中医非药物干预在社区老年失眠中的整合应用研究——基于智慧康养服务模式的实践探索

Research on the Integrated Application of Non‑Pharmacological Traditional Chinese Medicine Interventions for Insomnia among Community‑Dwelling Older Adults—A Practical Exploration Based on the Smart Health‑Care and Wellness Service Model

摘要: 本研究旨在构建智慧康养赋能下的中医非药物整合干预模式，完善社区老年失眠专业化康养服务体系。采用随机对照研究方法，选取80例社区老年失眠患者分为两组，对照组实施常规睡眠健康宣教与随访服务，观察组依托智慧康养平台，开展智慧分级筛查、中医辨证分型、多技术整合干预及动态方案迭代的闭环服务，持续干预12周，以PSQI睡眠评分、干预依从率、远期复发率作为核心评价指标。研究结果表明，观察组干预后睡眠质量显著优于对照组，干预依从性更高、远期复发率更低，全程未发生不良安全事件。本次试点研究证实，智慧赋能下的中医非药物整合干预模式可有效改善社区老年人睡眠状态，提升居家干预依从性，服务模式规范、安全性高。但受单中心、小样本等条件限制，该方案的普适性仍有待大样本、多中心研究进一步验证，仅可作为社区老年失眠智慧康养优化的初步实践参考。

Abstract: This study aims to develop an integrated non‑pharmacological intervention model of Traditional Chinese Medicine (TCM) empowered by smart health‑care and wellness services, so as to improve the professional health‑care service system for community‑dwelling older adults with insomnia. A randomized controlled trial was conducted, in which 80 community‑dwelling older adults suffering from insomnia were recruited and assigned to two groups. The control group received routine sleep‑health education and follow‑up services. Relying on a smart health‑care and wellness platform, the observation group received closed‑loop services including intelligent graded screening, TCM syndrome differentiation, integrated multi‑technique interventions and dynamic protocol iteration for a 12‑week intervention period. The Pittsburgh Sleep Quality Index (PSQI) score, intervention adherence rate and long‑term recurrence rate were adopted as core outcome indicators. The results revealed that the observation group achieved significantly better sleep quality, higher intervention adherence and lower long‑term recurrence rate compared with the control group. No adverse safety events occurred throughout the study. This pilot study demonstrated that the smart-empowered integrated non-pharmacological TCM intervention model can effectively improve the sleep status of community-dwelling older adults, promote adherence to home-based intervention, and provide a standardized and safe service model. Nevertheless, given the constraints of a single-center, small-sample design, the generalizability of this approach still needs to be verified in large-sample, multi-center studies, and the present findings can only serve as a preliminary practical reference for optimizing smart eldercare for community-dwelling older adults with insomnia.