子午流注择时穴位按摩联合耳穴贴压在维持性血液透析患者中的应用效果

Effect of midnight-noon ebb-flow-based acupoint massage combined with auricular point sticking on patients receiving maintenance haemodialysis

目的了解子午流注择时穴位按摩联合耳穴贴压对维持性血液透析患者焦虑抑郁及睡眠质量的影响。方法选择2021年6月至12月在本院血液透析中心行维持性血液透析患者104例,根据透析时间进行分组,单日透析为对照组,双日透析为观察组,每组各52例。对照组实施常规的护理方法,包括饮食干预、用药指导及评估患者焦虑抑郁及失眠产生的原因,根据证型给予针对性指导;观察组在对照组基础上实施子午流注择时穴位按摩联合耳穴贴压,两组干预时间14d。干预前后采用汉密尔顿焦虑量表(hamilton anxiety scale,HAMA)、汉密尔顿抑郁量表(hamilton depression scale,HAMD)和匹兹堡睡眠质量指数量表(pittsburgh sleep quality index,PSQI)对两组患者进行测评。结果干预前两组患者焦虑、抑郁和睡眠质量得分比较,差异无统计学意义(均P>0.05)。干预后观察组焦虑、抑郁和睡眠质量得分较干预前低且低于对照组(均P<0.001),干预后观察组焦虑、抑郁程度较对照组低;睡眠质量优于对照组。结论子午流注择时穴位按摩联合耳穴贴压可降低维持性血液透析患者焦虑和抑郁程度并改善患者的睡眠质量。本研究结合中医疗法和子午流注理论的优势,而且操作简便,可在临床及社区进行推广应用。

Objective To investigate the effect of midnight-noon ebb-flow-based acupoint massage combined with auricularplaster therapy on anxiety, depression and sleeping quality inpatients receiving maintenance haemodialysis. Methods A total of 104 patients with anxiety and depression were selected from the Haemodialysis Centre of the hospital between June and December, 2021. The patients were divided into two groups according to the date for dialysis: 52 patients who had the haemodialysis on odd-dates were assigned as the observation group, and the 52 patients who had the haemodialysison even-dates were assigned as the control group. The control group was treated with routine nursing care including diet intervention, medication guidance, evaluation of anxiety, depression and insomnia, as well as given with the guidance according to the syndromes considered with the traditional Chinese medicine(TCM). Apart from the measurers given to the control group, the observation group was treated with midnight-noon ebb-flow-based acupoint massage combined with auricular point sticking for 14 days. The Hamilton Anxiety Rating Scale, Hamilton Depression Scale and Pittsburgh sleep quality index were used for evaluations among the patients before and after the intervention. Results There was no significant difference in the scores of anxiety, depression and sleep quality between the two groups before intervention(P > 0.05), but the scores of anxiety, depression and sleep quality in the observation group after intervention were significantly lower than those before the intervention and lower than those in the control group(P<0.001). After the intervention, the anxiety and depression in the observation group was lower than those in the control group,and the quality of sleep in the observation group was better than that in the control group. Conclusions The combination of midnightnoon ebb-flow-based acupoint massage and auricular point plastering can reduce the anxiety and depression and improve sleep quality in patients receiving maintenance haemodialysis. This study combines the therapy of traditional Chinese medicine and the theory of midnightnoon ebb-flow so that it is advantageous for its simplicity in therapy and convenience for clinical application and community practices.