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

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