芳香疗法对血液透析患者睡眠质量及心理状态的影响

目的:探讨芳香疗法对血液透析患者睡眠质量及心理状态的影响。方法:选取2019年10月—2020年9月深圳市龙岗区第二人民医院收治的100例血液透析患者为研究对象,采用随机数字表法分为对照组与观察组各50例。对照组接受常规护理,观察组在对照组基础上加芳香疗法。比较两组患者汉密顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、匹兹堡睡眠质量指数量表(PSQI)、透析患者症状困扰量表(DSI)、世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评分。结果:干预前,两组PSQI评分比较,差异无统计学意义(P>0.05);干预后,观察组PSQI评分显著低于对照组,差异有统计学意义(P<0.05)。干预前,两组HAMD、HAMA评分比较,差异无统计学意义(P>0.05);干预后,观察组HAMD、HAMA评分均显著低于对照组,差异有统计学意义(P<0.05)。干预前,两组DSI评分比较,差异无统计学意义(P>0.05);干预后,两组DSI评分比较,差异无统计学意义(P>0.05)。干预前,两组WHOQOL-BREF评分比较,差异无统计学意义(P>0.05);干预后,观察组WHOQOL-BREF各维度评分显著高于对照组,差异有统计学意义(P<0.05)。结论:给予血液透析患者芳香疗法可有效提高患者睡眠质量,改善患者心理状态,值得推广。

Clinical observation of auricular needle-embedding therapy for primary insomnia

Objective:To observe the clinical efficacy of auricular needle-embedding therapy for treating primary insomnia.Methods:A total of 63 patients were randomly divided into a conventional acupuncture group and an auricular needleembedding group.The conventional acupuncture group received acupuncture at meridian points,while the auricular needle-embedding group received acupuncture at auricular points.Treatments were given once a day for 6 consecutive days,followed by a 1-day break,as a course of treatment.Both groups were treated for 2 courses.Before treatment,and after 1 course and 2 courses of treatment,the Pittsburgh sleep quality index(PSQI)score was assessed,and the efficacy was evaluated.Results:The cured and markedly effective rate and total effective rate of the auricular needle-embedding group were higher than those of the conventional acupuncture group,but there was no significant difference between the two groups(P>0.05).After 1 course of treatment,the PSQI global score and the scores of subjective sleep quality,sleep latency,sleep duration,habitual sleep efficiency,and daytime dysfunction of both groups decreased compared with those before treatment(P<0.01);there was no statistical significance in comparing the PSQI global score and individual component scores between the two groups(P>0.05).After 2 courses of treatment,the PSQI global score and the scores of sleep latency and habitual sleep efficiency of the auricular needle-embedding group decreased compared with those after 1 course of treatment(P<0.01 or P<0.05),while only the score of sleep latency of the conventional acupuncture group decreased compared with that after 1 course of treatment(P<0.05);the PSQI global score and the scores of subjective sleep quality and sleep latency of the auricular needle-embedding group were lower than those of the conventional acupuncture group(P<0.05).Conclusion:Both therapies can improve insomnia.Compared to conventional acupuncture,auricular needleembedding therapy demonstrates a therapeutic advantage in improving sleep latency and sleep quality,making it worthy of clinical promotion.

Curative effect of acupuncture and moxibustion on insomnia: a randomized clinical trial

OBJECTIVE: To observe the effect of acupuncture and moxibustion on insomnia and explore its mechanism. METHODS: One hundred and twenty patients were randomly divided into an experiment group and a control group. Sixty patients in the experiment group were treated once a day with acupuncture at Baihui (GV 20), Sishencong (EX-HN 1), Shenmai (BL 62), and Zhaohai (KI 6) and with moxibustion at Baihui (GV 20) and Sishencong (EX-HN 1). Sixty patients in the control group were acupunctured once a day at Shenmen (HT 7), Neiguan (PC 6), and Sanyinjiao (SP 6).The Pittsburgh Sleep Quality Index (PSQI) was used to compare sleep improvement between the two groups. RESULTS: The total effective rate was 87.7% in the experiment group and 76.3% in the control group. The PSQI scores and the total score were lower after treatment than before treatment in bothgroups. However, the reduction in the experiment group was greater than that in the control group in sleeping quality, time to fall asleep, sleeping disorder, and daytime function (P<0.05). CONCLUSION: Acupuncture and moxibustion at Baihui (GV 20), Sishencong (EX-HN 1), Shenmai (BL 62), and Zhaohai (KI 6) significantly improved insomnia symptoms in the experiment group compared with the control group.

Tuina for primary insomnia： a meta-analysis

Objective： To systematically evaluate the therapeutic efficacy of tuina therapy for primary insomnia. Methods： Nine Chinese and English databases were searched from the inception to May 2017 to identify randomized controlled trials （RCTs） studying tuina therapy for insomnia. The enrolled articles were all RCTs with tuina as the monotherapy or major therapy in the experiment group, with clear diagnostic criteria for primary insomnia well recognized worldwide or in China, and Pittsburgh sleep quality index （PSQI） as one of the outcome measures. Two researchers evaluated the risk of bias and quality of the enrolled studies by following Cochrane Handbook version 5.1.0. The meta-analysis was performed by RevMan version 5.3. Results： Eleven studies were included with a total of I 076 participants. The Western medication adopted in the control groups were benzodiazepine receptor agonists. The studies were all assessed as high risk of bias for blinding since blinding method was unable to be performed due to the specificity of tuina therapy; no study reported the support of fund or potential interest conflict, so they were all rated unclear for selective reporting. The meta-analysis showed that compared with other traditional Chinese medicine therapies, tuina worked more effectively in reducing the PSQI score （MD=-4.11〈O, 95% confidence interval （CI） -6.01 to -2.22, P〈0.O001）; compared with oral administration of Western medication, tuina showed more significant efficacy in reducing the PSQI score （MD=-3.42〈0, 95%CI -5.19 to -1.66, P〈0.O001）. Subgroup analysis showed that head tuina alone showed no significant difference compared with oral administration of Western medication regarding the change of PSQI score （MD=-4.19〈O, 95%CI -8.87 to 0.50, P〉0.05）; a combination of head and back tuina could more effectively reduce the PSOJ score compared with oral administration of Western medication （MD=-2.08〈O, 95%CI -3.09 to -1.06, P〈0.O001）. Conclusion： Tuina can produce more significant efficacy in treating primary insomnia compared with other traditional Chinese medicine therapies and oral administration of Western medication, especially the combination of head and back tuina.

The Needle-Rolling Therapy for Treatment of Non-organic Chronic Insomnia in 90 Cases

Objective: To evaluate the therapeutic effects of needle-rolling therapy for chronic insomnia. Methods: In the present multi-central randomly controlled clinical study, 180 cases of chronic insomnia were randomly divided into the following two groups, a treatment group (90 cases) treated by the needle-rolling therapy and a control group (90 cases) treated with clonopin. The treatment course for both the two groups was 4 weeks. The therapeutic effects were evaluated based on improvement of the TCM symptoms and the Pittsburgs's sleep-quality index (PSQI). Results: After treatment, there were significant differences between the two groups in the effective rate (P<0.05), and in the total score of PSQI and in the scores of the 4 sub-items, i.e. sleep-quality, sleep-efficiency, hypnotic and daytime function (P<0.05). Although there was no significant difference between the two groups in the effective rate after a 3-month follow-up period, significant differences still existed in the 3 sub-items of sleep-efficiency, hypnotic, and daytime function of the PSQI (P<0.05). Conclusion: As compared with hypnotics of the second generation, the needle-rolling therapy may show better therapeutic effects for chronic insomnia patients.