耳部全息刮痧治疗急性缺血性脑卒中患者便秘的研究进展
Research Progress of Auricular Holographic Scraping in the Treatment of Constipation in Patients with Acute Ischemic Stroke
DOI: 10.12677/tcm.2026.154230, PDF,   
作者: 申佳烨, 李春梅*, 肖 越, 丁元凤, 陈换利：吉首大学医学院，湖南 吉首；李 萍：湘西土家族苗族自治州民族中医院科教科，湖南 吉首；唐 杨：湘西土家族苗族自治州民族中医院神经内科，湖南 吉首
关键词: 耳部全息刮痧；急性缺血性脑卒中；便秘；中医护理；脑肠轴；Auricular Holographic Scraping； Acute Ischemic Stroke； Constipation； Traditional Chinese Medicine Nursing； Brain-Gut Axis
摘要: 急性缺血性脑卒中(AIS)便秘是临床高发并发症，加剧患者痛苦，易诱发严重不良事件，影响康复预后。耳部全息刮痧是中医护理特色适宜技术，以中医全息理论、经络学说为指导，用铜砭刺激耳部脏腑反射区，可疏通经络、调理脏腑、通导腑气，在AIS便秘干预中优势独特。本文梳理其干预AIS便秘的理论基础、临床应用现状及中西医作用机制，剖析技术应用体系不成熟、机制研究不足、疗效评价与人才体系有短板、临床转化与推广机制不完善等问题，提出研究方向和发展策略。研究旨在为耳部全息刮痧在AIS便秘中的临床推广、科研创新及护理实践体系完善提供参考，助力AIS便秘中医护理干预的循证化、精准化与专业化发展。
Abstract: Constipation secondary to acute ischemic stroke (AIS) is a frequent clinical complication, which aggravates patients’ suffering, easily induces severe adverse events and impairs rehabilitation prognosis. Auricular holographic scraping is a characteristic appropriate technology of traditional Chinese medicine (TCM) nursing. Guided by TCM holographic theory and meridian theory, it stimulates the viscera reflex zones on the auricle with a copper bian-stone to dredge meridians and collaterals, regulate zang-fu organs and unblock fu-qi, presenting unique advantages in the intervention of constipation after AIS. This paper reviews the theoretical basis, clinical application status and mechanisms of integrated traditional Chinese and western medicine of auricular holographic scraping for AIS-related constipation, analyzes the existing problems including immature technical application system, insufficient mechanism research, deficiencies in efficacy evaluation and talent system, as well as imperfect clinical transformation and promotion mechanism, and puts forward corresponding research directions and development strategies. This study aims to provide references for the clinical promotion, scientific research innovation and improvement of nursing practice system of auricular holographic scraping in AIS-related constipation, and promote the evidence-based, precise and professional development of TCM nursing interventions for AIS complicated with constipation.
文章引用：申佳烨, 李春梅, 肖越, 丁元凤, 陈换利, 李萍, 唐杨. 耳部全息刮痧治疗急性缺血性脑卒中患者便秘的研究进展[J]. 中医学, 2026, 15(4): 445-451. https://doi.org/10.12677/tcm.2026.154230

参考文献

[1] Prust, M.L., Forman, R. and Ovbiagele, B. (2024) Addressing Disparities in the Global Epidemiology of Stroke. Nature Reviews Neurology, 20, 207-221. [Google Scholar] [CrossRef] [PubMed]
[2] Martin, S.S., Aday, A.W., Almarzooq, Z.I., Anderson, C.A.M., Arora, P., Avery, C.L., et al. (2024) 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data from the American Heart Association. Circulation, 149, e347-e913. [Google Scholar] [CrossRef] [PubMed]
[3] 国家神经疾病医学中心, 首都医科大学宣武医院. 中国神经系统疾病报告2024 [M]. 北京: 科学出版社, 2025.
[4] Han, I.J., Lee, J., Song, H., Baek, I., Choi, J., Chung, J., et al. (2023) Imaging and Clinical Predictors of Acute Constipation in Patients with Acute Ischemic Stroke. Frontiers in Neuroscience, 17, Article ID: 1263693. [Google Scholar] [CrossRef] [PubMed]
[5] 杨依, 陈晓红, 段彦哲, 等. 脑肠轴在缺血性脑卒中病理过程中的作用及机制研究进展[J]. 中国免疫学杂志, 2025, 41(12): 3030-3035.
[6] 杨宇, 钟代曲, 沈盈盈, 等. 急性脑卒中病人排便情况的影响因素分析[J]. 护理研究, 2018, 32(24): 3870-3874.
[7] 牛香茹. 耳部全息铜砭刮痧对中风后便秘患者的护理效果观察[D]: [硕士学位论文]. 哈尔滨: 黑龙江中医药大学, 2022.
[8] 谢宁, 张国霞. 中医学基础[M]. 第4版. 北京: 中国中医药出版社, 2016.
[9] 林丽, 沈万莉, 李彩立, 等. 基于“全息理论”的耳部铜砭刮痧干预在慢性期脑卒中患者失眠中的应用效果[J]. 中国社区医师, 2024, 40(27): 94-96.
[10] 张李博, 付夜平, 鞠宝兆. 《黄帝内经》“心开窍于耳”理论探析[J]. 辽宁中医药大学学报, 2024, 26(5): 47-51.
