| ObjectiveThe study aimed to evaluate the effect of Nutritive-Defens ive Qi theory guided Chinese herbal foot bath on sleep quality,daytime sleepiness,anxiety,depression,sleep-wake rhythm,quality of life,level of blood pressure and heart rate among patients with insomnia.It can promote the advance of both time effect and standardization in Chinese herbal foot bath,furtherly to promote the development of TCM nursing.MethodsThis study was a randomized controlled trail.Accroding to the inclusion criteria,From January 2015 to January 2016,95 patients from a hospital of TCM in Chengdu Sichuan Province were included.They were divided into control group(n=31),time group(n=32),time and prescription group(n=32)by simple randomization.Before intervention,we optimized the procedure of the Chinese herbal foot bath therapy,then the control group was required to perform foot bath with Chinese herbal Guizhi(Cinnamomum cassia Presl)before going to bed(avoided youshi)and in the morning(avoided maoshi).The time group was asked to perform foot bath with same medicine at maoshi and youshi.The time and prescription group received foot bath with different herbal medicine at different time.Guizhi and Chaihu(Radjx bupleuri)were used at maoshi(5:00-7:00 AM),while Guizhi,Baishao(Paeonia lac tiflora Pall),Longgu(Os Draconis)and Concha Osreeae were used at youshi(5:00-7:00 PM).All groups performed foot bath twice a day.For the purpose of the study,several scales such as the Pittsburgh Sleep Quality Index(PSQI),Epworth sleepiness scale(ESS),Hamilton Anxiety Scale(HAMA),Self-rating depression scale(SDS),Athens Insomnia Scale(AIS),Short form 36 questionnaire(SF-36)as well as the level of blood pressure and heart rate were measured before and after the intervention.ResultsTotally,90 patients completed all data collection.In the control group,1 case lossed,in the time group,2 case lossed,while in the time and prescription group,1 cases rejected and 1 cases lossed.1.Sleep Quality.After the intervention,the total score and each dimensions' score of PSQI in the control group(sleep time,sleep disorder and sleep efficiency excluded),time group(sleep disorder excluded),time and prescription group were all lower than before(P <0.05 for all).Comparison among groups showed: the total PSQI score and score of each dimensions except sleep disorder had signif icant differences(P <0.05).Further pairwise comparisons in three groups showed: in the aspect of total PSQI score and score of each dimensions except sleep disorder,the time group was superior to the control group,the time and prescription group was superior to both time group and control group(P <0.05 for all).2.Sleep clinical effect.Comparison among groups showed significant differences(P <0.05).Further pairwise comparisons in three groups showed statistically signif icant only between the time and prescription group with the control group(P <0.017).3.Daytime sleepiness.After the intervention,the total score of ESS in the three groups were all lower than before(P <0.05 for all).Comparison among groups showed significant differences(P <0.05).Further pairwise comparisons in three groups showed: the time group was superior to the control group,the time and prescription group was superior to both time group and control group(P <0.05 for all).4.Anxiety Symptom.After the intervention,the total score of HAMA in the three groups were all lower than before(P <0.05 for all).Compar ison among groups showed signif icant differences(P <0.05).Further pairwise comparisons in three groups showed: the time group was superior to the control group,the time and prescription group was superior to both time group and control group(P <0.05 for all).5.Depressive Symptom.After the intervention,the total score of SDS in the three groups were all lower than before(P <0.05 for all).Comparison among groups showed no signif icant differences(P >0.05).6.Sleep-wake rhythm.After the intervention,the level of Sleep-wake rhythm disorder in the three groups were all lower than before(P <0.05 for all).Compar ison among groups showed signif icant differences(P <0.05).Further pairwise comparisons in three groups showed statistically signif icant only between the time and prescription group with the control group(P <0.017).7.Quality of Life.After the intervention,the total score and each dimensions' score of SF-36 in the control group(physiologic function and body pain excluded),time group,time and prescription group were all higher than before(P <0.05 for all).Comparison among groups showed: the total SF-36 score and score of each dimensions except physiologic function and body pain had signif icant differences(P <0.05).Further pairwise comparisons in three groups showed: in the aspect of total SF-36 score and score of each dimensions except physiologic function and body pain,the time group was superior to the control group,the time and prescription group was superior to both time group and control group(P <0.05 for all).8.Blood pressure and heart rate level: After the intervention,the level of blood pressure and heart rate in the three groups were all lower than before(P <0.05 for all).Comparison among groups showed significant differences(P <0.05).Further pairwise comparisons in three groups showed: the time group was superior to the control group,the time and prescription group was superior to both time group and control group(P <0.05 for all).ConclusionsThe Nutritive-Defensive Qi theory guided Chinese herbal foot bath can improve the quality of sleep and life,relieve the anxiety and depression,regulate the sleep-wake rhythm among patients with insomnia.This study can push the development of the time effect and standardization in Chinese herbal foot bath therapy,furtherly to promote the TCM nursing.It is worth to be further explored and widespread in hospitals and clinicals. |
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