中医特色疗法干预冠心病合并失眠患者睡眠质量的临床研究

Clinical Study of Sleep Quality on the Intervention of Traditional Chinese Medicine Characteristic Therapy in Patients with Coronary Heart Disease Complicated with Insomnia

摘要: 目的：观察温通刮痧配合八段锦改善气虚血瘀型冠心病患者失眠情况的疗效。方法：选取120例气虚血瘀型冠心病患者作为研究对象，将120例患者随机分成对照组、治疗组，每组60例。对照组在常规西医治疗基础上进行常规护理；治疗组在对照组基础上加用温通刮痧治疗及八段锦操，连续治疗2个疗程。对比两组患者治疗前后的中医症状积分及中医症状疗效。运用匹兹堡睡眠质量指数量(PSQI)表观察患者治疗前后的睡眠变化情况。结果：最终120例患者完成治疗。在中医症状积分上，治疗后治疗组多梦易醒、心悸、健忘、头晕目眩、神疲乏力、面色不华等症状较治疗前明显改善(P < 0.05)，对照组心悸、健忘、头晕目眩、面色不华等症状较治疗前明显改善(P < 0.05)，多梦易醒、神疲乏力等症状没有改善，在中医症候总积分比较方面，两组均较治疗前降低，且治疗组较对照组下降显著，差异均有统计学意义。在PSQI各维度比分比较方面，两组治疗后PSQI总评分均较治疗前降低，其中对照组的睡眠质量、入睡时间、睡眠时间、睡眠效率及日间功能障碍等评分下降明显，治疗组各维度评分均显著下降(P < 0.05)，组间比较上，治疗组治疗后PSQI睡眠时间、睡眠效率、睡眠障碍、催眠药物的应用及日间功能障碍等维度评分均低于对照组(P < 0.05)。在PSQI疗效上，对照组的总有效率为45.00%；治疗组总有效率为83.33%，治疗组总有效率优于对照组(P < 0.05)。结论：在常规西医治疗基础上加用中医特色疗法能很好改善气虚血瘀型冠心病合并失眠患者的中医症状及睡眠质量，温通刮痧配合八段锦质量有利于改善患者生活质量，促进患者早日康复，值得临床推广。

Abstract: Objective: To observe the effect of Wentong Guasha combined with Baduanjin on insomnia in patients with coronary heart disease of qi deficiency and blood stasis type. Methods: 120 patients with coronary heart disease of qi deficiency and blood stasis type were selected as the research objects. 120 patients were randomly divided into control group and treatment group, 60 cases in each group. The control group was given routine nursing on the basis of routine western medicine treatment. On the basis of the control group, the treatment group was treated with Wentong Guasha therapy and Baduanjin exercise for 2 consecutive courses. The scores of TCM symptoms and the curative effect of TCM symptoms before and after treatment were compared between the two groups. The Pittsburgh Sleep Quality Index (PSQI) table was used to observe the sleep changes of patients before and after treatment. Results: Finally, 120 patients completed the treatment. In terms of TCM symptom scores, after treatment, the symptoms of dreaminess, palpitation, forgetfulness, dizziness, fatigue, and pale complexion in the treatment group were significantly improved compared with those before treatment (P < 0.05). The symptoms of palpitation, forgetfulness, dizziness, and pale complexion in the control group were significantly improved compared with those before treatment (P < 0.05). There was no improvement in the symptoms of dreaminess, fatigue, and fatigue. In terms of the total score of TCM symptoms, both groups were lower than before treatment, and the treatment group was significantly lower than the control group. The difference was statistically significant. In terms of the comparison of PSQI scores in each dimension, the total PSQI scores of the two groups after treatment were lower than those before treatment. The scores of sleep quality, sleep time, sleep time, sleep efficiency and daytime dysfunction in the control group decreased significantly, and the scores of each dimension in the treatment group decreased significantly (P < 0.05). Compared with the control group, the scores of PSQI sleep time, sleep efficiency, sleep disorder, application of hypnotic drugs and daytime dysfunction in the treatment group were lower than those in the control group (P < 0.05). In terms of PSQI efficacy, the total effective rate of the control group was 45.00%; the total effective rate of the treatment group was 83.33%. The total effective rate of the treatment group was better than that of the control group (P < 0.05). Conclusion: On the basis of conventional western medicine treatment, the addition of traditional Chinese medicine characteristic therapy can improve the TCM symptoms and sleep quality of patients with coronary heart disease and insomnia of qi deficiency and blood stasis type. Wentong Guasha combined with Baduanjin quality is conducive to improving the quality of life of patients and promoting the early recovery of patients, which is worthy of clinical promotion.