| BackgroundAs a common cardiovascular disease that is extremely harmful to human health,coronary heart disease has a high incidence and high mortality,which is the main cause of death among residents in China and the world.At present,cardiovascular disease has become the leading cause of death in women,mainly related to the significant decrease in estrogen levels in perimenopausal women,which is associated with a significant increase in cardiovascular risk factors(lipid,blood pressure,body fat distribution,cardiac metabolic parameters,etc.).Perimenopausal women with coronary heart disease are often in a special physiological cycle,often with hot flashes,palpitation,chest tightness,chest pain,irritability,depression,fatigue,muscle and joint pain and other symptoms,resulting in high prevalence of insomnia and long-term insomnia.It will further increase the risk of cardiovascular and cerebrovascular diseases,which in turn affects the quality of life of patients.At present,drug treatment for insomnia often leads to a series of adverse reactions(such as dizziness,forgetfulness,circadian rhythm disorder,nausea,mouth pain,withdrawal and insomnia,etc.),and auricular acupoint pressure in non-medication therapy has been shown to be sleep quality has a good improvement effect,and there is no drug side effects,but it is rarely reported for perimenopausal women with coronary heart disease.This article mainly observes the effect of auricular acupoint pressure on the sleep quality and quality of life of perimenopausal women with coronary heart disease and insomnia,and discusses its clinical application value.ObjectivesTo explore the effect of auricular acupoint pressure on the sleep quality and quality of life of perimenopausal women with coronary heart disease and insomnia,and to provide a theoretical basis for the application of auricular acupoint pressure in perimenopausal women with coronary heart disease and insomnia.Methods1.A total of 106 patients with perimenopausal women with coronary heart disease and insomnia who met the inclusion criteria from September 2017 to October 2018 were selected as subjects.They were randomly divided into the intervention group(n=53)and the control group(n=53).2.The control group received conventional cardiology treatment(oxygen,anti-platelet aggregation,improving coronary blood supply by expanding coronary artery and promoting blood circulation,anticoagulation,beta blockers,calcium channel blockers,lipid-lowering,improve heart function,nutrition myocardium and other drug treatments,sublingual nitroglycerin at the onset of angina pectoris)and routine care(dietary guidance,psychological guidance,exercise guidance,sleep guidance,medication guidance,disease knowledge guidance);the intervention group given auricular acupoint pressure on the basis of the control group,select auricular points,heart,liver,kidney,pillow,sympathetic,Shenxnen,subcortical,endocrine.The operator disinfects the auricle skin with 75%alcohol,and then sticks the tape with the king's seedless seed on the selected ear acupuncture with a sterile tweezers.The patient presses it by himself,and feels sour,hemp,heat,swelling,Pain is appropriate,press 3 to 5 times a day,each time each point is pressed for 1 to 2 minutes,need to strengthen the pressure before going to bed,unilateral acupoints,two ears rotation,every 3 days to replace,a total of 4 weeks of intervention3.The two groups of patients were given the Pittsburgh Sleep Quality Index and Health Survey on the day of admission and the end of the treatment.The sleep quality and quality of life of the perimenopausal women with coronary heart disease were compared between the two groups.Results1.The completion of the trial in two groups of patients In the intervention group,2 patients withdrew from the middle,2 patients did not comply,a total of 49 patients completed,the completion rate was 92.45%;the control group lost 2 patients,a total of 51 cases were completed,the completion rate of 96.22%.There were no adverse events in the two groups.There was no significant difference in the completion of the two groups(P>0.05).2.Comparison of baseline data between the two groups before intervention In the intervention group,the average age was 50.43±2.54 years;the duration of coronary heart disease was 14.37± 16.12 months;the duration of insomnia was 8.29±6.28 months;the cardiac function grade was grade ? in 20 cases and grade ? in 29 cases;and the menstrual status was menstrual disorder in 23 cases and amenorrhea in 26 cases.The average age of the control group was 50.65±2.51 years;the duration of coronary heart disease was 13.37±14.36 months;the duration of insomnia was 7.76±5.91 months;the cardiac function grading was grade ? in 22 cases and grade ? in 29 cases;and the menstrual status was menstrual disorder in 18 cases and amenorrhea in 33 cases.There was no significant difference in age,course of disease,cardiac function classification,menstrual status,education level,marital status,occupational status,per capita monthly income between the two groups(P>0.05).3.Comparison of PSQI scores between two groups of perimenopausal women with coronary heart disease and insomnia There was no significant difference between the two groups in the PSQI score and the scores in each dimension before intervention(P>0.05).The scores of PSQI and each dimension after 4 weeks of intervention were lower than those before intervention.The difference was statistically significant(P<0.05).The difference between the intervention group and the pre-intervention PSQI total score was-5.12±1.38,the difference in sleep quality score was-1.04±0.41,and the difference in sleep time score was-1.37±0.53,sleep time score difference-0.78±0.65,sleep efficiency score difference-0.88±0.56,sleep disorder score difference-0.39±0.53,daytime dysfunction score difference-0.67±0.66.The difference between the total score of PSQI and the scores of each dimension after intervention for 4 weeks in the control group were-2.33±0.97,-0.35±0.48,-0.67±0.48,-0.29±0.46,-0.53±0.61,-0.16±0.42,-0.33± 0.48,there was a statistically significant difference between the two groups in the PSQI total score difference and the difference in the scores of each dimension(P<0.05).4.Comparison of sleep efficacy of two groups of perimenopausal women with coronary heart disease and insomnia In the intervention group,5 cases were cured after 4 weeks of intervention,13 cases were markedly effective,27 cases were effective and 4 cases were ineffective.The total effective rate was 91.84%.In the control group,3 cases were cured,9 cases were markedly effective,2 cases were effective and 14 cases were ineffective.The total effective rate was 72.55%.There was significant difference in the cure rate between the two groups(P<0.05).It shows that the effect of the intervention group on improving sleep quality is better than that of the control group.5.Comparison of quality of life scores between two groups of perimenopausal women with coronary heart disease and insomnia There was no significant difference in the quality of life between the two groups before intervention(P>0.05).The scores of life quality in each group after 4 weeks of intervention were lower than those before intervention.The difference between the two groups was statistically significant(P<0.05);the difference between the intervention group and the overall health score before intervention was 15.80±4.83,the difference of physiological function score was 13.37±3.87,the difference of somatic pain score was 17.30±11.99,and the difference of vitality score was 10.10±4.51,The mental health score difference of 8.65±3.50 was significantly higher than the overall health score difference of the control group 10.29±5.51,the physiological function score difference 7.84±3.91,the somatic pain score difference 13.16±8.59,and the vitality score difference 5.69±4.47.the difference in mental health score was 6.27±3.23.The difference between the two groups was statistically significant(P<0.05),but the differences in physiological function,emotional function and social function dimension between the two groups were not statistically significant(P>0.05).Conclusions1.Auricular acupoint pressure can effectively shorten the sleep time of perimenopausal women with coronary heart disease and insomnia,prolong the duration of sleep,improve sleep efficiency,reduce sleep disorders,improve daytime function and improve their sleep quality.2.Auricular acupoint pressure can alleviate somatic pain in perimenopausal women with coronary heart disease,improve physiological function,increase vitality,promote mental health,improve overall health of patients,and have a certain correlation with the improvement of sleep quality. |
PDF Full Text Request