刮痧联合拔罐治疗心脾两虚型失眠的临床研究

发布时间：2018-01-30 14:45

本文关键词： 失眠心脾两虚刮痧拔罐匹兹堡睡眠质量指数焦虑抑郁　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究目的:比较单一刮痧法、拔罐法和刮痧联合拔罐法改善心脾两虚型失眠患者睡眠质量、心脾两虚失眠中医症状、焦虑和抑郁情绪的疗效,丰富刮痧联合拔罐技术临床适用病种。研究方法:(1)基于护理循证理论,采用Meta分析法,以"刮痧干预失眠患者"为主题,客观评价刮痧治疗失眠的疗效和安全性,寻找临床中医刮痧治理失眠最佳实践方案;(2)将心脾两虚型失眠患者按照本研究既定的随机化方案分为刮痧组、拔罐组、联合治疗组。连续治疗10周后,观察比较三组匹兹堡睡眠质量指数(Pittsburgh Quality Sleep Index,PSQI)、心脾两虚失眠中医症状积分、自评焦虑量表(Self-Rating Anxiety Scale,SAS)和自评抑郁量表(Self-Rating Depression Scale,SDS)得分改善效果。研究结果:(1)meta分析提示,现有的刮痧改善失眠患者睡眠质量相关研究总体质量较差,在选择国际公认的失眠诊断标准和评价工具、正确收集资料、采用规范的刮痧方法、干预频率和疗程、明确具体的随机化方案和盲法的实施情况、刮痧治疗的安全性评价等方面需要进一步规范,为本研究制定失眠患者干预方案提供了前期循证理论基础;(2)治疗后,刮痧组、拔罐组、联合治疗组PSQI总分及各维度、心脾两虚中医症状量表得分、SAS和SDS得分较治疗前下降。除服催眠药物维度外,单一治疗组PSQI总分及其余维度、心脾两虚失眠中医症状量表得分、SAS和SDS得分均较治疗前下降。除主观睡眠质量维度外,联合治疗组PSQI总分及其余维度、心脾两虚失眠中医症状量表得分、SAS和SDS得分较单一治疗组低(均P0.05)。除入睡时间、睡眠效率维度外,刮痧组和拔罐组PSQI总分及其余各维度、心脾两虚失眠中医症状量表得分、SAS和SDS得分无差异(P0.05)。研究结论:单一刮痧和拔罐疗法均可以改善患者睡眠质量、心脾两虚中医症状、焦虑、抑郁情绪,但不能减少患者服用安眠药量。总体来说,刮痧联合拔罐可改善失眠患者的睡眠质量和焦虑、抑郁心理,且效果优于单一刮痧法、拔罐法。单一刮痧法效果好于单一拔罐法。
[Abstract]:Objective: to compare the effects of single scraping method, cupping method and combined cupping method on sleep quality, TCM symptoms, anxiety and depression of insomnia patients with deficiency of heart and spleen. Methods: based on the theory of nursing evidence based on the Meta analysis, "scraping intervention insomnia patients" as the theme. Objective to evaluate the curative effect and safety of scraping in treating insomnia, and to find the best practice scheme for treating insomnia by scraping in clinical Chinese medicine. The patients with insomnia with deficiency of both heart and spleen were divided into scraping group, cupping group and combined treatment group according to the randomization scheme established in this study. After 10 weeks of continuous treatment, the patients were divided into three groups: guasha group, cupping group and combined treatment group. Observe and compare three groups of Pittsburgh sleep quality index Quality Sleep index PSQI, TCM symptom score of deficiency of heart and spleen. Self-Rating Anxiety Scale. Sas) and Self-Rating Depression scale (SDS) scores were improved. The existing scraping improvement insomnia patients sleep quality related research overall quality is poor, in the choice of internationally recognized insomnia diagnostic standards and evaluation tools, correct collection of data, the adoption of standard scraping method. The frequency and course of intervention, the implementation of specific randomization scheme and blind method, and the safety evaluation of scraping treatment need to be further standardized. It provides the basis of evidence-based theory for the establishment of intervention program for insomnia patients in this study. After treatment, the total score of PSQI, the score of TCM symptom scale of deficiency of heart and spleen and the score of SDS in scraping group, cupping group and combined treatment group were lower than those before treatment. The total score of PSQI and other dimensions, the scores of TCM symptom scale and SDS of insomnia with deficiency of heart and spleen in single treatment group were lower than those before treatment, except subjective sleep quality dimension. The total score and other dimensions of PSQI and the scores of TCM symptom scale and SDS in the combined treatment group were lower than those in the single treatment group (all P 0.05, except sleep time). In addition to the sleep efficiency dimension, the total score of PSQI and other dimensions in the scraping group and cupping group, and the TCM symptom scale score of insomnia due to deficiency of heart and spleen. There was no difference between SAS and SDS scores. Conclusion: single scraping and cupping therapy can improve sleep quality, TCM symptoms of deficiency of heart and spleen, anxiety and depression. Generally speaking, scraping combined with cupping can improve sleep quality, anxiety and depression of insomnia patients, and the effect is better than single scraping method. The effect of single scraping method is better than that of single cupping method.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R244.4

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