【作者】 张鹏；

【导师】 王丽芹；

【作者基本信息】 黑龙江中医药大学 ， 护理（专业学位）， 2023， 硕士

【摘要】 目的:1.通过文献分析法明确腕踝针治疗失眠的时间参数选取现状以及存在问题,以探寻其中规律;2.通过临床对照试验明确腕踝针疗法治疗心悸患者失眠症状的作用效果,探究留针时长对腕踝针治疗失眠症状的疗效影响。方法:1.检索中国知识资源总库(CNKI)、万方数据库、维普数据库及Pub Med数据库中公开发表的所有关于腕踝针干预失眠的相关文献,时间自数据库建库起至2021年12月。将纳入文献的留针时长、针刺间隔时间及疗程等针刺时间参数信息进行提取,总结并分析腕踝针治疗失眠的时间参数规律。2.采取方便抽样法选取2021年11月至2023年2月在哈尔滨市某三家医院心血管科的住院且符合纳入排除标准的98例患者。按照分层随机分组的方法将98例心悸失眠患者随机分为对照组、试验1组、试验2组。对照组给予基础治疗与院内常规护理;试验1、2组患者在常规护理的基础上给予腕踝针治疗,试验1组留针30min、试验2组留针1h,每日针刺1次,连续针刺5次为1个疗程,三组均治疗2个疗程。应用一般情况调查表检测干预前三组患者基本资料的一致程度、分别应用PSQI量表(Pittsburgh Sleep Quality Index)及EQ-5D-5L量表(European Five Dimension Questionnaire 5Level)评价三组患者在干预前和治疗结束后的睡眠质量状况与生活质量状况、应用小米手环记录并计算出三组患者在治疗干预第一疗程、第二疗程阶段的日平均睡眠时长。以上所纳入的资料均录入SPSS26.0统计学软件进行统计分析。结果:1.干预前三组患者的一般资料、PSQI量表及EQ-5D-5L量表评分差异均无统计学意义(P>0.05),三组患者基线基本一致,具有可比性。2.治疗前后进行组内比较,三组患者PSQI量表及EQ-5D-5L量表评分均有明显改善,具有显著差异(P<0.05)。治疗1个疗程时三组患者的日平均睡眠时长无显著差异(P>0.05);而与治疗1个疗程相比,治疗2个疗程后各组患者的日平均总睡眠时长有明显提升,差异具有统计学意义(P<0.05)。3.经两个疗程的治疗后,相较于对照组,试验1、2组患者SQI量表及EQ-5D-5L量表评分的改善效果更明显,差异具有统计学意义(P<0.05);而试验1、2组患者的治疗效果略有差异,但差异无统计学意义(P>0.05)。结论:1.腕踝针疗法可以有效缓解心悸患者的失眠症状;2.腕踝针留置30min与留置1h,对失眠症状改善的效果无显著性差异,临床留置腕踝针30min、1h均可达到有效改善失眠的效果。更多还原

【Abstract】 Objective:1.Analyze the current situation and existing problems of the time parameters of wrist-ankle acupuncture treatment of insomnia through literature analysis to explore the rules;2.Through clinical control trial to clarify the effect of wrist-ankle acupuncture therapy on insomnia symptoms in patients with palpitations,and explore the effect of needle retention length on wrist-ankle acupuncture treatment on insomnia symptoms.Methods:1.Search all relevant literature published in China Knowledge Resources Database(CNKI),Wanfang Database,Weipu Database and Pub Med Database on wrist-ankle acupuncture intervention in insomnia,from the establishment of the database to December 2021.The time parameter information of acupuncture such as needle retention time,acupuncture interval time and course of treatment was extracted,and the time parameter rules of wrist-ankle acupuncture treatment for insomnia were summarized and analyzed.2.98 patients who were hospitalized in the cardiovascular department of three hospitals in Harbin from November 2021 to February2023 and met the exclusion criteria were selected by convenient sampling.According to the stratified randomization method,98 patients with palpitations and insomnia were randomly divided into control group,trial1 group and trial 2 group.The control group was given basic treatment and usual in-hospital care;Patients in trials 1 and 2 were given wrist-ankle acupuncture treatment on the basis of routine nursing,and the needles were kept for 30 min in trial group 1 and 1h in test group 2,acupuncture once a day,5 consecutive acupuncture times for 1 course of treatment,and 2 courses of treatment in all three groups.The general condition questionnaire was used to detect the consistency of basic data of the three groups of patients before the intervention,and the PSQI scale(Pittsburgh Sleep Quality Index)was applied respectively and the European Five Dimension Questionnaire 5 Level(EQ-5D-5L)evaluated the sleep quality and quality of life of the three groups of patients before and after the intervention,and used the Xiaomi Band to record and calculate the average daily sleep duration of the three groups in the first course and second course of treatment intervention.The above included data are entered into SPSS26.0 statistical software for statistical analysis.Results:1.There was no statistically significant difference in the scores of general data,PSQI scale and EQ-5D-5L scale of the three groups before the intervention(P>0.05),and the baselines of the three groups were basically consistent and comparable.2.Intra-group comparison before and after treatment,the scores of PSQI scale and EQ-5D-5L scale in the three groups were significantly improved,with significant differences(P<0.05).There was no significant difference in the average daily sleep duration of the three groups after one course of treatment(P>0.05),and compared with the first course of treatment,the average total daily sleep duration of the patients in each group was significantly increased after the two courses of treatment,and the difference was statistically significant(P <0.05)。3.After two courses of treatment,compared with the control group,the improvement effect of PSQI scale and EQ-5D-5L scale scores in patients in test groups 1 and 2 was more obvious,and the difference was statistically significant(P<0.05),while the treatment effect of patients in trial 1 and 2 groups was slightly different,but the difference was not statistically significant(P>0.05).Conclusion:1.Wrist and ankle acupuncture therapy can effectively relieve insomnia symptoms in patients with palpitations;2.The retention of wrist and ankle needles for 30 min and that for 1h,there is no significant difference in the improvement of insomnia symptoms.Clinical retention of wrist and ankle needles for 30 min and 1h can achieve the effective effect of improving insomnia.更多还原