Huang Shiou-Yun, Chiao Chia-Yi, Chien Li-Yin
Department of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Nursing, Asia University, Taichung, Taiwan.
College of Nursing, Chung-Shan Medical University, Taichung, Taiwan.
Int J Nurs Stud. 2025 Jan;161:104936. doi: 10.1016/j.ijnurstu.2024.104936. Epub 2024 Oct 24.
Chronic constipation is a common distressing symptom. Abdominal massage is a safe, noninvasive, and comfortable intervention. However, it is rarely used in formal clinical practice as its' effectiveness for chronic constipation remains unclear.
This systematic review aimed to investigate the effectiveness of abdominal massage on defecation frequency, stool consistency, colonic transit time, constipation symptoms, quality of life, laxative use, and adverse events in adults. Additionally, we aimed to compare the effectiveness of abdominal massage in chronic constipation with different etiologies and types of abdominal massage techniques.
Data from eight English and Chinese electronic databases until May 15, 2024, including randomized controlled trials (RCT) and quasi-experimental studies, were used. The risk of bias was assessed using the Cochrane risk-of-bias tool. Results were synthesized using a random-effect model. This study was registered on the 7th of January 2023 to the International Prospective Register of Systematic Reviews (PROSPERO, CRD42023385243).
A total of 23 studies with 1431 participants were eligible for the meta-analysis. Abdominal massage statistically significantly increased weekly defecation frequency (MD = 1.59; 95 % CI 1.06, 2.11; df = 10; I = 82 %), decreased gut transit time (MD = -21.53 h; 95 % CI -35.94, -7.12; df = 3; I = 65 %), and decreased constipation symptoms (SMD = -1.06; 95 % CI -1.33, -0.80; df = 18; I = 79 %) as compared to the control group; however, it did not reduce laxative use (OR: 0.43, 95 % CI 0.14, 1.34, p = 0.15; I = 74 %). In subgroup analysis, the effectiveness of defecation frequency appeared to be greater for functional constipation (SMD = 1.23; 95 % CI 0.87, 1.60; df = 6; I = 86 %) as compared to opioid-induced constipation (SMD = 1.06; 95 % CI 0.61, 1.50; df = 5; I = 5 %) or neurogenic bowel dysfunction (SMD = 0.68; 95 % CI 0.26, 1.10; df = 4; I = 51 %). There were statistically significant differences in defecation frequency between the functional constipation and neurogenic bowel dysfunction groups (p = 0.075). Acupressure and aromatherapy massage had a greater effect on defecation frequency (SMD = 1.63; 95 % CI 1.06, 2.21; df = 3; I = 86 %) than circular massage (SMD = 0.90; 95 % CI 0.57, 1.22; df = 10; I = 68 %) or electric device massages (SMD = 0.83; 95 % CI 0.15, 1.51; df = 1; I = 82 %); however, high heterogeneity and a limited number of articles were encountered. No adverse reactions were observed in the non-neurogenic bowel dysfunction group.
This study reveals the efficacy of abdominal massage in alleviating symptoms of chronic constipation, as well as the differences in the effectiveness of different constipation types and massage techniques. Patients, caregivers, and health professionals can select abdominal massage techniques based on their effectiveness in specific type of constipation or troublesome symptoms.
Abdominal massage is effective for chronic constipation, increasing defecation frequency and improving symptoms. Users can tailor massage technique to specific constipation type for optimal results. #ConstipationRelief #GutHealth.
慢性便秘是一种常见的令人苦恼的症状。腹部按摩是一种安全、无创且舒适的干预措施。然而，由于其对慢性便秘的有效性尚不清楚，在正规临床实践中很少使用。
本系统评价旨在研究腹部按摩对成年人排便频率、大便性状、结肠传输时间、便秘症状、生活质量、泻药使用及不良事件的有效性。此外，我们旨在比较腹部按摩对不同病因的慢性便秘及不同类型腹部按摩技术的有效性。
使用截至2024年5月15日来自八个英文和中文电子数据库的数据，包括随机对照试验（RCT）和准实验研究。使用Cochrane偏倚风险工具评估偏倚风险。结果采用随机效应模型进行综合分析。本研究于2023年1月7日在国际前瞻性系统评价注册库（PROSPERO，CRD42023385243）注册。
共有23项研究、1431名参与者符合荟萃分析的条件。与对照组相比，腹部按摩在统计学上显著增加了每周排便频率（MD = 1.59；95%CI 1.06，2.11；自由度 = 10；I² = 82%），缩短了肠道传输时间（MD = -21.53小时；95%CI -35.94，-7.12；自由度 = 3；I² = 65%），并减轻了便秘症状（SMD = -1.06；95%CI -1.33，-0.80；自由度 = 18；I² = 79%）；然而，它并没有减少泻药的使用（OR：0.43，95%CI 0.14，1.34，p = 0.15；I² = 74%）。在亚组分析中，与阿片类药物引起的便秘（SMD = 1.06；95%CI 0.61，1.50；自由度 = 5；I² = 5%）或神经源性肠道功能障碍（SMD = 0.68；95%CI 0.26，1.10；自由度 = 4；I² = 51%）相比，腹部按摩对功能性便秘排便频率的有效性似乎更大（SMD = 1.23；95%CI 0.87，1.60；自由度 = 6；I² = 86%）。功能性便秘组和神经源性肠道功能障碍组之间的排便频率存在统计学显著差异（p = 0.075）。与环形按摩（SMD = 0.90；95%CI 0.57，1.22；自由度 = 10；I² = 68%）或电动设备按摩（SMD = 0.83；95%CI 0.15，1.51；自由度 = 1；I² = 82%）相比，指压按摩和芳香疗法按摩对排便频率的影响更大（SMD = 1.63；95%CI 1.06，2.21；自由度 = 3；I² = 86%）；然而，存在高度异质性且文章数量有限。在非神经源性肠道功能障碍组中未观察到不良反应。
本研究揭示了腹部按摩在缓解慢性便秘症状方面的疗效，以及不同便秘类型和按摩技术有效性的差异。患者、护理人员和卫生专业人员可以根据腹部按摩技术对特定类型便秘或令人烦恼症状的有效性来选择。
腹部按摩对慢性便秘有效，可增加排便频率并改善症状。使用者可根据特定便秘类型调整按摩技术以获得最佳效果。#便秘缓解#肠道健康
