针刺联合耳穴贴压治疗骨髓瘤伴失眠的疗效观察及对认知功能、睡眠质量的影响  

Observation on the efficacy of acupuncture combined with auricular acupressure in the treatment of insomnia disorder in myeloma and its effect on cognitive function and sleep quality

作　　者：方文娟[1] 李红[1] 周丽丽[1] 叶文燕 FANG Wenjuan;LI Hong;ZHOU Lili;YE Wenyan(Lishui Municipal Central Hospital,Lishui 323000,China)

机构地区：[1]浙江省丽水市中心医院,丽水323000

出　　处：《上海针灸杂志》2023年第11期1157-1161,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：浙江省中医药重点研究项目(2022ZQ038)。

摘　　要：目的观察针刺联合耳穴贴压治疗骨髓瘤伴失眠的临床疗效及对认知功能、睡眠质量的影响。方法将160例骨髓瘤中重度疼痛合并失眠患者随机分为观察组(89例)与对照组(71例)。对照组采用常规药物治疗,观察组在对照组基础上采用针刺联合耳穴贴压治疗。观察两组治疗前后匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分、简易智力状态检查量表(mini-mental state examination,MMSE)、日常生活活动能力(activity of daily living,ADL)量表、视觉模拟量表(visual analog scale,VAS)、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)及汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评分变化,并比较两组临床疗效及骨髓瘤患者认知功能与睡眠质量的关系。结果观察组总有效率为94.4%,显著高于对照组的80.3%,差异有统计学意义(P<0.05)。治疗后,两组PSQI和VAS评分均下降,且观察组低于对照组,差异均有统计学意义(P<0.05);两组MMSE和ADL评分均上升,且观察组高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组HAMD和HAMA评分均下降,且观察组低于对照组,差异有统计学意义(P<0.05)。骨髓瘤患者认知功能与睡眠质量呈现显著正相关(P<0.05)。结论在常规药物基础上,针刺联合耳穴贴压治疗骨髓瘤伴失眠效果显著,能够有效提升患者睡眠质量及认知水平,改善疼痛及负性情绪。Objective To observe the clinical efficacy of acupuncture combined with auricular acupressure in the treatment of insomnia in myeloma and its effect on cognitive function and sleep quality.Method A total of 160 myeloma patients with moderate and severe pain and insomnia were randomly divided into observation group(89 cases)and control group(71 cases).The control group was treated with conventional medication,and the observation group was treated with acupuncture combined with auricular point sticking in addition to the treatment used in the control group.The Pittsburgh sleep quality index(PSQI)score,mini-mental state examination(MMSE)scale,activity of daily living(ADL)scale,visual analog scale(VAS),Hamilton depression scale(HAMD)and Hamilton anxiety scale(HAMA)scores before and after treatment were observed in the two groups,and the clinical efficacy of the two groups and the relationship between cognitive function and sleep quality in patients with myeloma were compared.Result The total effective rate of the observation group was 94.4%,which was significantly higher than 80.3%of the control group,the difference was statistically significant(P<0.05).After treatment,the PSQI and VAS scores of the two groups decreased,and those of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).The MMSE and ADL scores of the two groups increased,and those of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).After treatment,the HAMD and HAMA scores of the two groups decreased,and the scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).There was a significant positive correlation between cognitive function and sleep quality in patients with myeloma(P<0.05).Conclusion In addition to conventional medicine,acupuncture combined with auricular point sticking therapy has a significant effect on insomnia in pati

关 键 词：耳穴贴压 针刺疗法 针药并用 骨髓瘤 疼痛 睡眠启动和维持困难 失眠 认知功能 睡眠质量 

分 类 号：R246.6[医药卫生—针灸推拿学]