| Objective: To observe the clinical efficacy of auricular point pressing bean combined with meridian scraping in the treatment of insomnia syndrome of Liver depression and fire,evaluate the effect of this treatment plan on sleep quality,TCM syndromes and anxiety,and provide clinical basis for the combined application of TCM external treatment.Methods: According to the random number table method,108 cases of insomnia patients with liver depression and fire syndrome were divided into ear acupoint group(n=36),scraping group(n=36)and combined group(n=36).All groups were treated with routine nursing of daily life,disease observation,diet and emotion.Ear group on the basis of conventional nursing USES ear beans: Take shape ears,door god,heart,liver and nervous system subcortical,pillow,neurasthenia,neurasthenia,the eight main point for pressure,according to patients’ clinical symptoms were much dream zone,bravery,lienal,stomach,selection of the five match point,replace the points 2times per week,5 weeks continuous treatment.Scraping group on the basis of routine nursing using cycle scraping: Blow dry bilateral du meridian,bladder,foot sufficient sun jue Yin liver meridian and foot shaoyang bile,four chung,the sun god,sleeping,wind pool,heart,spleen shu yu,shu,door god,three vaginal intercourse common acupoints and best,shoulder well,such as liver,tan shu yu,inter-row,lr 3experience acupuncture point,scrapping 1 times a week,and treatment for five weeks in a row.The combined group was based on the group of ear acupuncture point pressing bean combined with rubella scraping,patients in the first visit every week,the first rubella scraping,followed by ear acupuncture point sticking,the second visit only replaced ear acupuncture point sticking,continuous treatment for 5weeks.Sleep index(PSQI),TCM syndrome rating Scale and self-rating Anxiety Scale(SAS)were filled in before intervention,5 weeks after intervention and one month after intervention to evaluate the effect of intervention.Chi-square test,one-way anova,non-parametric Kruskal-Wallis test,repeated measure ANOVA and generalized estimation equation were used for statistical analysis.Results:1.Case completion and sheddingA total of 94 patients completed the study,including 32 cases in the auricular acupoint group,30 cases in the scraping group and 32 cases in the combined group.There was no significant difference in the shedding rate among the three groups(P >0.05),which was comparable.2.Baseline comparisonThere were no statistically significant differences in general data,PSQI factor scores and total scores,TCM syndrome scores and SAS scores among the three groups before intervention(P > 0.05),indicating comparability.3.Comparison of sleep quality before and after intervention(1)Comparison of PSQI scores1)Time effect analysis: There were statistically significant differences in PSQI factor scores and total scores measured at different times(P < 0.05).After 5 weeks of intervention,the scores of other scales in auricular acupoint group were significantly lower than those before intervention except the score of sleeping drugs(P < 0.05).PSQI factor scores and total scores one month after the intervention were significantly lower than those before the intervention(P < 0.05).The score of sleep efficiency one month after intervention was significantly lower than that five weeks after intervention(P < 0.05).After 5 weeks of intervention,the scores of other scales in the scraping group were significantly lower than those before intervention except the score of sleeping drugs(P < 0.05).PSQI factor scores and total scores one month after the intervention were significantly lower than those before the intervention(P <0.05).The score of sleep time one month after intervention was significantly higher than that 5 weeks after intervention(P < 0.05).PSQI factor scores and total scores in the combined group were significantly lower than those before intervention 5 weeks after intervention and one month after intervention(P < 0.05).2)Effect analysis of intervention measures: There were statistically significant differences in sleep quality,sleep time,sleep time,scores of factors of daytime dysfunction and total PSQI scores measured by different intervention measures(P <0.05),which required further pairwise analysis.After 5 weeks of intervention,the PSQI total score of scraping group was significantly different from that of auricular acupoint group(P < 0.05).Compared with auricular acupoint group,there were statistically significant differences in sleep quality,sleep time,sleep time,scores of factors of daytime dysfunction and PSQI total score in combined group(P <0.05).Compared with the scraping group,there were statistically significant differences in sleep quality,sleep time,daily dysfunction factor scores and PSQI total score in the combined group(P < 0.05).One month after the end of intervention,the sleep quality,sleep time,the scores of factors of daytime dysfunction and PSQI total score in the combined group were significantly different from those in the auricular acupoint group and the scraping group(P < 0.05).3)Interaction between time and intervention: The interaction between the measurement time of sleep quality,sleep time score and PSQI total score and intervention was statistically significant(P < 0.05).