情志疗法联合耳穴揿针在混合痔术后尿潴留中的应用

目的 探讨基于中医心神论的情志疗法联合耳穴揿针在混合痔术后尿潴留中的应用效果.方法 选择安徽医科大学第一附属医院中医科2019年6月至2020年11月行混合痔外剥内扎术的93例病人为研究对象,采用随机数字表法分成A组(对照组)、B组(耳穴揿针组)及C组(耳穴揿针+情志疗法组),三组各31例.A组接受混合痔术后常规治疗,B组在术后常规治疗的基础上接受耳穴揿针疗法,C组在术后常规治疗的基础上给予情志疗法联合耳穴揿针法.术后评估病人首次排尿时间、尿潴留发生率、临床疗效,并在24 h内评估病人生活质量指数.结果 三组的首次排尿时间分别是(178.21±94.61)min、(102.79±87.93)min和(68.71±38.23)min,尿潴留发生率分别为29.03％、22.58％和0％,术后生活质量得分分别为(4.11±1.26)分、(3.12±1.34)分和(2.19±0.70)分.三组在首次排尿时间(F=15.257,P<0.001)、尿潴留发生率(χ2=9.230,P=0.010)、中医的临床疗效(Z=22.630,P<0.001)及生活质量指数(F=20.714,P<0.001)方面的比较,均差异有统计学意义(P<0.05).C组和B组的首次排尿时间、临床疗效、生活质量明显优于A组(P<0.017),C组尿潴留发生率明显比A组低(P<0.017);C组在尿潴留发生率、临床疗效、生活质量指数方面明显优于B组(P<0.017),C组与B组首次排尿时间差异无统计学意义(P>0.05);B组与A组的尿潴留发生率差异无统计学意义(P>0.05).结论 基于中医心神论的情志疗法联合耳穴揿针能发挥中医思想理念的优势,在防治混合痔外剥内扎术后尿潴留方面有一定疗效,能够促进病人的术后康复,提高其生活质量.

Application of emotional therapy combined with auricular acupoint acupuncture in urinary retention after mixed hemorrhoid surgery

Objective To explore the effect of emotional therapy combined with auricular acupoint acupuncture in urinary retentionafter mixed hemorrhoid surgery based on the theory of heart spirit of traditional Chinese medicine(TCM).Methods A total of 93 patients who received Milligan-Morgan hemorrhoidectomy (MMH) were selected in the First Affiliated Hospital of Anhui Medical University from June 2019 to November 2020.They were randomly divided into group A(control group), group B (auricular acupoint acupuncture group) and group C(auricular acupoint acupuncture + emotional therapy group), with 31 cases in each of the three groups.Group Areceived routine treatment after mixed hemorrhoid surgery, group B received auricular acupoint acupuncture therapy on the basis of routine postoperative treatment, and group C received emotional therapy combined with auricular acupoint acupuncture therapy on the basis of routine postoperative treatment.Postoperative patients'' first urination time, incidence of urinary retention and clinical efficacywere evaluated, and their quality of life index was evaluated within 24 h.Results The first urination time was (178.21±94.61) min,(102.79±87.93) min and (68.71±38.23) min, the incidence of urinary retention was 29.03%, 22.58% and 0%, and the postoperativequality of life scores were (4.11±1.26) points, (3.12±1.34) points and (2.19±0.70) points, respectively.There were statistically significant differences among the three groups in time of first urinate (F = 15.257, P< 0.001), incidence of urine retention (X2=9.230,P= 0.010), The clinical curative effect of TCM (Z=22.630, P< 0.001) and quality of life index (F= 20.714, P< 0.001) (P<0.05).Group B andgroup C were significantly superior to group A in terms of time of first urination, clinical efficacy and quality of life index (P<0.017), and the incidence of urinary retention in group C was significantly lower than that in group A (P<0.017).Group C was significantly better than group B in the incidence of urinary retention, clinical efficacy and quality of life index (P<0.017), and there was no statistically significant difference in the time of first urination between group B and group C (P>0.05).There was no significant difference dence of urinary retention between group A and group B (P>0.05).Conclusion Emotional therapy based on theory of heart spirit of traditional Chinese medicine combined with auricular acupoint acupuncture can give full play to the advantages of TCM ideology, and hasa certain effect on prevention and treatment of urinary retention after external MMH,which can promote postoperative recovery and improve the quality of life of patients.