| Objective:To investigate the sleep quality in patients of maintenance hemodialysis,discuss intervention effect of point-application treatment in chronic insomnia.Methods:This study consisted of two stages.The first stage was a descriptive research.100 patients of maintenance hemodialysis from Jiangsu Province Hospital of TCM were recruited to investigate the sleep quality and related influential factors were analyzed.The second stage was point-application therapy intervention.According to the scoring standard of Pittsburgh Sleep Quality Index,56 patients who got PSQI score?7 point were recognized as the subjects of intervention,then,they were treated with point-application intervention in addition to basic therapy.The subjects were treated continuously for 20 days,PSQI scores were assessed before and after treatment and compared to evaluate clinical effects of point-application treatment.SPSS22.0 software was used for statistical analysis.Correlation analysis for numerical variables and variance analysis for nominal variable,to explore the correlation between PSQI score and various factors.Numerical variables were described by mean standard deviation(x±S),and nominal variables were expressed as percentage or composition.The differences in PSQI scores of the subjects before and after the intervention were compared by non-parametric Wilcoxon test.All the tests were statistically significant with P<0.05.Results:1.The mean PSQI score of 91 subjects was 8.868±4.874,the average of subjective sleep quality was 1.428±0.920,the time of falling sleep 1.670±1.202,sleeping time 1.637±1.260,sleeping effect 1.417± 1.221,the handicap of sleeping 1.121 ±0.574,the drugs of hypnosis 0.417±0.955,function handicap in daytime 1.87±0.987.The investigation showed that 56 cases(61.54%)suffer chronic insomnia and 35cases(38.46%)sleep well.All projects of PSQI,The first three sleep problems are sleeping time(37.4%),the time of falling sleep(36.3%),sleeping effect(29.7%),subjective sleep quality(13.2%),function handicap in daytime(12.1%)followed,the drugs of hypnosis,function handicap in daytime accounted for the lowest proportion.2.Spearman correlation coefficient and one-way ANOVA showed that there were no significant statistical differences in gender,educational background,marital status,payment mode,the primary disease,the level of serum calcium,phosphorus,calcium-phosphorus product,serum albumin,hemoglobin with PSQI score(P>0.05);there was positive correlation in age(P<0.01),parathyroid hormone(P<0.05)with PSQI score.3.Nonparametric test showed that PSQI score,subjective sleep quality,the time of falling sleep,sleeping time,sleeping effect and function handicap in daytime were declined significantly after intervention(P<0.01);the handicap of sleeping,the drugs of hypnosis were also declined but statistical differences were contrary to the former.TCM therapeutic evaluation showed 3 cases had marked effect(6%),27 were effective(54%),20 no effect(60%),total efficiency was 60%.4.In this study,3 of 50 subjects had slight adverse reactions,and the incidence of adverse reactions was 6%.Conclusion:This study showed there is a high incidence of sleep disorder in patients of maintenance hemodialysis,sleeping time,the time of falling sleep,sleeping effect were the most common sleep problems.There was positive correlation in age and parathyroid hormone with sleep disorder.Point-application therapy can effectively improve sleeping time,the time of falling sleep,sleeping effect in patients of maintenance hemodialysis so as to improve the quality of sleep with less adverse reactions and high safety. |
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