基于症状管理理论的成人四弯风患者疾病体验的质性研究*

作者：朱雅琦1，刘霞珍1，李 宏2，唐陶然3，朱诗林2

单位：1.湖南中医药大学护理学院，湖南 长沙 410208； 2.湖南中医药大学第二附属医院，湖南 长沙 410005； 3.南方医科大学护理学院，广东 广州 510515

引用：引用：朱雅琦，刘霞珍，李宏，唐陶然，朱诗林.基于症状管理理论的成人四弯风患者疾病体验的质性研究[J].中医药导报,2026,32(4):115-119.

DOI：10.13862/j.cn43-1446/r.2026.04.018

PDF： 下载PDF

摘要：目的:基于症状管理理论，探讨成人四弯风（特应性皮炎）患者在“风燥湿热相搏，肌肤失养”病机下的疾病体验，为构建有效的中医护理干预提供理论依据。方法:采用描述性质性研究方法，对14例符合中医“四弯风”诊断标准的成人患者进行半结构化访谈，采用Colaizzi 7步分析法对资料进行编码与归类，并结合症状管理理论的生理、心理、社会三维框架进行整合分析。结果:共提炼出3大主题和6个亚主题，包括“风盛则痒，燥胜则干”的生理困扰（瘙痒与皮损恶性循环中的具象化痛苦），“湿热郁蒸，情志相激”的情志失调与心理困扰（搔抓失控背后隐藏的负性情绪、疾病归因认知变化与重构、对医疗系统的信任产生动摇），以及“与疾病共处”的疾病适应行为与动态需求（调试后的症状管理行为、情感需求下的家庭支持与协作）。结论：四弯风患者的疾病体验呈现“形神共病”的特点，中医护理需以“调体祛邪”为核心，整合症状管理理论，构建涵盖“祛风润肤-疏肝宁神-社会功能重建”的多维干预模式。

关键词：四弯风；特应性皮炎；疾病体验；中医证候；症状管理理论；质性研究；中医护理

Abstract：

Objective: Based on the Symptom Management Theory, to explore the disease experience of adult patients with Siwanfeng (wind of four fossae, atopic dermatitis) under the pathogenesis of "wind, dryness, dampness and heat intermingle and contend, leading to nutritional deficiency of the skin", so as to provide a theoretical basis for constructing targeted and effective TCM nursing interventions. Methods: A descriptive qualitative research method was adopted, and in-depth semi-structured interviews were conducted with 14 adult patients who met the TCM diagnostic criteria for Siwanfeng (wind of four fossae). The interview data were coded and categorized by using Colaizzi's seven-step analysis method, and an integrated analysis was carried out combined with the three-dimensional framework (physiological, psychological and social) of the Symptom Management Theory. Results: Three major themes and six sub-themes were extracted from the data: (1) Physiological distress of "excessive wind causes itching, dominant dryness causes dry skin" (the concrete suffering in the vicious cycle of itching and skin lesions); (2) Emotional dysregulation and psychological distress of "damp-heat stagnation and steaming, emotions mutually induce pathological changes" (negative emotions hidden behind uncontrolled scratching, cognitive changes and reconstruction of disease attribution, and wavering trust in the medical system); (3) Disease adaptation behaviors and dynamic needs of "living with the disease" (adjusted symptom management behaviors, family support and collaboration under emotional needs). Conclusion: The disease experience of patients with Siwanfeng is characterized by "comorbidity of body and spirit". TCM nursing should take "regulating constitution and eliminating pathogenic factors" as the core, integrate the Symptom Management Theory, and construct a multidimensional intervention model covering "dispelling wind and moistening the skin-soothing the liver and calming the spirit-reconstructing social function".

Key words：Siwanfeng (wind of four fossae); atopic dermatitis; disease experience; traditional Chinese medicine (TCM) syndrome; symptom management theory; qualitative research; TCM nursing

发布时间：2026-04-26

点击量：16