时辰节律的用药指导联合耳穴埋籽对老年高血压患者遵医行为、睡眠质量和情志状态的影响  

Effects of medication guidance based on circadian rhythms combined with auricular seed implantation on treatment compliance,sleep quality and emotional state in elderly patients with hypertension

作　　者：周红霞[1] 刘慧霞[2] 杨清柯 师卿杰 ZHOU Hongxia;LIU Huixia;YANG Qingke;SHI Qingjie(Cardiovascular Ward 1 of the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China;First and Second Wards of Rehabilitation Department,Third Affiliated Hospital of Henan University of Traditional Chinese Medicine;Blood Purification Department of the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine;Cardiovascular Department of the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine)

机构地区：[1]河南中医药大学第三附属医院心血管一病区(郑州),450000 [2]河南中医药大学大学第三附属医院康复科一二病区 [3]河南中医药大学第三附属医院血液净化科 [4]河南中医药大学第三附属医院心血管科

出　　处：《中国健康心理学杂志》2024年第9期1382-1386,共5页China Journal of Health Psychology

基　　金：2020-2021年度河南省中医药科学研究专项课题目录(编号:20-21ZY2224)。

摘　　要：目的:探讨基于时辰节律的用药指导联合耳穴埋籽对老年高血压患者遵医行为、睡眠质量和情志状态的影响。方法:选取2021年3月-2023年12月在某院收治的213例老年高血压患者,根据入院顺序和组间基本资料具可比性的原则分为观察组(2022年12月—2023年12月,n=106)和对照组(2021年3月——2022年11月,n=107),两组患者均予以基于时辰节律的用药指导,观察组联合耳穴埋籽,观察两组患者血压控制、睡眠质量、情志状态、遵医行为和生活质量变化。结果:两组干预后收缩压、舒张压均较干预前有所下降,且观察组血压下降幅度高于对照组(t=7.232,19.046;P<0.05);两组干预后匹兹堡睡眠质量指数(PSQI)评分和抑郁(SDS)、焦虑自评量表(SAS)评分均较干预前下降,且观察组PSQI评分和SAS、SDS评分均低于对照组(t=8.602,7.635,10.045;P<0.05);观察组在用药管理、生活管理和定期复查的遵医行为均优于对照组(χ^(2)=5.357,17.453,8.819;P<0.05)。两组生活质量各维度评分均较干预前均上升,且观察组生活质量各维度评分高于对照组(t=5.648,3.441,3.457,3.971,8.766;P<0.05)。结论:基于时辰节律的用药指导联合耳穴埋籽可有效控制老年高血压患者的血压波动,提升睡眠质量,改善患者情志状态,进一步提高遵医行为,形成良性循环。Objective:To explore the effects of medication guidance based on circadian rhythms combined with auricular seed implantation on treatment compliance,sleep quality and emotional state in elderly patients with hypertension.Methods:A total of 213 elderly patients with hypertension admitted to the hospital were enrolled between March 2021 and December 2023.According to admission order and comparability principle of inter-group basic data,they were divided into control group(March 2021-November 2022,medication guidance based on circadian rhythms,n=107)and observation group(December 2022-December 2023,auricular seed implantation on basis of control group,n=106).The changes in blood pressure control,sleep quality,emotional state,treatment compliance and quality of life in the two groups were observed.Results:After intervention,systolic blood pressure and diastolic blood pressure were decreased in both groups,and the decrease was greater in observation group than control group(t=7.232,19.046;P<0.05).After intervention,scores of Pittsburgh sleep quality index(PSQI),self-rating depression scale(SDS)and self-rating anxiety scale(SAS)were decreased in both groups,which were lower in observation group than control group(t=8.602,7.635,10.045;P<0.05).The treatment compliance(medication management,life management,regular reexamination)in observation group was better than that in control group(χ^(2)=5.357,17.453,8.819;P<0.05).After intervention,quality of life scores were increased in both groups,which were higher in observation group than that in control group(t=5.648,3.441,3.457,3.971,8.766;P<0.05).Conclusion:Medication guidance based on circadian rhythms combined with auricular seed implantation can effectively control blood pressure fluctuation in elderly patients with hypertension,improve sleep quality and emotional state,further improve treatment compliance and form a virtuous cycle.

关 键 词：高血压 老年 耳穴埋籽 时辰节律 用药指导 遵医行为 睡眠质量 情志状态 

分 类 号：R749.92[医药卫生—神经病学与精神病学] R395.6[医药卫生—临床医学]