背景：健康指導是中醫護理獨立業務範圍之一，研究發現，便秘中醫護理指導可改善老人便秘症狀及排便次數，然而以便秘中醫護理指導來改善大學生便秘問題之實證研究有限。
目的：探討便秘中醫護理指導對於改善大學生便秘症狀及生活品質之成效。
方法：採類實驗雙組前後測設計，以立意取樣有便秘症狀之大學生共55位（實驗組24位，控制組31位）。實驗組首先由教學醫院中醫師進行便秘中醫四診評估及辨證，再由中醫護理教師提供四小時之便秘中醫護理指導；控制組則給予便秘衛教單張，介入前、介入第二週及第六週以結構性問卷進行資料的收集。以廣義估計方程式(generalized estimating equation, GEE)分析便秘中醫護理指導對改善便秘之成效，經控制「前測效應」、「控制組之成長效應」及年齡、身體質量指數(body mass index)後，以比較組別與前後測之交互作用。
結果：經GEE之迴歸模式檢定，發現實驗組與控制組間於第二週與第六週介入效果分別為排便間隔時間（第二週= -1.42,p < .001 ；第六週=-1.27,p < .001)、便秘症狀（第二週=-8.10,p < .001 ;第六週=-7.09, < .001)、便 秘生活品質（第二週=-19.69, p < .001 ;第六週=-20.58, p < .001)及自覺便秘嚴重度（第二週=-1.35, p < .001 ;第六週=-1.31, p < .05)。表示便秘中醫護理指導較衛教單張能有效改善便秘之困擾。
結論：便秘中醫護理指導可提供照護指引及居家自我保健之參考。

Background: Providing nursing instructions is an independent function of Chinese medicine nursing. Chinese medicine nursing instructions related to constipation have been shown to effectively relieve constipation symptoms and improve bowel movement intervals in the elderly. Little research has addressed the effectiveness of traditional Chinese medicine in managing constipation symptoms in college students.
Purpose: This quasi-experimental study examines the effectiveness of traditional-Chinese-medicine (TCM) nursing instructions in managing constipation symptoms and improving quality of life in college students.
Methods: A quasi-experimental research design was used. Participants comprised a purposive sampling of 55 college students (experimental group: 24 students; control group: 31 students). Experimental-group participants received 4 hours of TCM nursing instructions within 2 weeks of being examined by a Chinese medical doctor, who used four Chinese medicine examination (inspection, listening/smelling, inquiry, and palpation) and pattern identification techniques. Control-group participants received usual care comprising a health-education pamphlet on constipation management. All participants completed a structured questionnaire prior to receiving their intervention. The second and third data collections were conducted during week 2 and 6. Generalized estimating equations (GEE) analysis examined the effects of TCM nursing instructions on constipation management. Pretest effect, growth effect, age, and body mass index (BMI) were all controlled to compare interactions between the two groups and pre-test/post-test differences.
Results: GEE analysis showed that both groups had improved significantly at 2- and 6-weeks post-test. Intervention effects were: bowel movement interval (week two = -1.42, p < .001; week six = -1.27, p < .001), constipation symptoms (week two = -8.10, p < .001; week six = -7.09, p < .001), quality of life (week two = -19.69, p < .001; week six = -20.58, p < .001), and self-reported constipation severity (week two = -1.35, p < .001; week six = -1.31, p < .05). Results found improvements in constipation symptoms in the intervention group to be significantly higher than in the control group.
Conclusions: Study results support that Chinese medicine nursing instructions are effective in relieving constipation symptoms and may be more effective than current standard pamphlet recommendations.