脑卒中便秘患者中医护理干预效果Meta分析
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摘要
目的:评价中医护理对脑卒中便秘患者的干预效果。方法:通过计算机检索多个中英文数据库,搜索符合纳入及排除标准的随机对照实验,评价纳入的文献质量后,采用RevMan5.3进行数据分析。结果:共纳入10个随机对照实验,Meta分析结果显示:7项研究将有效率作为评价指标,中医护理干预组有效率明显高于对照组,合并效应具有统计学意义[OR=3.87,95%CI(2.43,6.17),P<0.01];5项研究将便秘发生率作为评价指标,中医护理干预组便秘发生率明显低于对照组,合并效应具有统计学意义[OR=0.23,95%CI(0.13,0.42),P<0.01];4项研究将护理满意度作为评价指标,其中有2项研究由于使用的护理满意度评估工具不同,无法提取数据后进行Meta分析,另2项研究进行Meta分析后显示中医护理干预组患者的护理满意度高于对照组,合并效应具有统计学意义[OR=8.63,CI(3.11,23.90),P<0.01]。结论:中医护理干预脑卒中便秘患者的临床疗效优于对照组。但由于纳入分析的研究较少,整体质量偏低,需要开展更多大样本、高质量的临床研究,来进一步证实中医护理干预对脑卒中便秘患者的疗效。
Objective: To evaluate the effect of TCM nursing intervention for post-stroke constipation. Methods: Randomized clinical trials(RCTs) that assessed the effect of TCM nursing intervention for post-stroke constipation were selected in multiple electronic databases. RevMan5.3 software was used to analyze the data after quality assessment, and data extraction were made for eligible RCTs. Results: A total of 10 RCTs were included. Meta-analysis results showed that 7 studies regarded efficiency as an evaluation index, and the effective rate of TCM nursing intervention group was significantly higher than that of control group [OR=3.87,95% CI(2.43,6.17), P<0.01].Five studies regarded the incidence of constipation as an evaluation index, and the incidence of constipation in TCM nursing intervention group was significantly lower than that in control group [OR=0.23,95%CI(0.13,0.42), P<0.01]. The 5 studies regarded nursing satisfaction as an evaluation index, and two of the studies were unable to extract data for meta-analysis because the different nursing satisfaction assessment tools were used. The other 2 studies conducted meta-analysis showed that the nursing satisfaction of TCM nursing intervention group was higher than that of the control group [OR=8.63,95%CI(3.11,23.90), P<0.01]. Conclusion: The effect of TCM nursing intervention for post-stroke constipation is better than that of the control group. However, due to fewer studies included in the analysis and the overall quality is low. The more large samples and high-quality clinical research are needed to further confirm the efficacy of TCM nursing intervention on stroke patients with constipation.
Objective: To evaluate the effect of TCM nursing intervention for post-stroke constipation. Methods: Randomized clinical trials(RCTs) that assessed the effect of TCM nursing intervention for post-stroke constipation were selected in multiple electronic databases. RevMan5.3 software was used to analyze the data after quality assessment, and data extraction were made for eligible RCTs. Results: A total of 10 RCTs were included. Meta-analysis results showed that 7 studies regarded efficiency as an evaluation index, and the effective rate of TCM nursing intervention group was significantly higher than that of control group [OR=3.87,95% CI(2.43,6.17), P<0.01].Five studies regarded the incidence of constipation as an evaluation index, and the incidence of constipation in TCM nursing intervention group was significantly lower than that in control group [OR=0.23,95%CI(0.13,0.42), P<0.01]. The 5 studies regarded nursing satisfaction as an evaluation index, and two of the studies were unable to extract data for meta-analysis because the different nursing satisfaction assessment tools were used. The other 2 studies conducted meta-analysis showed that the nursing satisfaction of TCM nursing intervention group was higher than that of the control group [OR=8.63,95%CI(3.11,23.90), P<0.01]. Conclusion: The effect of TCM nursing intervention for post-stroke constipation is better than that of the control group. However, due to fewer studies included in the analysis and the overall quality is low. The more large samples and high-quality clinical research are needed to further confirm the efficacy of TCM nursing intervention on stroke patients with constipation.
引文
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[13] 李颐红,常艳,张建霞,等.中医护理对脑卒中便秘患者的影响[J].医学与社会,2015,28(B06):293-294.
[14] 宋建琼,祁原婷,赵亚丽,等.中医护理在脑梗死恢复期便秘患者中的应用[J].云南中医中药杂志,2018,39(04),96-97.
[15] 吴志勤.脑卒中患者便秘原因分析及中医护理干预[J].光明中医,2015,30(2):386-387.
[16] 徐英,乌鲁玛.中医护理老年脑卒中的患者便秘效果分析[J].中国继续医学教育,2016,8(7):246-247.
[17] Jun-Qiang Zhao,Fen Zhou,Ying Sun,et al.Insights on the development of TCM nursing[J].International Journal of Nursing Sciences,2016,3(3):328-331.
[2] Li J,Yuan M,Liu Y,et al.Incidence of constipation in stroke patients:a systematic review and Meta-analysis[J].Medicine,2017,96:e7225.
[3]Camara-Lemarroy CR,Ibarra-Yruegas BE,Gongora-Rivera F.Gastrointestinal complications after ischemic stroke [J].Neurol Sci,2014,346:20–5.
[4] Wen J,Zhuang Z,Zhao M,et al.Treatment of poststroke constipation with moxibustion:A case report[J].Medicine,2018,97(24):e11134.
[5] 夏美艳,李晶超.系统化护理干预在预防脑卒中患者便秘的效果分析[J].中国药物经济学,2014,9(2):345-346.
[6] Hao Y,Liu H,Yue S,et al.Introducing traditional Chinese nursing:a review of concepts,theories and practices[J].Int Nurs Rev,2011,58(3):319e27.
[7] 赵春苗.中医护理干预对脑卒中合并便秘的临床疗效观察[J].河南中医,2014,(B11):22-23.
[8] 刘愿红.中医护理老年脑卒中患者便秘效果观察[J].临床医药文献电子杂志,2018,5(07):119-120.
[9] 陈照霞.中医护理老年脑卒中患者便秘效果观察[J].中国保健营养,2017,(4):44-45.
[10] 宋颖坤,王静.脑中风后便秘患者的中医护理方式与施行效果评估[J].中西医结合心血管病电子杂志,2018,6(13):106-107.
[11] 陈久红,冯宜霞.脑卒中患者便秘的原因分析及中医护理干预[J].中国社区医师,2014,30(34):137-138.
[12] 杨丽超,赖昕.中医护理对老年脑卒中患者便秘的效果分析[J].中国肛肠病杂志,2018,(1):42-43.
[13] 李颐红,常艳,张建霞,等.中医护理对脑卒中便秘患者的影响[J].医学与社会,2015,28(B06):293-294.
[14] 宋建琼,祁原婷,赵亚丽,等.中医护理在脑梗死恢复期便秘患者中的应用[J].云南中医中药杂志,2018,39(04),96-97.
[15] 吴志勤.脑卒中患者便秘原因分析及中医护理干预[J].光明中医,2015,30(2):386-387.
[16] 徐英,乌鲁玛.中医护理老年脑卒中的患者便秘效果分析[J].中国继续医学教育,2016,8(7):246-247.
[17] Jun-Qiang Zhao,Fen Zhou,Ying Sun,et al.Insights on the development of TCM nursing[J].International Journal of Nursing Sciences,2016,3(3):328-331.