| Objective:Develop an intervention program for elderly patients with Qi deficiency and blood stasis type stroke and insomnia,and explore the application effect of pestle needle therapy in elderly patients with Qi deficiency and blood stasis type insomnia.Method:Through literature review,expert letter inquiries and preliminary experiments,an intervention program for elderly patients with stroke and insomnia of Qi deficiency and blood stasis type was formulated.According to the admission criteria,72 elderly patients with stroke and insomnia with Qi deficiency and blood stasis type were selected from October 2019 to December 2020 in the Department of Neurology of a Chinese Medicine Hospital in Jiangxi Province.The patients were randomly divided into a control group and a test group,with 36 cases in each.The control group received routine nursing care,and the test group received pestle needle therapy on the basis of the control group.Before the intervention,14 days and 28 days after the intervention,the two groups of patients were treated with the TCM Syndrome Table of Qi Deficiency and Blood Stasis,Pittsburgh Sleep Quality Index(PSQI),Simplified-Geriatric Depression Scale(GDS-15),and the National Institute of Health stroke scale(NIHSS)to evaluate the TCM syndromes of Qi deficiency and blood stasis,sleep quality,depression level and neurological impairment.Result:1.Comparison of baseline data of the two groups of patients: A total of 72 cases were included in the study,2 cases(34 cases)in the experimental group,no loss in the control group(36 cases),and 70 effective cases were finally obtained.The two groups of general data(demographic statistics,disease-related data)and outcome indicators were not statistically different(P>0.05),and they were comparable.2.Comparison of TCM syndrome scores between the two groups of patients with Qi deficiency and blood stasis:(1)Comparison between groups: the difference before intervention was not statistically significant(P=0.769);the scores of the test group were significantly lower than the control group on the 14 th and 28 th day after the intervention,and the difference was statistically significant meaning(P=0.000).(2)Repeated measurement comparison: The difference in time effect between the two groups before intervention,14 d and 28 d after intervention was statistically significant(P=0.000);there was an interaction effect between time*groups(P=0.000).(3)Comparison between the two groups: 14 d and 28 d after the intervention,the scores of TCM syndromes of Qi deficiency and blood stasis were lower than before the intervention,and the scores on 28 d after intervention were lower than 14 d after intervention,but the scores of the experimental group after intervention were significantly lower than the control group.The difference was statistically significant(P<0.017).3.Comparison of sleep quality(PSQI)scores between the two groups:(1)Comparison between groups: the difference before intervention was not statistically significant(P=0.856);the scores of the test group were significantly lower than the control group on the 14 th and 28 th day after the intervention,and the difference was statistically significant(P=0.000).(2)Repeated measurement comparison: The difference in time effect between the two groups before intervention,14 d and 28 d after intervention was statistically significant(P=0.000);there was an interaction effect between time*groups(P=0.000).(3)Comparison between the two groups: 14 d and 28 d after the intervention,the sleep quality scores of the two groups were lower than before the intervention,and the scores on the 28 d after the intervention were lower than the 14 d after the intervention,but the scores of the experimental group after the intervention were significantly lower than the control group,the difference was statistically significant(P<0.017).4.Comparison of depression level(GDS-15)scores between the two groups:(1)Comparison between groups: The difference before intervention was not statistically significant(P=0.453);the scores of the test group were significantly lower than the control group on the 14 th and 28 th day after the intervention,and the difference was statistical learning significance(P=0.000).(2)Repeated measurement comparison: The difference in time effect between the two groups before intervention,14 d and 28 d after intervention was statistically significant(P=0.000);there was an interaction effect between time*groups(P=0.000).(3)Comparison between the two groups: 14 d and 28 d after the intervention,the depression level score of the two groups was lower than before the intervention,and the score 28 d after the intervention was lower than the 14 d after the intervention,but the score of the experimental group after the intervention was significantly lower than the control group,the difference was statistically significant(P<0.017).5.Comparison of neurological impairment(NIHSS)scores between the two groups:(1)Comparison between groups: the difference before intervention was not statistically significant(P=0.738);the score of the test group was significantly lower than the control group 14 days and 28 days after intervention,with differences statistical significance(P=0.000).(2)Repeated measurement comparison: before intervention,14 d and 28 d after intervention,the difference between the two groups and the time effect was statistically significant(P=0.000);there was an interaction effect between time*groups(P=0.000).(3)Comparison between the two groups: the scores of neurological deficits in the two groups were lower than before the intervention at 14 d and 28 d after the intervention,and the scores at 28 d after the intervention were lower than the 14 d after the intervention,but the scores of the experimental group after the intervention were significantly lower than the control group,the difference was statistically significant(P<0.017).Conclusion:1.In this study,the routine nursing of elderly patients with Qi deficiency and blood stasis type stroke and insomnia can significantly improve the TCM syndromes and sleep quality of patients with Qi deficiency and blood stasis,reduce depression,and promote the recovery of neurological impairment.2.The program is safe,effective,economically feasible,and highly maneuverable.It can effectively improve the quality of life of elderly patients with Qi deficiency and blood stasis stroke and insomnia,it has a good clinical application value. |
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