發(fā)布時(shí)間：2018-01-30 14:45

  本文關(guān)鍵詞： 失眠 心脾兩虛 刮痧 拔罐 匹茲堡睡眠質(zhì)量指數(shù) 焦慮 抑郁　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：研究目的:比較單一刮痧法、拔罐法和刮痧聯(lián)合拔罐法改善心脾兩虛型失眠患者睡眠質(zhì)量、心脾兩虛失眠中醫(yī)癥狀、焦慮和抑郁情緒的療效,豐富刮痧聯(lián)合拔罐技術(shù)臨床適用病種。研究方法:(1)基于護(hù)理循證理論,采用Meta分析法,以"刮痧干預(yù)失眠患者"為主題,客觀評(píng)價(jià)刮痧治療失眠的療效和安全性,尋找臨床中醫(yī)刮痧治理失眠最佳實(shí)踐方案;(2)將心脾兩虛型失眠患者按照本研究既定的隨機(jī)化方案分為刮痧組、拔罐組、聯(lián)合治療組。連續(xù)治療10周后,觀察比較三組匹茲堡睡眠質(zhì)量指數(shù)(Pittsburgh Quality Sleep Index,PSQI)、心脾兩虛失眠中醫(yī)癥狀積分、自評(píng)焦慮量表(Self-Rating Anxiety Scale,SAS)和自評(píng)抑郁量表(Self-Rating Depression Scale,SDS)得分改善效果。研究結(jié)果:(1)meta分析提示,現(xiàn)有的刮痧改善失眠患者睡眠質(zhì)量相關(guān)研究總體質(zhì)量較差,在選擇國際公認(rèn)的失眠診斷標(biāo)準(zhǔn)和評(píng)價(jià)工具、正確收集資料、采用規(guī)范的刮痧方法、干預(yù)頻率和療程、明確具體的隨機(jī)化方案和盲法的實(shí)施情況、刮痧治療的安全性評(píng)價(jià)等方面需要進(jìn)一步規(guī)范,為本研究制定失眠患者干預(yù)方案提供了前期循證理論基礎(chǔ);(2)治療后,刮痧組、拔罐組、聯(lián)合治療組PSQI總分及各維度、心脾兩虛中醫(yī)癥狀量表得分、SAS和SDS得分較治療前下降。除服催眠藥物維度外,單一治療組PSQI總分及其余維度、心脾兩虛失眠中醫(yī)癥狀量表得分、SAS和SDS得分均較治療前下降。除主觀睡眠質(zhì)量維度外,聯(lián)合治療組PSQI總分及其余維度、心脾兩虛失眠中醫(yī)癥狀量表得分、SAS和SDS得分較單一治療組低(均P0.05)。除入睡時(shí)間、睡眠效率維度外,刮痧組和拔罐組PSQI總分及其余各維度、心脾兩虛失眠中醫(yī)癥狀量表得分、SAS和SDS得分無差異(P0.05)。研究結(jié)論:單一刮痧和拔罐療法均可以改善患者睡眠質(zhì)量、心脾兩虛中醫(yī)癥狀、焦慮、抑郁情緒,但不能減少患者服用安眠藥量�？傮w來說,刮痧聯(lián)合拔罐可改善失眠患者的睡眠質(zhì)量和焦慮、抑郁心理,且效果優(yōu)于單一刮痧法、拔罐法。單一刮痧法效果好于單一拔罐法。
[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.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R244.4

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