生物反馈治疗老年原发性高血压与老年Ⅱ型糖尿病的疗效研究

发布时间：2018-07-29 20:41

【摘要】：目的观察生物反馈疗法对老年原发性高血压和老年Ⅱ型糖尿病患者的心理生理反应的调节效果,并探讨生物反馈疗法对老年原发性高血压和老年Ⅱ型糖尿病的治疗效果,从而为治疗老年高血压和老年糖尿病提供一定的实践和理论依据。方法2016年5月-6月于四川省宜宾市某乡镇选取符合世界卫生组织建议的高血压诊断标准的原发性高血压患者以及符合糖尿病诊断标准的Ⅱ型糖尿病患者。根据入组标准和排除标准,选取40名老年高血压患者按照随机数字表法分为高血压治疗组和高血压对照组,同时选取40名老年糖尿病Ⅱ型糖尿病患者按照随机数字表法分为糖尿病治疗组和糖尿病对照组,每组各20例。实验方法与步骤:(1)采用自制一般信息调查表收集研究对象的基本情况(包括年龄、性别、受教育程度等)。(2)分别测量高血压治疗组与对照组血压值以及糖尿病治疗组与对照组血糖值并作为初始值记录。(3)选用生物反馈仪(spirit-8)压力训练中指导语放松训练模块对高血压治疗组和糖尿病治疗组患者进行治疗,患者在指导语的引导下渐进性地进行放松,每次25分钟,每周2次,一共实施8次。治疗结束后高血压治疗组测量右臂血压作为结束值并记录,糖尿病治疗组测取指尖血测试血糖值并记录。(4)治疗组所有成员完成生物反馈治疗后,分别采集治疗组和对照组的血压以及血糖值。结果1、高血压治疗组在接受治疗后血压呈下降趋势,八次治疗后收缩压(t=5.65,p=0.00)、舒张压(t=3.18,p=0.00)以及脉压差(t=4.87,p=0.00)与第一次治疗前相比有明显的降低,差异有统计学意义。2、糖尿病治疗组在接受治疗后血糖呈下降趋势,八次治疗后血糖与第一次治疗前相比有明显的降低,差异有统计学意义(t=2.02,p=0.04)。3、高血压治疗组经过八次生物反馈治疗后,左脑θ波(t=2.29,p=0.03)在第八次治疗后明显低于治疗前的基线水平,治疗后的rmssd值(t=-3.12,p=0.00)和sdnn值(t=-2.6,p=0.02)均明显高于治疗前的基线水平,差异有统计学意义。4、糖尿病治疗组经过八次生物反馈治疗后,右脑θ波(t=-2.12,p=0.00)、左脑θ波(t=-2.20,p=0.04)和心率(t=-2.71,p=0.01)在第八次治疗后明显低于治疗前的基线水平,治疗后的皮温(t=5.94,p=0.00)、rmssd值(t=2.44,p=0.03)和sdnn值(t=2.25,p=0.04)均明显高于治疗前的基线水平,差异有统计学意义。5、治疗组血压血糖的改善情况与性别、年龄、婚姻状况、文化程度、家庭住址、居住情况、与配偶关系、有几个孩子以及与子女关系均不具有相关性(p均0.05)。6、对高血压治疗组治疗前后和随访3个月与6个月收缩压(f=6.69,p=0.00)、舒张压(f=4.91,p=0.00)和脉压差(f=4.19,p=0.00)进行单因素方差分析,分析结果表明有明显组间效应,采用事后检验的lsd方法可知,高血压治疗组收缩压治疗后与治疗前相比明显降低(p=0.001),与治疗后相比明显降低(p=0.010),随访6个月与治疗前相比收缩压明显降低(p=0.031),与治疗后相比收缩压明显降低(p=0.027);舒张压治疗后与治疗前相比明显降低(p=0.002),随访3个月与治疗前相比明显降低(p=0.007),随访6个月与治疗前相比明显降低(p=0.002),组脉压差治疗后与治疗前相比明显降低(p=0.003),差异均具有统计学意义。对糖尿病治疗组治疗前后和随访3个月与6个月随机血糖值进行单因素方差分析,分析结果表明有明显组间效应(f=7.44,p=0.00),采用事后检验的lsd方法可知,随访3个月与治疗前相比明显降低(p=0.001),随访6个月与治疗前相比明显降低(p=0.001),差异均具有统计学意义。结论1、本研究表明生物反馈治疗对老年原发性高血压和老年Ⅱ型糖尿病的辅助治疗有一定效果。2、采用辅助的生物反馈的治疗方法,老年高血压患者左脑θ波波幅明显下降,sdnn、rmssd值显著提高,老年Ⅱ型糖尿病患者左右脑θ波波幅与心率明显下降,SDNN、RMSSD值显著提高,由此可以推测,生物反馈治疗有利于抑制老年高血压与老年糖尿病患者的交感神经兴奋性,起到降低血压血糖的作用。3、患者血压血糖的改善情况不受性别、年龄、婚姻状况、文化程度等人口因素的影响,如能按照治疗要求掌握正确的方法并坚持放松训练,均可以得到比较好的治疗效果。4、生物反馈治疗对老年原发性高血压患者的血压和老年Ⅱ型糖尿病患者的随机血糖都具有较为长期的调控作用。
[Abstract]:Objective To observe the effect of biofeedback therapy on the psychological and physiological responses of elderly patients with primary hypertension and elderly type 2 diabetes, and to explore the therapeutic effect of biofeedback therapy on elderly primary hypertension and elderly type 2 diabetes, so as to provide some practical and theoretical basis for the treatment of elderly hypertension and senile diabetes. Methods in May 2016 -6 months in a township in Yibin, Sichuan Province, a primary hypertension patient and a diabetic patient who met the diagnostic criteria of the WHO recommended by the WHO were selected as the criteria for diabetes. According to the criteria for the entry and the exclusion criteria, 40 elderly hypertensive patients were selected according to the random number table method. At the same time, 40 patients with diabetes type II diabetes were divided into diabetes treatment group and diabetes control group, with 20 cases in each group. The experimental methods and steps: (1) a self-made general information questionnaire was used to collect the basic information of the research subjects (including age, sex, education. (2) the blood pressure of the hypertension treatment group and the control group, the blood glucose value of the diabetes treatment group and the control group were recorded and the initial value was recorded. (3) the guidance language relaxation training module of the biofeedback (spirit-8) training was used to treat patients with hypertension treatment group and diabetes treatment group, and the patients were guided in the guidance language. Take a gradual relaxation, 25 minutes each time, 2 times a week and 8 times. After the treatment, the hypertension treatment group measured the right arm blood pressure as the end value and recorded the blood glucose in the fingertip blood test. (4) all the members of the treatment group completed the biofeedback treatment and collected the blood pressure of the treatment group and the control group respectively. Results 1, 1, the blood pressure of the hypertension treatment group decreased after the treatment, the eight times after treatment, the systolic pressure (t=5.65, p=0.00), the diastolic pressure (t=3.18, p=0.00) and the pulse pressure (t=4.87, p=0.00) had a significant decrease compared