Observation Of The Efficacy Of Auricular Acupressure Treatment In Maintenance Hemodialysis Patients With Insomnia

Objective:As well as we know that insomnia is one of the most problems in maintenance haemodialysis patients,and likely to contribute impairment the quality of life, which has a positive correlation with patients' survival.However there have been only a few studies in recent by investigation in China and other states and study it few how to improve sleep quality in order to enhance their living quality.So I would like to evaluate the prevalence,demographic and clinical features for hemodialysis insomnia.Especially to observe the clinic therapeutic effect of auricular points sticking on hemodialysis insomnia.Methods:A questionnaire was administered to all patients on maintenance hemodialysis at the Hemodialysis Centre in NO.1 hospital of wuhan,to assess their sleep complaints during January and december in 2007.Sixty cases were enrolled and diagnosed with the criteria of insomnia and the different types of Traditional Chinese Medicine(TCM),which had to have been on hemodialysis for more than three months and the questionnaires(in a Chinese version)total score of the Pittsburgh Sleep Quality Index(PSQI)is over seven.Those with a history of insomnia before on maintenance haemodialysis were excluded.They were randomly divided into three groups:the therepy group in auricular point sticking(20 cases),the soporific group(20 cases)and the control group treated with comfort,intercommunion, etal(20 cases).Quality of sleep was measured by the Pittsburgh Sleep Quality Index (PSQI),The patients were treated for 8 weeks continuously,subsequently visited for 6 months.We look into the score of subjective sleep quality,the time of falling asleep,sleeping time,sleeping effect,the handicap of sleeping,the drugs of hypnosis,function handicap in daytime,the total score of PSQI before and after treatment,and asses the clinic therapeutic effect of sleeping by selfcomparison (PSQI)before and after treatment and contrasting with three groups.Noting the patiengs'name,gender,age,the primary affection,the time of maintenance haemodialysis,the frequence of haemodialysis,the type of traditional chinese medicine,the reasons of insomnia and so on.Collecting the serum guideline such as levels of haemoglobin(HGB),albumin(ALB),Parathorome hormone (PTH),Serum ferfitin(Ferr),blood urea nitrogen(BUN),creatinine(Cr),the combine of carbon dioxide(TCO2),kalium(K),calcium(Ca),phosphor(P) and so on.Looking into the score of subjective sleep quality,the time of falling asleep,sleeping time,sleeping effect,the handicap of sleeping,the drugs of hypnosis,function handicap in daytime,the total score of PSQI at four week, eight week,and half one year after treatment.Four week is a treatment period,all patients inrolled are treated two periods.Their demographic data and biochemical and hematologic parameters were analyzed.Results:After one period of treatment,There were significant differences in subjective sleep quality and the time of falling asleep(P＜0.01);sleeping time,sleeping effect,the handicap of sleeping,the drugs of hypnosis and the function handicap in daytime(P＜0.001)between the therepy group in auricular point sticking and the soporific group,the soporific group have a better effect on sleep quality than the therepy group in auricular point sticking,the control group still have a good effect, but lower than the two therapy groups.After two periods of treatment,There were significant differences(P＜0.05)in the total score of PSQI,the therepy group in auricular point sticking make a great progressive when compared with the soporific group and control group.Six months later after treatment,the drugs of hypnosis the soporific group is well above when compared with the therepy group in auricular point sticking and contrlo group(P＜0.001).There is a significance difference clinical relative information were collected at pre-therapy,four week and eight week in three groupss.Conclusions:The therapy with auricular point sticking auricular point sticking is good for improving insomnia,which is safe,convenient,cheap,no reliance,no paint, good acceptance,longer effect-lasting time and so on.the soporific group' short-term clinic therapeutic effects prior to the therepy group in auricular point sticking,but inferior in long-term clinic therapeutic effects.The short-term as well as long-term clinic therapeutic effect is significant the therepy group in auricular point sticking.So it is worthwhile to extend.