广州医科大学学报

目的：观察神阙穴贴敷疗法治疗人工膝关节置换术后便秘的临床疗效。方法：选取2020年1月至2022年12月广州市正骨医院接受人工膝关节置换术患者112例，随机分为对照组、治疗组。对照组采用常规便秘预防措施，术后膳食指导及腹部按摩；治疗组在上述基础上增加四黄散贴敷神阙穴。护理人员每日评估患者排便情况。记录两组患者术后便秘的发生率、术后首次排气的时间、术后首次排便时间、术后5天内的总排便次数、术后第7天Wexner评分，分析两组患者治疗效果。结果：术后患者首次排气时间：对照组（18.85±2.35）h，治疗组（16.67±1.63）h。术后首次排便时间：对照组（3.30±0.76）d，治疗组（1.42±0.59）d。5天内排便总次数：对照组（1.35±0.48）次，治疗组（2.50±0.53）次。两组患者治疗效果比较，其中显效：对照组3.57%，治疗组55.35%；有效：对照组91.07%，治疗组42.85%；无效：对照组5.35%，治疗组1.78%。术后第7天Wexner评分：对照组（9.46±3.03）分，治疗组（7.82±3.31）分。差异具有统计学意义。结论：四黄散神阙穴贴敷疗法治疗膝关节置换术后便秘操作简单无侵入性、安全、能有效预防便秘的发生，患者接受度高，适合在临床中推广应用。

Objective:To observe the clinical efficacy of Shenque Acupoint application therapy on constipation after total knee arthroplasty.Methods:112 patients who received total knee arthroplasty in Guangzhou Orthopedic Hospital from January 2020 to December 2022 were selected and randomly divided into control group and treatment group. The control group received routine preventive measures,including early functional exercise,rational diet and abdominal massage after operation. Shenque Acupoint application therapy with Sihuang powder was add in the treatment group. The nurse daily evaluated the patients' abdominal exhaust,defecation,Wexner score and cared for them until discharged. The first postoperative abdominal exhaust time,the the first postoperative defecation time,the total defecation times in 5 day afert surgery,and the wexner score in the 7th day after surgeru were recorded.Results:The first postoperative exhaust time was(18.85±2.35)h in the control group while(16.67±1.63)h in the treatment group. The first postoperative defecation time was 3.30±0.76 days in the control group while 1.42±0.59 days in the treatment group. The total defecation times in 5 day afert surgery was 1.35±0.48 times in the control group and 2.50±0.53 times in the treatment group. Compared the results of two group,3.57% of patients were excellent in the control group while 55.35% in the treatment group. 91.07% of patients were good in control group while 42.85% in treatment group;5% of the patients were noneffective in control group while 1.78% in treatment group;the wexner score in the7th day aftre surgery was 9.46±3.03 in treatment group while 7.82±3.31 in treatment group.Conclusion:The Shenque Acupoint application therapy with Sihuang powder treating constipation after total knee arthroplasty is simple,noninvasive and safe. It is effective,and suitable for clinical application.