耳穴压豆联合穴位按摩对慢性肾功能衰竭维持血液透析患者睡眠及生活质量的影响

目的] 研究耳穴压豆联合穴位按摩对慢性肾功能衰竭维持血液透析伴睡眠障碍患者睡眠及生活质量的影响。方法] 选取2018年5月-2019年5月在深圳市宝安区中医院肾病科就诊的慢性肾功能衰竭维持血液透析伴睡眠障碍患者76例，随机分为对照组和观察组，各38例。两组患者均接受常规血液透析及其他对症治疗，对照组患者予慢性肾功能衰竭维持血液透析基础护理，包括导管护理、一般宣教、生活指导等，观察组在对照组基础上予耳穴压豆及穴位按摩治疗，穴位按摩每日进行1次，耳穴压豆隔日1次，两组患者均连续观察4周。干预前后均进行匹兹堡睡眠质量指数（PSQI）评分，抑郁自评量表（SDS）、焦虑自评量表（SAS）评分，肾病相关生活质量（KDTA）评分，并比较干预后两组患者睡眠改善临床疗效。结果] 干预后，观察组患者PSQI各维度评分及总分，SDS、SAS评分与干预前及对照组比较均显著降低（P<0.05），KDTA生活质量评分与干预前及对照组比较均显著升高（P<0.05）。观察组睡眠改善总有效率为92.1%，与对照组71.1%比较，具有统计学差异（P<0.05）。结论] 慢性肾功能衰竭维持血液透析伴睡眠障碍患者在基础护理同时，予耳穴压豆联合穴位按摩疗法，可以有效改善患者睡眠质量，减少入睡时间，延长有效睡眠时间，改善睡眠质量，缓解抑郁、焦虑等不良情绪，提高生活质量。

Effect of acupoint massage combined with auricular acupoint pressing on sleep and quality of life in patients with slow renal failure caused by hemodialysis

Objective] To study the effects of acupoint massage combined with auricular acupoints on maintaining sleep and quality of life in patients with chronic renal failure and sleep disorders.Methods] The 76 patients with chronic renal failure and sleep disorders who underwent hemodialysis in the department of nephrology,Baoan District Chinese Medicine Hospital,from May 2018 to May 2019 were randomly divided into the control group and the observation group,and each group had 38 cases. Both groups received routine hemodialysis and other symptomatic treatment. The control group received basic care for hemodialysis chronic renal failure,including catheter care,general education,life guidance,etc. The observation group provided acupressure and auricular points on the basis of the control group. Compressed bean treatment,acupressure was performed once a day,and auricular points were pressed once every other day. Both groups were observed for 4 weeks. Pittsburgh Sleep Quality Index (PSQI) score,Self-rating Depression Scale (SDS),Self-rating Anxiety Scale (SAS) score,Kidney Disease-related Quality of Life (KDTA) score were compared before and after intervention,and sleep improvement was compared between the two groups after intervention.Results] After the intervention,the scores and total scores of PSQI in the observation group were significantly lower than those in the control group (P<0.05). The KDTA quality of life score was significantly higher than that before the intervention and the control group (P<0.05). The total effective rate of sleep improvement in the observation group was 92.1%,which was significantly different from the control group (71.1%) (P<0.05).Conclusion] Patients with chronic renal failure who maintained hemodialysis and sleep disorders were treated with the basic care and acupoint massage therapy,which can effectively improve the patient''s sleep quality,reduce sleep time,prolong the effective sleep time,improve sleep quality,relieve depression,anxietyand improve the quality of life.