Abstract:

Objective To investigate the effects of timed acupoint application based on the Meridian Flow Theory on nocturnal polyuria symptoms and autonomic nervous function in patients with Parkinson’s disease，aiming to provide evidence for Traditional Chinese Medicine（TCM） nursing interventions for nocturnal urinary frequency in Parkinson’s patients. Methods A pre-post self-control design in quasi-experimental research was employed，enrolling 89 Parkinson’s patients with nocturnal polyuria symptoms admitted to the neurology department of a tertiary A general hospital from October 2022 to September 2024. In addition to conventional treatment，patients received tailored nursing interventions based on TCM syndrome differentiation and the cyclical patterns of organ-meridian qi-blood flow during the 12 two-hour periods. Specifically，a self-developed herbal ointment was applied to the Shenque（CV8），Guanyuan（CV4），and bilateral Shenshu（BL23） acupoints during the Shen（3-5 PM） and You（5-7 PM） periods，when qi-blood flows through the Bladder and Kidney meridians，respectively. Each treatment course lasted 5 days，with 2 consecutive courses administered. Outcome measures included efficacy of nocturnal frequent urination，nocturia frequency，single void volume，post-void residual urine volume，International Consultation on Incontinence Questionnaire-Short Form （ICIQ-SF） scores，and Overactive Bladder Symptom Score（OABSS） before and after intervention. Results Among the 89 enrolled patients，3 withdrew due to local skin allergies，leaving 86 patients for final evaluation. The overall effective rate post-intervention was 68.60%. Significant improvements were observed in all measured parameters：nocturnal urinary frequency decreased from 4.00（3.75，6.00） to 3.00（2.00，4.00） times；single void volume increased from 100（80，150） mL to 150（100，200） mL；the residual urine volume in the bladder decreased from 69.0（23.8，127.5）mL to 39.0（26.5，73.0）mL，and the differences were statistically significant（P<0.001）；ICIQ-SF scores decreased from 7.0（4.0，10.0）score to 4.5（1.0，7.0）score；OABSS scores decreased from 9.0（8.0，11.0）score to 6.0（5.0，9.0）score. All changes were statistically significant（P<0.001）. Conclusion The timed acupoint application intervention based on the Meridian Flow Theory effectively alleviates nocturnal polyuria symptoms in Parkinson’s disease patients，to provide references for clinical practice in Traditional Chinese Medicine nursing.

Key words: Meridian Flow, Timing Selection, Acupoint Application, Parkinson’s Disease, Nocturnal Polyuria, Traditional Chinese Medicine Nursing

摘要：

目的 探讨基于子午流注理论择时穴位贴敷对帕金森病患者夜间尿频症状及膀胱过度活动症等的影响，旨在为帕金森病患者夜间尿频的中医护理干预提供依据。方法 采用类实验研究中自身前后对照设计，便利抽样选取2022年10月至2024年9月于北京市某三级甲等综合医院神经内科收治的89例帕金森病伴夜间尿频症状的患者为研究对象。在常规治疗基础上，根据中医辨证分型结合十二时辰中脏腑经络气血盛衰交替规律辨证施护，于申时、酉时气血依次流注于膀胱经、肾经期间贴敷自主研发组方的中药膏剂于神阙、关元、肾俞（双侧），每5 d为1个疗程，连续干预2个疗程。比较干预前后患者夜间尿频疗效、夜尿频次、单次夜尿量、膀胱残余尿量、国际尿失禁咨询委员会尿失禁问卷评分、膀胱过度活动症症状评分的差异。结果 初始纳入患者89例，3例出现局部皮肤过敏后脱落，最终纳入86例。干预后总有效率为68.60%。夜尿频次由4.00（3.75，6.00）次降低为3.00（2.00，4.00）次、单次夜尿量由100（80，150）mL增至150（100，200）mL，膀胱残余尿量由69.0（23.8，127.5）mL降为39.0（26.5，73.0）mL，差异均有统计学意义（P<0.001）。国际尿失禁咨询委员会尿失禁问卷评分从7.0（4.0，10.0）分降至4.5（1.0，7.0）分，膀胱过度活动症症状评分从9.0（8.0，11.0）分降至6.0（5.0，9.0）分，差异均有统计学意义（P<0.001）。结论 实施基于子午流注理论择时穴位贴敷干预方案能有效改善帕金森病患者的夜间尿频症状，为中医护理临床实践提供参考。

关键词: 子午流注, 择时, 穴位贴敷, 帕金森病, 夜间尿频, 中医护理学