[11] 张颖清. 生物全息诊疗法[M]. 济南: 山东大学出版社, 1987.
[12] 刘帧, 陈勇, 陈泽林, 等. 基于中医经典和现代研究探析络脉理论基础及临床应用规律[J]. 中华中医药杂志, 2024, 39(11): 5719-5725.
[13] 刘凤选, 梅御寒, 刘芝修, 等. 耳部全息铜砭刮痧方法的临床应用[J]. 中国护理管理, 2019, 19(10): 1445-1448.
[14] 王鳕, 唐建清, 赵晔, 等. 李氏铜砭刮痧在奥沙利铂所致周围神经病变中的运用[J]. 中医药导报, 2021, 27(12): 188-190.
[15] 王羽乔琳, 秦元梅, 钟远, 等. 虎符铜砭刮痧疗法的作用机制及临床应用进展[J]. 光明中医, 2020, 35(21): 3475-3478.
[16] Arendsen, L.P., Thakar, R. and Sultan, A.H. (2019) The Use of Copper as an Antimicrobial Agent in Health Care, Including Obstetrics and Gynecology. Clinical Microbiology Reviews, 32, e00125. [Google Scholar] [CrossRef] [PubMed]
[17] Chen, J., Jiang, Y., Shi, H., Peng, Y., Fan, X. and Li, C. (2020) The Molecular Mechanisms of Copper Metabolism and Its Roles in Human Diseases. Pflügers Archiv-European Journal of Physiology, 472, 1415-1429. [Google Scholar] [CrossRef] [PubMed]
[18] 徐若馨, 蒋谷芬, 谢冰婵, 等. 基于全息论耳部刮痧治疗失眠效果的meta分析[J]. 中国医药科学, 2023, 13(23): 97-100.
[19] 王巧艳. 耳部全息铜砭刮痧在中风后便秘患者护理中的应用[J]. 中文科技期刊数据库(引文版)医药卫生, 2024(3): 195-199.
[20] 顾建丽, 杨蓓, 秦素萍. 耳部全息铜砭刮痧联合耳尖放血治疗脑卒中后肠道热结型便秘患者的效果观察[J]. 实用临床医药杂志, 2023, 27(2): 97-100.
[21] 张超, 潘平康, 王晓玲, 等. 清热通腑汤联合吞咽康复训练对急性缺血性脑卒中后真性球麻痹痰热腑实证患者吞咽功能康复的影响[J]. 世界中西医结合杂志, 2022, 17(8): 1644-1648.
[22] 邹彬, 顾青, 顾伟, 等. 刮痧疗法作用机制的实验研究进展[J]. 现代中西医结合杂志, 2020, 29(28): 3189-3192.
[23] 梁婵. 基于脑肠轴理论对比醒脑开窍针法与常规针刺法治疗脑卒中后便秘的临床疗效[D]: [硕士学位论文]. 长沙: 湖南中医药大学, 2023.
[24] Xiao, Q., Liu, T., Li, J. and Sun, Z. (2025) Auriculotherapy May Help to Reduce Gastrointestinal Reactions and Improve Quality of Life Post Chemotherapy. Explore, 21, Article ID: 103129. [Google Scholar] [CrossRef] [PubMed]
[25] Xu, Q., Yang, J., Zhu, B., Yang, L., Wang, Y. and Gao, X. (2012) The Effects of Scraping Therapy on Local Temperature and Blood Perfusion Volume in Healthy Subjects. Evidence-Based Complementary and Alternative Medicine, 2012, Article ID: 490292. [Google Scholar] [CrossRef] [PubMed]
[26] 姜荣荣, 杨涛, 徐桂华, 等. 基于计算机视觉的腰背痛患者痧象图片处理和分析研究[J]. 中华中医药学刊, 2024, 42(5): 13-16.
[27] 王群, 刘斌, 李奇林, 等. 甘油三酯葡萄糖指数及全身免疫性炎症指数与急性缺血性脑卒中的相关性[J]. 中国急救医学, 2025, 45(3): 211-217.
[28] 杨红艳, 朱彩红, 骆凌云, 等. 头部铜砭刮痧对脑卒中后轻中度认知功能障碍患者的干预研究[J]. 中国医药导报, 2024, 21(4): 153-156, 187.
[29] 国家卫生计生委办公厅国家中医药管理局办公室. 国家中医药管理局办公室、国家卫生计生委办公厅关于印发中医医疗技术相关性感染预防与控制指南(试行)的通知[EB/OL].
http://www.natcm.Gov.cn/bangongshi/zhengcewenjian/2018-03-24/838.html, 2024-05-24.
[30] Ren, Q., Yu, X., Liao, F., Chen, X., Yan, D., Nie, H., et al. (2018) Effects of Gua Sha Therapy on Perimenopausal Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Complementary Therapies in Clinical Practice, 31, 268-277. [Google Scholar] [CrossRef] [PubMed]
[31] 唐四元. 基于交叉融合的护理学学科发展思路[J]. 军事护理, 2022, 39(8): 1-2.
[32] 苏湘. 六字诀联合穴位点按预防急性期腰椎间盘突出症患者便秘的疗效研究[D]: [硕士学位论文]. 吉首: 吉首大学, 2025.
[33] 程雅琳, 钟叶萍. 基于中医治未病理论的预防管理对降低护理不良事件发生率的应用效果[J]. 中医药管理杂志, 2024, 32(14): 194-196.