以系統性文獻回顧探討穴位按壓於便秘之應用

A Systematic Review of Acupressure in Constipation

背景：藥物治療或灌腸處置，是便祕常見的治療方式；此模式易致使便秘、腹瀉輪流交替且易有藥物交互作用之情況發生。目的：希冀藉由完整的文獻檢索、搜尋策略、批判、評價等步驟，歸納穴位按壓於便秘之臨床應用。方法：採系統性文獻回顧法，依Smyth(2002)年提出之系統性文獻查證九大步驟執行，針對以穴位按壓為主要應用的介入性研究，進行資料庫研究文章的搜尋、檢索，共篩選出七篇文章，納為本研究樣本。結果：本研究結果：(1)穴位按壓於便秘之臨床運用，可有效增加便意感、排氣次數及減輕腹脹；(2)常用穴位為足三里、天樞穴及合谷穴。(3)操作手法多採按揉法；每次按壓六至二十分鐘；按壓力道三公斤；持續三天至二週之操作模式。結論：便秘之穴位按壓具成效。穴位按壓操作模式建立，不僅有助於提昇臨床照護品質，並可發揮護理獨特功能。

Background: Drugs and enema are the common methods of treatment for constipation. However, they can easily result in alternating constipation and diarrhea. Moreover, drug interaction can easily happen. Purpose: To assess the role of acupressure in constipation in clinical practice through the process of complete literature search strategy, critique, appraisal, and evaluation. Method: Through systematic review of literature, this study utilized the nine explicit steps of systematic literature investigation of studies dealing with the application of acupressure by searching the database according to Smyth in 2002. A total of 7 papers were identified and included in the current study. Results: (1) Clinical utilization of acupressure results in increasing the sensation of defecation and the frequency of passing gas, as well as reducing abdominal distention. (2) The commonly used acupressure points include Zusanli, Tainshu and He Gu. (3) Acupressure should be operated through rubbing method, for 6 to 20 minutes each time, with pressure strength of 3 kg and continued for 3 days to 2 weeks. Conclusion: Acupressure is effective in relieving constipation. Developing a standard operating procedure in acupressure will not only elevate the quality of clinical nursing care, but will also express the unique function of nursing.