杨瑞 高娟 何花

〔摘要〕 目的 观察八段锦联合五行音乐疗法对冠心病伴失眠患者睡眠质量和生活质量的干预疗效。方法 采用随机数字表法将86例冠心病伴失眠患者分为实验组和对照组，每组43例。对照组给予冠心病常规治疗和护理，实验组在对照组基础上施以八段锦联合五行音乐疗法。分别在干预前、干预1周和干预4周后比较两组患者匹兹堡睡眠质量指数（PSQI）量表和生活质量量表（SF-36）得分情况。结果 干预1周和4周后，两组患者的PSQI得分均下降（P<0.05），两组患者的SF-36得分均升高（P<0.05），但实验组优于对照组，差异有统计学意义（P<0.05）;实验组干预前后PSQI和SF-36得分比较，差异有统计学意义（P<0.05）。结论 八段锦联合五行音乐疗法能提高冠心病伴失眠患者的睡眠质量，提高患者的生活质量。

〔关键词〕 冠心病;失眠;八段锦;五行音乐;睡眠质量;生活质量

〔中图分类号〕R256.23;R541.4       〔文献标志码〕B       〔文章编号〕doi：10.3969/j.issn.1674-070X.2020.07.024

〔Abstract〕 Objective To observe the intervention effect of Baduanjin exercise and five-element music therapy in the improvement of sleep quality and life quality of coronary heart disease patients combined with insomnia. Methods A total of 86 patients with coronary heart disease and insomnia were randomly divided into an experimental group and a control group according to random number table， with 43 cases in each group. The control group was given routine treatment and nursing of coronary heart disease， and the experimental group was given Baduanjin exercise and five-element music therapy on the basis of the control group. The scores of Pittsburgh Sleep Quality Index （PSQI） and SF-36 quality of life score were compared before intervention， 1 week after intervention and 4 weeks after intervention. Results After 1 week and 4 weeks of intervention， the PSQI scores of the 2 groups decreased （P<0.05）， and the SF-36 scores of the 2 groups increased （P<0.05）. The scores of the experimental group were better than those in the control group， and the differences had statistical significance （P<0.05）. The PSQI and SF-36 scores of the experimental group before and after intervention had statistical significance （P<0.05）. Conclusion Baduanjin exercise and five-element music therapy can improve sleep quality and life quality of coronary heart disease patients combined with insomnia.

〔Keywords〕 coronary heart disease; insomnia; Baduanjin; five-element music therapy; sleep quality; quality of life

随着社会人口老龄化，人们生活方式的变化，我国冠心病的患病率和病死率逐年增高，已成为严重影响人民群众生命安全的重大公共卫生问题之一[1]。冠心病症状如夜间胸闷、心绞痛发作等，均影响正常睡眠过程，部分患者存在失眠表现，对其睡眠质量以及生活质量造成较大影响[2]。有关研究表明，冠心病合并失眠患者其心率变异性（HRV）各指标下降，可增加其血液黏稠度、血小板聚集、心率、血压等，从而降低心室颤动阈值，并引起心电性事件以及缺血性事件，严重时还可能造成患者猝死[3]。目前，针对此类患者，临床多予以长期口服镇静剂，部分药物长期服用具有戒断效应，而新型改善睡眠药物费用较高，患者长期服用依从性较差[4]。因此，加强对冠心病伴失眠患者的關注，了解其睡眠状态，并采取针对性的干预措施，提高生活质量，促进其早日康复，已成为临床上亟待解决的问题。……