestinal Symptom Rating Scale，GSRS）评分、胃蛋白酶原Ⅰ、胃蛋白酶原Ⅱ、胃蛋白酶原Ⅰ/胃蛋白酶原Ⅱ的变化。结果 最终纳入患者66例，对照组及试验组各脱落1例。干预14 d内，试验组恶心、呕吐、腹胀、腹泻症状发生率低于对照组（P<0.05）；干预第1、8、14天，两组GSRS评分存在时间和组间的交互效应（F_交互=5.338，P_交互=0.017）；干预第8天，试验组的胃蛋白酶原Ⅰ、胃蛋白酶原Ⅱ低于对照组，胃蛋白酶原Ⅰ/胃蛋白酶原Ⅱ高于对照组（均P<0.05）。两组治疗过程中，均无严重不良事件发生。结论 砭石中药热熨能改善造血干细胞移植患者预处理期胃肠道症状，降低胃肠道反应发生率，为护士应用砭石中药热熨技术提供临床指导。

关键词: 药熨疗法, 造血干细胞移植, 胃肠道, 中医护理学