Abstract:

Objective The study aimed at exploring the effect of time-selected auricular point pressing based on Ziwu Liuzhu theory on patients with dysphagia after anterior cervical surgery，which is important to provide clinical evidence for clinical intervention. Methods A total of 153 patients who underwent anterior cervical surgery in the department of orthopedics of a tertiary A general hospital in Zhejiang Province from January to November 2025 were included by convenience sampling，and randomly divided into 3 groups（n=51 per group） using SAS software. Routine auricular point pressing intervention on the basis of routine nursing care was performed in experimental group 1，while time-selected auricular point pressing intervention based on Ziwu Liuzhu theory was performed in experimental group 2. Participants in the control group received routine nursing care for cervical surgery. The differences in Water Swallowing Test grading，Numerical Rating Scale（NRS） score for swallowing pain，time to first intake of regular diet，and length of hospital stay were compared among the 3 groups on the 1st，3rd，5th，and 7th days after surgery. Results A total of 153 patients completed the study（n=51 per group）. Generalized estimating equations（GEE） analysis revealed that there were significant time-by-group interaction effects across the 3 outcomes of the Water Swallowing Test（normal，suspected dysphagia，and abnormal dysphagia） among the 3 groups of patients（Wald χ²_interaction=14.060，P=0.029；Wald χ²_interaction=16.869，P=0.032；Wald χ²_interaction=22.407，P=0.004）；repeated measures analysis of variance showed an interaction effect between time and group in swallowing pain among the 3 groups（F_interaction=9.526，P<0.001）. Simple effect analysis showed that the proportion of participants classified as having abnormal swallowing disorders in the Water Swallowing Test of experimental group 2 on the 3rd，5th，and 7th days after surgery were lower than experimental group 1 and the control group（all P<0.001）；the NRS scores of experimental group 2 on the 3rd，5th，and 7th days after surgery were lower than those of experimental group 1 and the control group（all P<0.001）. The time to first intake of regular diet in experimental group 2 was 17.00（14.00，23.00） h，shorter than 40.00（36.50，45.00） h in experimental group 1 and 66.60（50.30，72.00） h in the control group（P<0.001）. The length of hospital stay in experimental group 2 was 4.00（3.50，4.50） d，shorter than 6.00（5.50，6.50） d in experimental group 1 and 7.00（6.00，8.00） d in the control group（P<0.001）. Conclusion Time-selected auricular point pressing based on Ziwu Liuzhu theory can effectively improve swallowing function，alleviate swallowing pain，shorten the time to first intake of regular diet and length of hospital stay in patients after anterior cervical surgery. Its effect is superior to routine auricular point pressing and routine nursing care，making it a safe and effective postoperative rehabilitation nursing intervention.

Key words: Midnight-Noon Ebb-Flow Acupoint Selection, Auricular Acupressure with Seeds, Anterior Cervical Spine Surgery, Dysphagia, Traditional Chinese Medicine Nursing

摘要：

目的 探讨基于子午流注理论的择时耳穴贴压对颈椎前路手术后吞咽困难患者的影响，为临床干预提供循证依据。 方法 采用便利抽样法，选取2025年1—11月在浙江省某三级甲等综合医院骨科行颈椎前路手术患者153例作为研究对象，通过SAS软件随机分为3组，每组51例。试验组1在常规护理基础上实施常规耳穴贴压干预，试验组2在常规护理基础上实施基于子午流注理论的择时耳穴贴压干预，对照组实施颈椎手术常规护理。比较三组术后第1、3、5、7天的洼田饮水试验分级、吞咽疼痛数字评定量表评分，以及首次进食时间、住院时间的差异。 结果 153例全部完成研究。广义估计方程分析显示，三组洼田饮水试验分级在正常、可疑吞咽障碍及异常吞咽障碍3个结局上均存在时间与组间的交互效应（Wald χ²_交互=14.060，P=0.029；Wald χ²_交互=16.869，P=0.032；Wald χ²_交互=22.407，P=0.004）；重复测量方差分析显示，三组吞咽疼痛存在时间与组间的交互效应（F_交互=9.526，P<0.001）。简单效应分析显示，试验组2术后第3、5、7天洼田饮水试验分级为异常吞咽障碍的比例低于试验组1和对照组（均P<0.05）；试验组2术后第3、5、7天疼痛数字评定量表评分均低于试验组1和对照组（均P<0.001）。试验组2首次进食时间为17.00（14.00，23.00）h，短于试验组1的40.00（36.50，45.00）h和对照组的66.60（50.30，72.00）h（P<0.001）。试验组2的住院时间为4.00（3.50，4.50）d，短于试验组1的6.00（5.50，6.50）d和对照组的7.00（6.00，8.00）d（P<0.001）。 结论 实施基于子午流注理论的择时耳穴贴压能有效改善颈椎前路术后患者吞咽功能、缓解吞咽疼痛、缩短首次进食时间及住院时间，其效果优于常规耳穴贴压及常规护理，是一种安全、高效的术后康复护理干预措施。

关键词: 子午流注法, 耳穴贴压, 颈椎前路手术, 吞咽困难, 中医护理学