| Objective:To observe the efficacy of pressing auricular acupoints in an appropriate time combined with health education over WeChat platform on maintained hemodialysis patients with ins to obtomnia,andain a simple,convenient,effective,and experienced nursing treatment method for MHD insomnia patients.Methods:Sixty-four patients with maintenance hemodialysis insomnia from hemodialysis purification center of a triple-A Chinese medicine hospital in Shandong province were enrolled and numbered randomly by the computer.Patients with odd number were allocate to experimental group(n=32),and patients with even number were allocated to control group(n=32).All of the 64 patients were diagnosed and categorized based on the syndrome differentiation of TCM.During the intervention period,all the patients were banned from hypnotic drugs,and routine dialysis treatment was performed.Treatments such as reducing blood pressure,correcting anemia,improving cardiac function,and adjusting acid-base balance were carried out according to the original plan.Patients from the experimental group were incorporated into a WeChat group.Hemodialysis related knowledge was taught through WeChat regularly,questions raised by the patients were answered timely,and treatment was MHD in time.The main acupoints were shenmen(TF4),sympathetic(AH6a),subcortex(AT4),Kidney(CO 10),heart(CO15)and spleen(CO13),and the corresponding points were selected according to the combination of disease differentiation and pattern differentiation.If patients are of Spleen-Kidney Yang deficiency type,endocrine(CO18)will be included;if patients are of Liver depression forming fire type,points of liver(C012)and liver Yang will be included;if patients are of Phlegm-stasis type,points of bailing 2,gallbladder(CO11)and endocrine(C018)will be included;if patients are of heart-spleen deficiency type,points of stomach(C04)and gallbladder(CO11)will be included;if patients are of fire excess from Yin deficiency type.points of liver(CO12)and endocrine(CO18)will be included;if patients are of Heart and gallbladder qi deficiency type,gallbladder(CO11)will be included;if patients with hypertension,groove of posterior surface(PS)will be included.By pressing gently with a probe,sensitive points were located,marked and then disinfected with 75%alcohol.Paste seeds on the right acupoints,and both ears alternate at the interval of 3-5 days.Press the ear beans for about 3-5 minutes,3 times a day at 9 o’clock,12 o’clock and 19 o’clock respectively for two courses with two weeks as a course.The control group was given routine dialysis nursing knowledge only.The Pittsburgh sleep quality index scale(PSQI),quality of life scale score(SF-36)and hemodialysis knowledge level questionnaire were used to evaluate the patients before and after the education.The experimental data were analyzed by SPSS22.0 software.Results:There was no difference between the two groups before intervention.There were significant differences in the experimental group after intervention in the total PSQI score,sleep quality,time to fall asleep,sleep efficiency,sleep disturbance,and daytime function(P<0.01),and differences in sleep time(P<0.05);there were significant differences in the control group in total PSQI scores,sleep quality,sleep disorders,daytime function and other four indicators(P<0.01),as well as differences in sleep efficiency(P<0.05).There were significant differences between the two groups in total PSQI score,sleep quality,time to fall asleep,sleep efficiency,sleep disorders(P<0.01),and differences in daytime function(P<0.05).Statistical analysis of the quality of life scale score(SF-36):There were significant differences in the experimental group in Physical Functioning(PF),Role-Physical(RF),General Health(GH),Vitality(VT),Social Functioning(SF),Role-Emotional(RE),Mental Health(MH)and Reported Health Transition(HT)after intervention(P<0.01),and difference in Bodily Pain(BP)(P<0.05);there were significant differences in the control group in PF,SF and RE(P<0.01),and differences in RF,MH and HT after intervention(P<0.05).Comparison between groups:there were differences between the two groups in PF and RE(P<0.05).Scores of Hemodialysis related knowledge were significantly different in the experimental group and between the groups after intervention(P<0.01).In either group:there was a significant difference in systolic and diastolic blood pressure after intervention(P<0.01),but no difference in the control group(P>0.05);between the two groups:there was a significant difference in diastolic blood pressure(P<0.01)and a difference in systolic blood pressure(P<0.05)in the experimental group.There were significant differences in the total score of PSQI,the difference of systolic pressure,the difference of diastolic pressure and the difference of scores of hemodialysis knowledge level after intervention between the two groups(P<0.01).Comparing the efficacy on insomnia between the two groups,the total effective rate in the experimental group was 90.63%and that in the control group was 34.38%,with a significant difference(P<0.01).According to the analysis of all TCM syndromes,the total effective rate of pressing auricular acupoint in an appropriate time on all syndromes was more than 80%,among which the effect on spleen and kidney Yang deficiency,heart-spleen deficiency,and phlegm-stasis was particularly significant,with the total effective rate of 100.00%Conclusion:1.Pressing auricular acupoint in an appropriate time can significantly improve the sleep quality of MHD patients with insomnia,especially significant for patients with spleen-kidney Yang deficiency,heart-spleen deficiency,or phlegm-blood stasis.2.Quality of Life(QOL)of patients is significantly improved and the level of hypertension can be effectively reduced,especially for diastolic pressure.3.By using WeChat platform to promote health knowledge,the patients’ cognition level of dialysis knowledge was improved,and their compliance to the treatment of auricular acupoint pressure was increased.It could promote patients’ mental and physical comfort,and improve sleep quality and life quality.Its advantages lie in:(1)highlighting the advantages and characteristics of Traditional Chinese Medicine nursing by corelate nursing according to syndrome differentiation with appropriate treating hours,which is every effective;(2)Up to now,similar studies are rare;moreover,it is easy to operate and has no side effects,and it is easy for patients to accept and easy for clinical publicity and education. |
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