摘要
目的探讨中药足浴对维持性血液透析患者睡眠质量和症状困扰的影响。方法以2013年4月—2014年3月在中南大学湘雅医院血液透析中心进行维持性血液透析治疗的76例患者为研究对象,采用随机数字表法将其分为干预组和对照组,每组38例。对照组仅接受医院常规宣教,干预组在接受医院常规宣教的基础上再接受为期8周的中药足浴。采用中文版匹兹堡睡眠质量指数量表(PSQI)与透析患者症状困扰量表(DSI)比较两组睡眠质量和症状困扰情况。结果干预前两组患者PSQI总分及各维度得分比较,差异均无统计学意义(P>0.05);干预后干预组的主观睡眠质量、睡眠时间、睡眠障碍、日间功能障碍得分及PSQI总分均低于对照组,差异有统计学意义(P<0.05);而入睡时间、睡眠效率及催眠药物得分虽低于对照组,但差异无统计学意义(P>0.05)。干预组干预后PSQI总分及各维度得分均有所降低,差异有统计学意义(P<0.01);对照组干预后PSQI总分及各个维度得分有所降低,但差异无统计学意义(P>0.05)。干预前,两组患者DSI总分及各维度得分比较,差异均无统计学意义(P>0.05);干预后干预组的DSI总分、症状困扰程度、症状严重程度及症状发生数目得分均低于对照组,差异有统计学意义(P<0.05),两组症状出现频率得分比较,差异无统计学意义(P>0.05)。干预组干预后各维度得分及DSI总分均降低,差异有统计学意义(P<0.01);对照组干预后各维度分值及DSI总分有所降低,但差异无统计学意义(P>0.05)。干预组干预后在入睡困难、瘙痒、烦躁、性兴奋困难、肌肉痉挛、皮肤干燥、担心、焦虑、悲伤、注意力不集中和紧张的症状发生率较干预前下降,差异有统计学意义(P<0.05);入睡困难、易醒、瘙痒、烦躁、性欲减退、性兴奋困难、皮肤干燥、担心、头晕、焦虑、悲伤、咳嗽、不安腿得分较干预前降低,差异有统计学意义(P<0.05)。结论中药足浴干预可有效改善维持性血液透析患者睡眠质量,减轻症状困扰。
Objective To explore the effect of TCM foot-bath therapy on the sleep quality and symptom distress of maintenance hemodialysis patients. Methods A total of 76 maintenance hemodialysis patients in Hemodialysis Center of Xiangya Hospital of Central South University were enrolled from April 2013 to March 2014. The patients were divided into intervention group and control group with 38 cases in each group by random number table. The control group received routine health education;the intervention group received TCM foot-bath therapy for 8 weeks besides routine health education. The sleep quality and symptom distress of the two groups were compared by pittsburg sleep quality index（ PSQI） scale of Chinese version and dialysis symptom index（ DSI）. Results No significant differences existed in the total score of PSQI and the score of each dimension between the two groups（ P 〉0. 05） before intervention. After intervention,the scores of subjective sleep quality,sleeping time,sleep disorders,daytime dysfunction score and the total score of PSQI of the intervention group were lower than those of the control group（ P 〉0. 05）; the scores of sleep time,sleep efficiency and hypnotic drugs of the intervention group were lower than those of the control group but the difference was not significant（ P 〈0. 05）. The total score of PSQI and the score of each dimension of the intervention group were lower after intervention than those before intervention（ P 〈0. 01）; the total score of PSQI and the score of each dimension of the control group were lower after intervention than those of before intervention but the difference was not significant（ P 〉0. 05）. No significant difference existed in the total score of DSI and the score of each dimension between the two groups（ P 〉0. 05） before intervention; after intervention,the total score of DSI and the scores of symptom distress degree,severity of symptom and numbers of symptoms were lower than those of the control group（ P 〈0. 05）;but the difference of symptoms frequency between two groups was not significant（ P 〉0. 05）. The total score of DSI and the score of each dimension of the intervention group were lower after intervention than those before intervention（ P 〈0. 01）; the total score of DSI and the scores of each dimension of the control group were lower after intervention than those before intervention but the difference was not significant（ P 〉0. 05）. The incidence rates of the symptoms of difficulty in falling asleep,pruritus,dysphoria,difficulty in sex excitement, muscle spasm, dry skin, worry, anxiety, sadness, inattention and tension of the intervention group were lower after intervention than those before intervention（ P 〈0. 05）; the scores of difficulty in falling asleep,restless sleep, pruritus, dysphoria, sexual hypoactivity, difficulty in sex excitement, dry skin, worry, dizziness,anxiety,sadness,cough and restless leg of the intervention group were lower after intervention than those before intervention（ P 〈0. 05）. Conclusion TCM foot-bath therapy can effectively improve sleep quality of patients with maintenance hemodialysis and alleviate symptom distress.
出处
《中国全科医学》
CAS
CSCD
北大核心
2016年第10期1207-1212,共6页
Chinese General Practice
关键词
维持性血液透析
中药足浴
睡眠质量
症状困扰
Maintenance hemodialysis TCM foot-bath Sleep quality Symptom distress
