金金　徐东娥　陈紫君　王燕飞

[關键词] 引阳入阴推拿;耳穴埋豆;脑卒中;失眠;焦虑;抑郁

[中图分类号] R248.9;R473.75          [文献标识码] B          [文章编号] 1673-9701（2021）27-0168-04

Effect of massage to induce yang conducting to yin combined with auricular buried beans on insomnia， anxiety and depression after cerebral apoplexy

JIN Jin1   XU Dong′e2   CHEN Zijun1   WANG Yanfei1

1.Department of Neurology，Tongde Hospital of Zhejiang Province，Hangzhou   310012，China; 2.Department of Nursing，Tongde Hospital of Zhejiang Province，Hangzhou   310012，China.

[Abstract] Objective To investigate the effect of massage to induce yang conducting to yin combined with auricular buried beans on insomnia，anxiety and depression of patients with cerebral apoplexy. Methods A total of 60 patients with insomnia after cerebral apoplexy in our hospital from August 2019 to March 2020 were selected as research objects and they were randomly divided into the intervention group （n=30） and the control group （n=30）. Both groups were given auricular buried beans， on the basis of which the intervention group was treated with the massage to induce yang conducting to yin. PSQI score，HAMD score and HAMA score were compared between the two groups before and after intervention. Results （1）After intervention， the scores of each dimension and total score of PSQI between the intervention group and control group were significantly lower than those before intervention，and the difference was statistically significant（P<0.05）. After the intervention， the scores of each dimension and total score of PSQI in the intervention group were significantly lower than those in the control group， and the difference was statistically significant （P<0.05）. （2）HAMD scores between the intervention group and control group after intervention were significantly lower than those before intervention， and the differences were statistically significant（P<0.05）. After intervention， HAMD score in the intervention group was （7.6±1.1） points， which was significantly lower than that of （10.2±1.3） points in the control group， and the differences were statistically significant（P<0.05）. （3） HAMA scores between the intervention group and the control group after intervention were significantly lower than those before intervention， and the differences were statistically significant（P<0.05）. After intervention， HAMA score in the intervention group was （7.2±1.1）points， which was significantly lower than of （10.5±1.3） points in the control group， and the difference was statistically significant（P<0.05）. Conclusion Massage to induce yang conducting to yin combined with auricular buried beans can significantly improve insomnia and alleviate anxiety，depression and other bad emotions in patients with cerebral apoplexy.

[Key words] Massage to induce yang conducting to yin; Auricular buried beans; Cerebral apoplexy; Insomnia; Anxiety; Depression

脑卒中患者睡眠障碍发生率高于一般人群，其中又以失眠最为常见，严重影响脑卒中患者的情绪、功能锻炼及生活质量，长期睡眠不足还会影响免疫功能，引起一系列不良事件的发生[1]。研究显示，存在睡眠障碍的脑卒中患者，日常生活活动能力更低，神经功能缺损更严重[2]。脑卒中后焦虑、抑郁的发生既有心理因素也有生理因素。脑卒中后抑郁是脑卒中常见的并发症之一，与脑卒中时间相关，表现为抑郁心境的情感障碍，严重者甚至会产生轻生的念头。近年来中医疗法在卒中后康复中的作用越来越受到重视。失眠本身也会加重患者焦虑、抑郁的情绪，焦虑、抑郁情绪又会加重失眠。引阳入阴推拿是治疗失眠的重要中医疗法，既往研究显示，其可改善不寐患者的睡眠质量[3]。也有报道其可改善患者的焦虑、抑郁状况[4-5]。耳穴埋豆法是重要的中医疗法之一，通过穴位贴压达到刺激耳穴、调整机体平衡、宁心安神、治疗疾病的作用。本研究联合引阳入阴推拿法与耳穴埋豆法治疗脑卒中后失眠的患者，观察其对患者睡眠治疗、焦虑、抑郁情绪的影响，现报道如下。

1 资料与方法

1.1一般资料

选取2019年8月至2020年3月我院脑卒中后失眠的患者60例为研究对象。纳入标准[6]：①脑梗死;②局灶性神经功能缺损;③匹兹堡睡眠质量指数（Pittsburgh sleep quality index，PSQI）[7]≥7分，且在卒中后发……