| Objective: To investigate the insomnia status of community elderly insomnia in Nanning City,analyze the influential factors of the occurrence of community elderly insomnia,and screen out the influential factors of elderly patients with insomnia sleep quality,summarize the distribution characteristics of traditional Chinese medicine syndromes and analyze its correlation with the sleep quality of elderly patients.On this basis,guided by the dialectical thought of traditional Chinese medicine and the theory of circular movement,to explore the nursing effect of Tired of scrapping combined with Ear acupoint pressing bean in the treatment of insomnia syndrome in-coordination between heart and kidney.Methods: Part one was investigation study.From January to June,2022,480 elderly people from 4 communities in Nanning City were selected to conduct questionnaires on demographic data,insomnia status,anxiety,quality of life,TCM syndrome and other data were collected by general data questionnaire,Pittsburgh Sleep Quality Rating Scale(PSQI),TCM syndrome Questionnaire,Broad Anxiety Scale(GAD-7),and Quality of Life Scale(SF-12).The single factor analysis was used to screen out the influencing factors of community elderly insomnia.For the elderly patients with insomnia in the community,according to their sleep quality scores,the factors related to sleep quality were analyzed by multiple linear regression.Part two was intervention study.A total of 144 elderly patients with insomnia In-coordination between heart and kidney who received medical treatment in 4 communities from July to November 2022 and met the inclusion and exclusion criteria were selected as the study objects,and they were randomly divided into control group,Tired of scrapping group,Ear acupoint pressing bean group and combination group according to the principle of 1:1:1:1.The control group guided the patients with insomnia according to the traditional Chinese medicine nursing program of daily life,diet and emotional nursing.Tired of scrapping group on the basis of the control group,scraping once a week,continuous intervention for 4 weeks;Ear acupoint pressing bean group on the basis of the control group was treated with auricular point pressure bean,the auricular point patch was changed twice a week,continuous intervention for 4 weeks;Combined group on the basis of the control group to carry on the meridian scraping combined with auricular point pressure bean.The intervention cycle of the four groups was 4weeks,scraping once a week and replacing auricular point patch twice a week,continuous intervention for 4 weeks.Pittsburgh Sleep Quality Rating Scale(PSQI)score,TCM Syndrome Score Scale score,Broad Anxiety Scale(GAD-7)score,and Quality of Life Scale(SF-12)score were recorded before intervention and 4 weeks after intervention,and compared to evaluate the effect of intervention.Analysis of variance,rank sum test,paired sample t test and other statistical methods were used to analyze the intervention effect.When P<0.05,the difference was considered statistically significant.Results: 1.A total of 480 questionnaires were sent out in the survey,and458 were effectively received,with a recovery rate of 95.41%.Among 458 subjects,202 patients had insomnia,and the incidence of insomnia was 44.1%.2.In the elderly with insomnia,the distribution of TCM syndrome types was67 cases(33.2%)of in-coordination between heart and kidney,47 cases(23.3%)of heart and spleen deficiency,24 cases(11.9%)of heart and gallbladder qi deficiency,24 cases(11.9%)of phlegm-heat disturbance of heart,31 cases(15.3%)of liver fire disturbance of heart.3.In the elderly with insomnia,the main TCM syndrome type is in-coordination between heart and kidney.4.Gender,education level,smoking,drinking,monthly income,Exercise habits,chronic diseases,years of illness,current health status,anxiety and quality of life were influencing factors of insomnia with elderly in the community(P < 0.05).5.Exercise habits,monthly income,anxiety,TCM syndrome type were influencing factors of the sleep quality of elderly patients with insomnia in the community.In the intervention study:1.Comparison of PSQI scores: Except the control group,PSQI scores of the other three groups after intervention were statistically significant compared with those before intervention(all P<0.05).After intervention,inter-group results showed that there was a statistically significant difference in PSQI scores between different groups(F=107.35,P<0.001).Pair-to-pair comparison showed that the PSQI scores of auricular point group,tired ofscrapping group,tired ofscrapping combined with auricular ear acupoint pressing bean group were lower than those of control group(all P<0.05);The