with the first treatment, the difference was statistically significant.2, the diabetes treatment group had a lower blood sugar after receiving treatment. After eight times of treatment, the blood sugar was significantly lower than that before the first treatment. The difference was statistically significant (t=2.02, p=0.04).3. After eight times of biofeedback treatment, the left brain theta wave (t=2.29, p=0.03) was significantly lower than the baseline level before treatment, and the RMSSD value (t=-3.12, p=0.00) and SDNN after treatment. The values (t=-2.6, p=0.02) were significantly higher than the baseline levels before treatment, and the difference was statistically significant.4. After eight times of biofeedback therapy, the right brain (t=-2.12, p=0.00), left brain Bo (t=-2.20, p=0.04) and heart rate (t=-2.71, p=0.01) were significantly lower than the baseline levels of the treatment group after eight times of biofeedback treatment, and the skin temperature after treatment (t=5.9). 4, p=0.00), the value of RMSSD (t=2.44, p=0.03) and SDNN (t=2.25, p=0.04) were significantly higher than the baseline levels before treatment. The difference was statistically significant.5. The improvement of blood pressure in the treatment group was related to sex, age, marital status, educational level, family address, residence, relationship with spouses, several children and their relationship with their children. (P 0.05).6, the single factor analysis of variance was carried out between before and after treatment and 3 months and 6 months of systolic blood pressure (f=6.69, p=0.00), diastolic pressure (f=4.91, p=0.00) and pulse pressure difference (f=4.19, p=0.00) before and after treatment in the treatment group of hypertension. The results showed that there were obvious inter group effects. Compared with the treatment significantly decreased (p=0.001) before treatment (p=0.010), the systolic pressure decreased significantly (p=0.031) compared with that before treatment (p=0.031), and the systolic pressure was significantly lower than that of the treatment (p=0.027); diastolic pressure was significantly lower than before treatment (p=0.002), and the follow-up was significantly lower than that before treatment (p=0.007). The follow-up period of 6 months was significantly lower than that before treatment (p=0.002). The difference was significantly lower than before treatment (p=0.003), and the difference was statistically significant. The results showed that there were significant inter group effects (f=7.44, p=0.0). 0), the LSD method of post examination showed that the follow-up 3 months was significantly lower than that before treatment (p=0.001), and the follow-up 6 months was significantly lower than before treatment (p=0.001), and the difference was statistically significant. Conclusion 1. This study showed that biofeedback therapy has some effect on the adjuvant treatment of elderly primary hypertension and type 2 diabetes. .2, with the aid of biofeedback therapy, the amplitude of theta wave in the left brain of the elderly patients with hypertension was significantly decreased, and the value of SDNN and RMSSD increased significantly. The amplitude and heart rate of the left and right brain theta wave and heart rate of the elderly patients with type II diabetes were significantly decreased, and the values of SDNN and RMSSD were significantly improved. Therefore, it is possible to speculate that biofeedback therapy is beneficial to the inhibition of elderly hypertension and old sugar. The sympathetic excitability of the patients with urinary disease plays a role in reducing blood pressure and blood sugar.3. The improvement of blood pressure in patients is not affected by the influence of sex, age, marital status, and educational level, such as the ability to master the correct methods and adhere to the relaxation training according to the requirements of treatment, and get better therapeutic effect,.4, biofeedback. Treatment has a long-term regulatory effect on blood pressure in elderly patients with essential hypertension and random glucose in elderly patients with type 2 diabetes.
【学位授予单位】：成都医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R544.1;R587.1

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