| Objective:Insomnia is a common clinical symptom in patients with mild cognitive impairment(MCI),which may aggravate the degree of cognitive impairment.Acupoint massage therapy as a safe and convenient intervention method has been widely used in the elderly insomnia population.The purpose of this study is to provide a reference for the community empirical study by systematically evaluating the research of acupoint massage intervention on insomnia in the elderly,and to explore the effect of acupoint massage therapy on sleep quality and cognitive function of patients with insomnia in the community,so as to provide practical evidence for the prevention and treatment of cognitive diseases in the community.Methods:In evidence-based research,we use computers to search china HowNet,Wanfang,VIP,Chinese biomedical literature,PubMed,web of science and Cochrane Library and other databases,the limited retrieval time is from January 2008 to December 2019.Two researchers strictly accept,arrange and extract information from the randomized controlled study of acupoint massage therapy in the elderly insomnia patients.In case of disagreement,the third researcher will make a decision through consultation.Use RevMan5.3 software for meta analysis of relevant data.From September to December 2019,60 elderly patients with MCI insomnia who met the criteria of receiving and discharging were given sleep intervention for 3 months in 6 communities under the jurisdiction of the public health management department of Hongshan traditional Chinese medicine hospital.The intervention group was treated with acupoint massage and the control group received sleep health education.Before and after the intervention,Pittsburgh Sleep Quality Index(PSQI)and Insomnia Severity Index(ISI)were used to assess the sleep status of the elderly with insomnia in MCI,and Montreal Cognitive Assessment text(MoCA)was used to assess the functional status of various cognitive areas of the patients.SPSS 22.0 software was used for data analysis.Paired t-test was used for intra group comparison before and after intervention,and two independent samples t-test and repeated measurement ANOVA were used for inter group comparison.Results:Finally,13 RCT studies were evaluated systematically.The results showed that acupoint massage could effectively improve the sleep quality of the elderly insomnia patients under different health conditions[MD=-3.02,95%CI(-4.51,-1.53)].When the intervention period was 3 months,the effect value of acupoint massage therapy was[MD=-1.63,95%CI(-2.04,-1.23)],and the heterogeneity among the studies was low(P<0.00001,I~2=0);when the control measure was health education or routine treatment and nursing combined with other health knowledge education,the effect value of acupoint massage therapy was only[MD=-1.56,95%CI(-1.97,-1.14)](P=0.71,I~2=0%).In the research program,the commonly used acupoints include shenting,Taiyang,Sanyinjiao,sleeping,Neiguan,Baihui and Zusanli.The subjective evaluation scale is the main tool to evaluate the intervention effect.After a 3-month sleep intervention for elderly MCI insomniacs in the community,the PSQI and ISI total scores of the two groups of patients were significantly lower than before the intervention(P<0.01);repeated analysis of variance analysis results showed that sleep quality,falling asleep In terms of time,sleep efficiency,difficulty falling asleep,difficulty maintaining sleep,satisfaction with sleep patterns and the degree of worry/pain about sleep,there was a statistically significant difference between the intervention effects of the two interventions(P<0.05).At the same time,the total MoCA scores of the two groups of patients also changed significantly before the intervention(P<0.01).Two independent sample t-tests were used to compare the difference between the two groups before and after the intervention.The results showed that in attention and orientation,the difference between the two groups.The difference was statistically significant(P<0.05).Conclusion:(1)Acupoint massage could effectively improve the sleep quality of elderly insomnia patients under different health conditions;(2)After rubbing the head and face points on Dumai,Zheyang,Shouyang,Zuoyang,Shouyang,Zuyangming and Shouyangming.It could not only effectively improve the sleep quality and reduce the severity of insomnia,but also improve the patients'subjective feelings;(3)Acupoint massage therapy could also have a positive effect on the cognitive function of the elderly with MCI insomnia;(4)As a harmless and practical self-care measure,acupoint massage is worth popularizing and applying in community chronic disease management. |
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