PSQI score oftired ofscrapping combined with auricular ear acupoint pressing bean group was lower than that of auricular point group andtired ofscrapping group(all P<0.05);The PSQI score of auricular point group after intervention was lower than that oftired ofscrapping group(P<0.05).It suggests that the effect of tired ofscrapping combined with auricular point pressure bean group is the best in improving patients’ sleep quality,followed by auricular point group and Gua Sha group.2.Comparison of TCM syndrome scores: Except the control group,the difference of principal syndrome scores after intervention in the other three groups was statistically significant compared with before intervention(all P<0.05).After intervention,there were significant differences in principal syndrome scores among different groups(F=22.83,P<0.001).Pairings comparison showed that the scores of principal syndrome in auricular point group,tired ofscrapping group,tired ofscrapping combined with auricular ear acupoint pressing bean group were lower than those in control group(all P<0.05);The main syndrome scores of tired ofscrapping combined with auricular ear acupoint pressing bean group were lower than those of auricular point group and tired ofscrapping group(all P<0.05);There was no difference in the main syndrome score between auricular point group and Xunjing Guasha group after intervention(P>0.05).It suggests that the effect of tired ofscrapping combined with auricular point pressure bean group is the best in improving TCM syndromes,and the effect oftired ofscrapping group is equivalent to that of auricular point group.3.Comparison of GAD-7 scores: After intervention,anxiety scores of the four groups were statistically significant compared with those before intervention(P<0.05).After intervention,anxiety scores of different groups were significantly different(F=107.35,P<0.001).Pair-to-pair comparison showed that the anxiety scores of auricular point group,tired ofscrapping group,tired ofscrapping combined with auricular ear acupoint pressing bean group were lower than those of control group(all P<0.05);The anxiety score of tired ofscrapping combined with auricular ear acupoint pressing bean group was lower than that of auricular point group andtired ofscrapping group(all P<0.05);After intervention,there was no difference in the scores of main syndrome oftired ofscrapping compared with auricular point group(P>0.05).It suggests thattired of scrapping combined with auricular point pressure bean group has the best effect in improving anxiety,and the effect oftired ofscrapping group is equivalent to auricular point group.4.Comparison of SF-12 scores: After intervention,there were statistically significant differences in overall health,physiological function,physiological function,emotional function and mental health among the four groups(all P<0.05).Further pairings comparison showed that the scores of physiological function and mental health oftired ofscrapping combined with auricular acupoint compression Dou group were higher than those of tired of scrapping group and auricular acupoint group(all P<0.05).There was no difference in the overall health and emotional function scores of Xunjing Guasha combined with auricular ear acupoint pressing bean group compared with auricular point group(P>0.05).The scores of overall health and emotional function oftired ofscrapping group were lower than those of auricular point group(P<0.05),suggesting thattired ofscrapping combined with auricular ear acupoint pressing bean group had the best effect in improving life quality,followed by auricular point group and tired of scrapping group.Conclusion(s):1.The incidence of insomnia among the elderly in Nanning community is high,and the distribution of TCM syndrome types is mainly heart-kidney disharmony,which suggests that the community should pay attention to the syndrome differentiation and care of elderly insomnia.2.The intervention measures of tired of scrapping,auricular ear acupoint pressing bean,tired of scrapping combined with auricular ear acupoint pressing bean all can effectively change patients’ good sleep quality,reduce TCM syndromes,relieve anxiety,improve quality of life.Auricular point pressure bean in improving patients’ sleep quality,improve quality of life effect is better than tired of scrapping.The community can choose to use according to the actual situation.3.Tired of scrapping combined with auricular point pressure bean has a synergistic effect,which is significantly superior to a single daring measure in improving patients’ sleep quality,alleviating TCM syndrome,relieving anxiety and improving quality of life.It is worth promoting and applying in the community. |
