耳穴贴压联合膈肌呼吸法治疗急进高原人员应激性睡眠障碍的临床观察

Auricular point sticking combined with diaphragmatic breathing exercise in treatment of stress-induced sleep disorder following acute high-altitude exposure

目的观察耳穴贴压联合膈肌呼吸法对急进高原人员应激性睡眠障碍的临床疗效。方法2019年9月将236名失眠严重程度指数量表(ISI)评分>7分的急进高原人员以区队为单位,按抽签的方式随机分为耳穴组(66人)、呼吸组(72人)、联合组(45人)和对照组(53人)。受试者均为男性,年龄18~24(18.95±1.07)岁。耳穴组给予耳穴贴压;呼吸组进行膈肌呼吸法训练;联合组进行耳穴贴压和膈肌呼吸法训练;对照组不予处理。以ISI量表、疲劳症状自评量表、心境状态量表(精力值)为评价指标。结果共208例受试者完成研究(耳穴组58例,呼吸组66例,联合组36例,对照组48例)。1)ISI量表:治疗第2天,耳穴组、联合组受试者ISI评分均显著低于对照组(7.53±0.82、7.22±0.68 vs 8.21±0.77);治疗第6天耳穴组、呼吸组和联合组ISI评分均显著低于对照(6.95±0.51、7.32±0.59、6.44±0.61 vs 7.83±0.56),差异均有统计学意义(P<0.05)。2)疲劳症状自评量表:治疗第1天耳穴组、联合组疲劳症状自评量表评分均显著低于对照组(8.55±0.84、8.19±1.19 vs9.81±1.10);治疗第2、6天耳穴组、呼吸组及联合组疲劳症状自评量表评分均显著低于对照组(2 d:7.26±0.83、7.55±1.13、7.17±1.13 vs 8.73±1.07;6 d:6.22±0.92、6.42±1.15、5.78±1.22 vs 7.73±1.35),差异均有统计学意义(P<0.05)。3)心境状态量表(精力值):治疗第1、2天,呼吸组、联合组精力值评分均显著高于对照组(1 d:12.62±1.83、12.83±1.42 vs 11.58±1.47;2 d:13.97±1.97、14.67±1.91 vs 11.73±1.72);治疗第6天,耳穴组、呼吸组及联合组精力值评分均显著高于对照组(12.50±1.54、14.45±1.87、15.53±1.86 vs 11.81±1.55),差异均有统计学意义(P<0.05)。联合组在治疗第6天各指标改善情况均优于呼吸组和联合组(P<0.05)。结论耳穴贴压、膈肌呼吸法均能改善急进高原人员睡眠质量,降低疲劳感,增加精力值,两者联合效果更好。

Objective To observe the clinical effects of auricular point sticking combined with diaphragmatic breathing exercise on stress-induced sleep disorder following acute high-altitude exposure.Methods In September 2019,236 subjects with ISI scale score greater than 7 were randomly divided into auricular point group(n=66),breathing group(n=72),combined group(n=45)and control group(n=53).The subjects were all male with an average age of(18.95±1.07)years(range,18-24 years).The auricular point group was given auricular point sticking.The breathing group received training of diaphragm-breathing exercise.The combined group received auricular point sticking and diaphragm-breathing training.The control group recieved no therapies.ISI scale,Fatigue Self-assessment scale and Profile of Mood States(Vigor score)were used as evaluation indexes.Results Totally 208 cases completed the program(58 cases in the auricular point group,66 cases in the breathing group,36 cases in the combined group and 48 cases in the control group).Compared with the control group,the ISI scores of the auricular point group and the combined group on the second day were significantly lower(8.21±0.77 vs 7.53±0.82 and 7.22±0.68).And the ISI score of the auricular point group,the breathing group and the combined group on the sixth day of treatment were also significantly lower than that of the control group(6.95±0.51,7.32±0.59,6.44±0.61 vs 7.83±0.56)(all P<0.05).The score of Fatigue Self-assessment scale on the first day of treatment in the auricular point group and the combined group was significantly lower than that of the control group(8.55±0.84 and 8.19±1.19 vs9.81±1.10,P<0.05,respectively).And the scores of the auricular point group,the breathing group and the combined group on the second and sixth day of treatment reduced significantly when compared with control group(2 d:7.26±0.83,7.55±1.13,7.17±1.13 vs 8.73±1.07;6 d:6.22±0.92,6.42±1.15,5.78±1.22 vs 7.73±1.35;all P<0.05).Compared with the control group,the Vigor score of the breathing group and the combined group on the first and second day of treatment increased significantly(1 d:12.62±1.83,12.83±1.42 vs 11.58±1.47;2 d:13.97±1.97,14.67±1.91 vs 11.73±1.72;all P<0.05).And it was also higher in the auricular point group,the breathing group and the combined group when compared with control group on the sixth day of treatment(12.50±1.54,14.45±1.87,15.53±1.86 vs 11.81±1.55,P<0.05.respectively).The combined group was superior to the breathing group and the auricular group in terms of all the indicators mentioned above on the sixth day(all P<0.05).Conclusion Bothauricular point sticking and diaphragm breathing can improve sleep quality,reduce fatigue and increase vigor for cases with high altitude exposure,and the combination will work better.