Abstract:

Objective　To explore the effect of the Plan-Do-Check-Act (PDCA) nursing mode combined with traditional Chinese medicine enema for patients with ulcerative colitis. Methods　This was a prospective study. Eighty-two patients with ulcerative colitis treated at Hanzhong Hospital of Traditional Chinese Medicine from April 2019 to March 2023 were divided into an experimental group and a control group using the random number table method, with 41 patients in each group. The experimental group included 27 males and 14 females, with an age of (41.73±6.18) years and a disease duration of (7.04±1.31) months; there were 22 mild cases and 19 moderate cases. The control group included 23 males and 18 females, with an age of (42.59±6.43) years and a disease duration of (6.72±1.53) months; there were 23 mild cases and 18 moderate cases. The control group received conventional treatment and routine nursing intervention, while the experimental group received conventional treatment, PDCA nursing, and traditional Chinese medicine enema, for 4 weeks. The recovery effects, serum levels of inflammatory factors, and scores of Ulcerative Colitis Disease Activity Index (UCDAI) and Inflammatory Bowel Disease Questionnaire (IBDQ) were compared between the two groups by t and χ² tests. Results　The total effective rate of the experimental group was higher than that of the control group [90.24% (37/41) vs. 73.17% (30/41)], with a statistical difference (x²=3.998; P=0.046). After the intervention, the levels of C-reaction protein (CRP) and interleukin-6 (IL-6) in the experimental group were lower than those in the control group [(4.04±0.64) mg/L vs. (6.12±0.73) mg/L and (1.67±1.07) ng/L vs. (2.98±1.15) ng/L], with statistical differences (t=13.719 and 5.340; both P<0.05); the scores of rectal bleeding, diarrhea, endoscopic findings, and physician evaluation in the experimental group were lower than those in the control group [(1.23±0.29) vs. (1.38±0.31), (1.21±0.27) vs. (1.43±0.26), (1.06±0.23) vs. (1.16±0.22), and (1.14±0.31) vs. (1.39±0.28)], with statistical differences (t=2.263, 3.758, 2.012, and 3.832; all P<0.05); the scores of intestinal symptoms, systemic symptoms, social function, and emotional function in the experimental group were higher than those in the control group [(67.84±4.73) vs. (60.13±4.26), (29.71±2.73) vs. (27.36±2.68), (27.72±2.31) vs. (24.06±2.08), and (69.82±5.36) vs. (64.67±4.79)], with statistical differences (t=7.755, 3.933, 7.539, and 4.587; all P<0.05). Conclusion　PDCA nursing mode combined with traditional Chinese medicine enema has significant advantages in treating patients with ulcerative colitis, and effectively improving the treatment effect and their quality of life.

Key words:

Ulcerative colitis, PDCA nursing, Traditional Chinese medicine enema, Recovery effect, Quality of life

摘要：

目的　探讨计划-执行-检查-处理（Plan-Do-Check-Act，PDCA）护理模式联合中药灌肠在溃疡性结肠炎中的应用效果。方法　采用前瞻性研究设计，选取2019年4月至2023年3月汉中市中医医院收治的82例溃疡性结肠炎患者，随机数字表法分为两组，各41例。试验组中，男27例、女14例，年龄（41.73±6.18）岁，病程（7.04±1.31）个月，病情程度：轻度22例、中度19例。对照组中，男23例、女18例，年龄（42.59±6.43）岁，病程（6.72±1.53）个月，病情程度：轻度23例、中度18例。对照组给予常规治疗及常规护理干预，试验组在常规治疗、护理的基础上给予PDCA护理模式联合中药灌肠；均持续干预4周。比较两组康复效果、血清炎性因子水平、溃疡性结肠炎疾病活动指数（UCDAI）、炎症性肠病生活质量评价量表（IBDQ）评分。统计学方法采用t检验、χ²检验。结果　试验组总有效率［90.24%（37/41）］高于对照组［73.17%（30/41）］，差异有统计学意义（χ²=3.998，P=0.046）。干预后试验组CRP、IL-6水平分别为（4.04±0.64）mg/L、（1.67±1.07）ng/L，低于对照组的（6.12±0.73）mg/L、（2.98±1.15）ng/L，差异均有统计学意义（t=13.719、5.340，均P<0.05）；试验组便血、腹泻、内镜表现、医生评价评分分别为（1.23±0.29）分、（1.21±0.27）分、（1.06±0.23）分、（1.14±0.31）分，均低于对照组的（1.38±0.31）分、（1.43±0.26）分、（1.16±0.22）分、（1.39±0.28）分，差异均有统计学意义（t=2.263、3.758、2.012、3.832，均P<0.05）；试验组肠道症状、全身症状、社会功能、情感功能评分分别为（67.84±4.73）分、（29.71±2.73）分、（27.72±2.31）分、（69.82±5.36）分，均高于对照组的（60.13±4.26）分、（27.36±2.68）分、（24.06±2.08）分、（64.67±4.79分），差异均有统计学意义（t=7.755、3.933、7.539、4.587，均P<0.05）。结论　PDCA护理模式联合中药灌肠治疗溃疡性结肠炎中效果显著，并能有效改善患者的生活质量。

关键词:

溃疡性结肠炎, PDCA护理, 中药灌肠, 康复效果, 生活质量