耳穴压豆与认知行为护理干预围手术期焦虑的中西医结合研究进展

Research Progress on Integrated Traditional Chinese and Western Medicine in Auricular Acupressure and Cognitive-Behavioral Nursing Intervention for Perioperative Anxiety

摘要: 围手术期焦虑是外科患者普遍存在的心理应激问题，发生率高、危害广泛，已成为围手术期管理的重要议题。耳穴压豆和认知行为护理作为具有代表性的非药物干预手段，近年来受到广泛关注。耳穴压豆以中医全息理论和经络学说为基础，通过刺激耳廓特定穴位(如神门、心、皮质下、交感等)，调节自主神经功能和HPA轴活性，发挥镇静安神之效的潜力；认知行为护理则以认知行为理论为指导，通过认知重建和行为激活帮助患者建立适应性应对模式，有助于缓解术前紧张情绪。本文从围手术期焦虑的流行病学、影响因素及其危害出发，系统梳理两种干预方式的理论基础与作用机制，综述各自在围手术期焦虑管理中的临床研究进展，并探讨中西医两种干预路径的优势互补与整合策略，以期为围手术期焦虑的综合护理实践提供参考。

Abstract: Perioperative anxiety is a prevalent psychological stress problem among surgical patients, characterized by high incidence and widespread adverse effects, and has become a critical issue in perioperative management. Auricular acupressure and cognitive-behavioral nursing, as representative non-pharmacological interventions, have drawn increasing attention in recent years. Auricular acupressure, grounded in the holographic theory and meridian doctrine of traditional Chinese medicine, exerts sedative and tranquilizing effects by stimulating specific auricular points (e.g., Shenmen, Heart, Subcortex, and Sympathetic) to regulate autonomic nervous function and the activity of the hypothalamic-pituitary-adrenal (HPA) axis. Cognitive-behavioral nursing, guided by cognitive-behavioral theory, helps patients establish adaptive coping patterns through cognitive restructuring and behavioral activation, thereby helping alleviate preoperative tension. Starting from the epidemiology, influencing factors, and hazards of perioperative anxiety, this paper systematically reviews the theoretical foundations and mechanisms of action of the two interventions, summarizes their respective clinical research progress in perioperative anxiety management, and explores the complementary advantages and integration strategies of these two approaches from the perspectives of Chinese and Western medicine, with the aim of providing a reference for comprehensive nursing practice for perioperative anxiety.