(2)Comparison of sleep efficacyIn auricular acupoint group,2 cases were cured,7 cases were effective,15 cases were effective,8 cases were ineffective,the effective rate was 75.0%;In scraping group,3 cases were cured,8 cases were effective,14 cases were effective,5 cases were ineffective,the effective rate was 83.3%;In the combined group,3 cases were cured,12 cases were effective,11 cases were effective,6 cases were ineffective,and the effective rate was 81.3%.There was no significant difference in sleep efficacy among the three groups(P > 0.05).4.Comparison of TCM syndromes before and after intervention(1)Comparison of TCM syndrome score1)Time effect analysis: There were statistically significant differences in TCM syndrome scores measured at different times(P < 0.05).The TCM syndrome scores of the three groups were significantly lower than those before intervention 5 weeks after intervention and one month after intervention(P < 0.05).The TCM syndrome score of auricular point group and scraping group was significantly higher one month after intervention than that of 5 weeks after intervention(P < 0.05).2)Effect analysis of intervention measures: There were statistically significant differences in TCM syndrome scores measured by different intervention measures(P< 0.05),which required further pairwise analysis.After 5 weeks of intervention,the TCM syndrome score of the combined group was significantly different from that of the auricular acupoint group(P < 0.05).One month after the end of intervention,the TCM syndrome score of the combined group was significantly different from that of the auricular point group and the scraping group(P < 0.05).3)Interaction between time and intervention: The interaction between the measurement time of TCM syndrome score and intervention was statistically significant(P < 0.05).(2)Comparison of TCM syndromes and curative effectsIn auricular acupoint group,1 case was cured,3 cases were effective,18 cases were effective,10 cases were ineffective,the effective rate was 68.8%.In scraping group,0 cases were cured,4 cases were effective,21 cases were effective,5 cases were ineffective,the effective rate was 83.3%;In the combined group,2 cases were cured,6 cases were effective,18 cases were effective,6 cases were ineffective,and the effective rate was 81.3%.There was no significant difference in TCM syndrome efficacy among the three groups(P > 0.05).5.Comparison of SAS scores before and after intervention(1)Time effect analysis: SAS scores measured at different times had statistically significant differences(P < 0.05).SAS scores of auricular acupoint group,scraping group and combined group were significantly lower than those before intervention 5weeks after intervention and 1 month after intervention(P < 0.05),but SAS scores of one month after intervention were significantly higher than those of 5 weeks after intervention(P < 0.05).(2)Effect analysis of intervention measures: There was no statistical significance in SAS scores measured by different intervention measures(P > 0.05).After 5 weeks of intervention and one month after the end of intervention,SAS scores of the combined group were significantly different from those of the auricular acupoint group and the scraping group(P < 0.05).(3)Interaction between time and intervention: There was no statistical significance in the interaction between measurement time of SAS score and intervention(P > 0.05).6.Incidence of adverse reactionsThere was 1 case of adhesive allergy in auricular acupoint group(3.1%),2 cases of skin damage in scraping group(6.7%),and 1 case of dizzy scraping reaction in combined group(3.1%).The incidence of adverse reactions in the three groups was low,and there was no statistical significance(P > 0.05).Conclusion:(1)Ear point pressure bean,circular scraping,ear point pressure bean combined with circular scraping can effectively improve the sleep quality of insomnia patients with liver depression and fire syndrome,reduce TCM syndromes,relieve anxiety,low incidence of adverse reactions,two kinds of TCM external treatment combined with the best effect.(2)In a short period of time to improve the total quality of sleep and reduce the TCM syndrome,the effect is better than ear acupoint pressing beans.However,auricular acupoint pressing bean has a more stable effect on shortening sleep time,improving sleep efficiency and improving total sleep quality.The combination of the two has a more stable effect on improving sleep quality,prolonging sleep maintenance time,reducing daytime dysfunction,improving total sleep quality and improving TCM syndromes.(3)With the extension of time,the overall effect of ear acupoint pressing beans,rubella scraping,ear acupoint pressing beans combined rubella scraping is gradually weakening. |
PDF Full Text Request