腹部穴位刺激對改善護理之家老人便秘之先導試驗

A Pilot Study on the Effect of Abdominal Acustimulation on Constipation for Older Persons in a Nursing Home

葉麗雪(Li-Hsueh Yeh)

指導教授 ： 曾月霞

中山醫學大學/醫學院/醫學研究所/碩士(2006年)

https://doi.org/10.6834/CSMU.2006.00073

摘要

便秘是長期照護機構常見的老年住民的健康問題。臨床上治療便秘的處置包括藥物及非藥物治療，然而藥物治療不但增加老人生理負擔，也會有藥物間的交互作用產生，而以灌腸侵入性方式之治療，不僅造成老人不舒適感，也會造成大腸穿孔等嚴重傷害，因此宜考慮非藥物之治療方式。中醫療法中的穴位刺激是一種非侵入性、非藥物的便秘治療方式，故本研究應用穴位刺激的原理，以德國辣椒標膏藥敷貼於腹部穴位來測試對改善老人便秘的成效。本研究目的為：(1). 探討護理之家便秘老人，其便秘之不適症狀；(2). 確認護理之家便秘老人在接受腹部穴位刺激之措施介入後，其便秘改善情形。本研究採類實驗研究設計，使用面對面問卷調查法進行資料收集。使用工具包括「Bristol糞便性質量表」及「病人自評便秘症狀量表」。採方便取樣，以台中市一所護理之家之老年住民為研究對象，共收案17人。以SPSS10.0軟體進行統計分析，統計方法包括描述性統計、Wilcoxon signed rank test。統計分析結果顯示有88.2%（n=15）的便秘老人需要很用力擠壓才能解出來。以需要很用力擠壓才能解出來（M=2.18, SD= 1.29）以及與有便意但是解不出來（M= 2.18, SD= 1.33）的情形為最嚴重的不適症狀，腹部穴位刺激可以改善護理之家老人排便之不適症狀（z=-3.30, p= .001），排便次數在使用後也有增加的情形（0.53 vs 0.80）。本研究結果可提供穴位刺激處理老人便秘非藥物方法之實證依據。

關鍵字

腹部穴位刺激 ； 辣椒膏 ； 便秘 ； 老人

並列摘要

Constipation is a common health problem for older adults residing in long-term care facilities. Treatments of constipation include pharmacological and nonpharmacological therapies. Pharmacological therapies, however, increase physical burdens and induce the medication interaction. Use of enema may cause uncomfort and the trauma of colon perforation. Therefore, non-pharmacological therapy may be suggested for older persons with onstipation.
Acustimulation, one of Chinese traditional medicine therapies, is a noninvasive and non-pharmacological therapy for constipation. Thus, the researcher used capsicum plaster on abdominal acupuncture points based on the theory of acustimulation to test the effect on constipation. The purposes of this study were to (1) describe the symptom of constipation in order adults, (2) identify effects of applying capsicum plaster to abdominal acupuncture points on constipation. A quasi-experimental research design was used. Data were collected by face to face interview using structure questionnaires including 〝Bristol Stool Form Scale〞and〝Patient Assessment of Constipation-The Symptom Questionnaire〞. Convenient sampling was used to obtain subjects. Seventeen older adults in a nursing home in Taichung participated in this study. Descriptive analysis and Wilcoxon signed rank test were used for statistic analysis. Results of statistic analysis revealed that 88.2% (n=15) of elders with constipation need to strain or squeeze to pass bowel movement.〝Straining or squeezing to try to pass bowel movement〞(M= 2.18, SD= 1.29) and〝feeling you had to pass bowel movement but you couldn’t (false alarm)〞(M= 2.18, SD= 1.33) were the most uncomfortable symptoms. Frequency of bowel movement ( 0.53 vs 0.80 )and uncomfortable symptoms associated with constipation ( z=-3.30, p= .001 ) were improved after the use of abdominal acustimulation. The finding of this study can provide evidence base for use of abdominal acustimulation to manager constipation problem in order persons.

並列關鍵字

abdominal acustimulation ； capsicum plaster ； constipation ； order person

參考文獻

王煌輝、李榮貴（1997）．六磨湯治療慢性機能性便秘之研究．中醫藥雜誌，8 （2），65－72。

林世瑜、莊榮彬（1998）．便秘及其處理．安寧療護雜誌，8，26－30。

張莉琴、戴玉慈、翁昭旼（2001）．住院老人便秘之危險因素．臺灣醫學，5（6），607－614。

楊俊仁、黃富源（1996）．慢性便秘和大便失禁．當代醫學，23（3），211－215。

廖崇成、王熙閔、吳美娟（2005）．敷貼辣椒膏對於長期臥床病患便秘改善之先導性研究．中西整合醫學雜誌，6（2），54-55。