中医辨证护理干预慢性萎缩性胃炎临床护理体会

Clinical Nursing Experience of Traditional Chinese Medicine Syndrome Differentiation Nursing in the Intervention of Chronic Atrophic Gastritis

摘要: 目的：总结中医辨证护理模式应用于慢性萎缩性胃炎患者的临床实践经验，探讨中医特色护理对改善患者消化道不适、提升自我管理能力的实际价值。方法：选取本院消化内科收治的慢性萎缩性胃炎患者为观察对象，基于中医四诊结果区分证型，从情志疏导、辨证膳食、中医外治、起居调护、用药指导五个维度落实个性化护理干预，持续观察患者症状改善情况与健康认知掌握程度。本研究属于临床护理经验总结，未采用VAS、GSRS、SF-36等标准化量表开展量化评分，未进行t检验、卡方检验等统计学分析。结果：经分层辨证护理干预2~4周后，患者胃脘疼痛、反酸嘈杂、腹胀嗳气等核心胃肠症状明显缓解，因躯体不适诱发的失眠、烦躁等情绪问题同步改善，患者可自主掌握适配自身体质的饮食、养生方案，疾病自我管理意识显著增强，科室护理满意度持续提升。结论：针对慢性萎缩性胃炎开展分型辨证施护，遵循中医整体观与辨证论治核心思想，可精准匹配不同证型患者病机特点，有效缓解临床症状，充分发挥中医药护理特色，适宜在消化内科常态化推广运用。

Abstract: Objective: To summarize the clinical practical experience of traditional Chinese medicine (TCM) syndrome differentiation nursing in patients with chronic atrophic gastritis, and explore the practical value of characteristic TCM nursing in alleviating digestive tract discomfort and improving patients’ self-management ability. Methods: Patients diagnosed with chronic atrophic gastritis admitted to the Department of Gastroenterology of our hospital were selected as research subjects. Syndrome types were differentiated according to four diagnostic methods of TCM. Individualized nursing interventions were carried out from five aspects: emotional counseling, syndrome differentiation diet, external TCM therapies, daily life regulation and medication guidance. The improvement of symptoms and mastery of health knowledge were observed continuously. This study is a summary of clinical nursing experience. Standardized scales including VAS, GSRS and SF-36 were not adopted for quantitative evaluation, and statistical analyses such as t-test and chi-square test were not performed. Results: After 2 to 4 weeks of hierarchical syndrome differentiation nursing intervention, typical gastrointestinal symptoms including stomachache, acid regurgitation, stomach upset, abdominal distension and belching were greatly relieved. Insomnia, irritability and other emotional problems caused by physical discomfort were improved simultaneously. Patients could master diet and health regimens suitable for their physical constitution independently, with obviously enhanced awareness of disease self-management and improved nursing satisfaction. Conclusion: Based on the holistic concept and treatment based on syndrome differentiation of TCM, classified syndrome differentiation nursing can precisely correspond to the pathogenesis characteristics of patients with different syndromes, relieve clinical symptoms effectively and give full play to the advantages of TCM nursing. It is worthy of popularization and routine application in the department of gastroenterology.