中医心身兼治理论在社区老年慢性疼痛伴失眠患者治疗中的运用

The therapeutic effect of community elderly patients with chronic pain and insomnia by applying the theory of“physiological and psychological therapy”of Chinese medicine

目的探讨中医"心身兼治"理论运用于社区老年慢性疼痛伴失眠患者治疗的效果。方法选取丽水市紫金街道、杭州市小河湖墅街道和嘉兴市新嘉街道3个社区的120例老年慢性疼痛伴失眠患者进行研究,将这些患者随机分为观察组与对照组各60例。对照组给予常规西医镇痛及药物催眠治疗,观察组在西医镇痛治疗基础上结合中医"心身兼治"理论进行治疗。2组均在治疗30 d后予以疗效评价。结果(1)3个疗程治疗结束后,观察组疗效优于对照组,差异具有统计学意义(P<0.05)。(2)2组老年慢性疼痛伴失眠患者经过治疗后,睡眠质量改善情况(SRSS)、疼痛程度(NRS)、焦虑(SAS)、抑郁(SDS)评分均较治疗前降低,差异有统计学意义(P<0.05)。治疗后观察组SRSS、NRS、SAS、SDS评分显著低于对照组,差异有统计学意义(P<0.05)。(3)治疗后观察组健康调查量表SF-36中,生理功能(PF)、生理职能(RP)、躯体疼痛(BP)、总体健康(GH)、活力(VT)、社会功能(SF)、情感职能(RE)、精神健康(MH)等8个维度评分均优于对照组,差异具有统计学意义(P<0.05)。结论将中医"心身兼治"理论运用到老年慢性疼痛伴失眠患者的社区管理中能有效减轻患者的疼痛感,缓解失眠症状,从而提高该类患者的生存质量。

Objective To investigate the therapeutic effect of community elderly patients with chronic pain and insomnia by applying the theory of ＂physiological and psychological therapy＂ of Chinese medicine. Methods It selected 120 community elderly patients with chronic pain and insomnia in Zhijing Street of Lishui City, River and Lake Street of Hangzhou City and Xinjia Street of Jiaxing City as the research subjects. The patients were randomly divided into observation group and control group with 60 people in each group. The control group was given western medicine analgesia and drug hypnosis therapy in a routine way while the observation group was treated with the theory of ＂physiological and psychological thera- py＂ of Chinese medicine on the basis of western medicine treatment. The curative effects of the two group were evaluated after 30 d of treatment. Results ①Afler 3 courses of treatment, the effect of observation group was better than control group. The difference was statistically significant（ P 〈 0.05 ）. ②After the treatment, grades of sleep quality improvement （ SRSS）, degree of pain （ NRS）, anxiety （SAS） and depression （SDS） in both groups were lower than those before treatment,and the difference was statistically significant（P 〈 0.05 ）. After treatment, SRSS, NRS, SAS, SDS scores of the observation group were significantly lower than those of the control group, with statistical significance （P 〈 0.05 ）. ③After treatment, eight dimension scores in the SF-36 health survey table of the observation group, including physiological function （ PF）, physiological functions （RP） , body pain （ BP ）, general health （ GH ）, vitality （ VT）, social function （ SF ） , role emotional（RE） and mental health（MH） were better than those in the control group, and the difference was statistically significant（P 〈0.05）. Conclusion Applying the theory of ＂physiological and psychological therapy＂ of Chinese medicine to the community management of the community elderly patients with chronic pain and insomnia can effectively relieve the pain of patients and alleviate insomnia symptoms so as to improve the quality of life of the patients.