Effect of scraping intervention based on the midnight-noon ebb-flow theory combined with emotional nursing on patients with primary hypertension with phlegm-dampness stagnation

doi:10.3760/cma.j.issn.1007-1245.2023.03.024

Abstract

Abstract:

Objective　To explore the effect of scraping intervention under the theory of midnight-noon ebb-flow combined with emotional nursing on patients with primary hypertension with phlegm-dampness stagnation. Methods　It was a prospective randomized controlled trial. From February 2021 to February 2022, 110 patients with primary hypertension with phlegm-dampness stagnation in Luoyang Hospital of Traditional Chinese Medicine were selected and were divided into two groups according to the order of admission, with 55 cases in the control group and 55 cases in the observation group. In the control group, there were 29 males and 26 females, aged (55.16±3.26) years; in the observation group, there were 30 males and 25 females, aged (55.01±3.68) years. The control group was given routine intervention, and the observation group was given scrapping intervention guided by the theory of midnight-noon ebb-flow and emotional nursing on this basis. The blood pressure control, scores of Therapeutic Adherence Scale for Hypertensive Patients (TASHP), Spitzer Quality of Life Index (SQOL), and Profile of Mood States (POMS), and nursing satisfaction were compared between the two groups. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　After nursing, the systolic blood pressure and diastolic blood pressure in the observation group were (134.25±5.05) mmHg (1 mmHg=0.133 kPa) and (84.56±4.82) mmHg, which were lower than those in the control group [(139.64±5.62) mmHg and (91.06±5.18) mmHg], with statistically significant differences (both P<0.001). After nursing, the scores of TASHP and SQOL in the observation group were higher than those in the control group [(102.86±5.28) points vs. (83.16±5.73) points, (8.69±0.59) points vs. (7.94±0.67) points], with statistically significant differences (both P<0.001). After nursing, the positive mood state score in the observation group was higher than that in the control group [(34.67±2.33) points vs. (30.24±3.28) points], and the negative mood state score was lower than that in the control group [(63.76±6.82) points vs. (75.08±6.49) points], with statistically significant differences (both P<0.001). The nursing satisfaction of the observation group was higher than that of the control group [96.36% (53/55) vs. 83.64% (46/55)], with a statistically significant difference between the two groups (χ²=4.950, P=0.026). Conclusion　Scraping intervention under the theory of midnight-noon ebb-flow combined with emotional nursing can improve the mood states in patients with primary hypertension, enhance their compliance behaviors, help them to maintain blood pressure stable, and thus improve their quality of life and satisfaction.

Key words:

Primary hypertension, Scraping, Theory of midnight-noon ebb-flow, Emotional nursing

摘要：

目的　探究子午流注理论下的刮痧干预联合情志护理在痰湿壅盛证原发性高血压患者中的应用效果。方法　本研究为前瞻性随机对照试验。选取2021年2月至2022年2月在洛阳市中医院就诊的痰湿壅盛证原发性高血压患者110例，根据入院顺序不同分为2组。对照组55例中男29例，女26例，年龄（55.16±3.26）岁；观察组55例中男30例，女25例，年龄（55.01±3.68）岁。对照组给予常规干预，观察组在此基础上给予子午流注理论指导的刮痧干预与情志护理。对比两组血压控制情况，高血压治疗依从性量表（TASHP）、Spitzer生活质量指数（SQOL）、心境状态量表（POMS）评分及护理满意度。统计学方法采用独立样本t检验、配对t检验、χ²检验。结果　护理后观察组收缩压、舒张压分别为（134.25±5.05）mmHg（1 mmHg=0.133 kPa）、（84.56±4.82）mmHg，均低于对照组的（139.64±5.62）mmHg、（91.06±5.18）mmHg，差异均有统计学意义（均P<0.001）；护理后观察组患者的TASHP评分、SQOL评分均高于对照组［（102.86±5.28）分比（83.16±5.73）分、（8.69±0.59）分比（7.94±0.67）分］，差异均有统计学意义（均P<0.001）；护理后观察组积极心境评分高于对照组［（34.67±2.33）分比（30.24±3.28）分］，消极心境评分低于对照组［（63.76±6.82）分比（75.08±6.49）分］，差异均有统计学意义（均P<0.001）；观察组护理总满意度高于对照组［96.36%（53/55）比83.64%（46/55）］，两组比较差异有统计学意义（χ²=4.950，P=0.026）。结论　子午流注理论下刮痧干预联合情志护理可改善原发性高血压患者的心境状态，增强遵医行为，有助于患者维持血压稳定，从而提高生活质量与满意度。

关键词:

原发性高血压, 刮痧, 子午流注理论, 情志护理

Li Run, Li Liuna, Wang Mengqi, Niu Jingjing, Li Ruili, Chen Yuanyuan, Jiang Jiamei.

Effect of scraping intervention based on the midnight-noon ebb-flow theory combined with emotional nursing on patients with primary hypertension with phlegm-dampness stagnation [J]. International Medicine and Health Guidance News, 2023, 29(3): 404-408.

李润李柳娜王梦琪牛晶晶李瑞丽陈园园江佳美.

子午流注理论下的刮痧干预联合情志护理对痰湿壅盛证原发性高血压患者的影响 [J]. 国际医药卫生导报, 2023, 29(3): 404-408.

References

[1] 胡国庆,李学文. 朔州市朔城区农村人群高血压流行病学调查[J]. 中西医结合心脑血管病杂志,2021,19(18):3188-3191. DOI:10.12102/j.issn.1672-1349.2021.18.028.
[2] Khademian Z, Kazemi Ara F, Gholamzadeh S. The effect of self care education based on Orem's nursing theory on quality of life and self-efficacy in patients with hypertension: a quasi-experimental study[J]. Int J Community Based Nurs Midwifery, 2020, 8(2): 140-149. DOI:10.30476/IJCBNM.2020.81690.0.
[3] 戴晶,商锰男,地娜拉·加力肯,等. 中医药治疗原发性高血压病的代谢组学研究进展[J]. 江苏中医药,2021,53(11):81-85. DOI:10.19844/j.cnki.1672-397X.2021.11.025.
[4] 胡瑞学,熊兴江,陈仁波,等. 近两年中医药干预原发性高血压病临床试验结局指标的分析[J]. 中国中药杂志,2021,46(6):1547-1557. DOI:10.19540/j.cnki.cjcmm. 20200730.502.
[5] 郑筱萸. 中药新药临床研究指导原则:试行[M]. 北京:中国医药科技出版社,2002:229-231.
[6] 中国高血压防治指南修订委员会,高血压联盟(中国,中华医学会心血管病学分会中国医师协会高血压专业委员会,等. 中国高血压防治指南(2018年修订版)[J]. 中国心血管杂志,2019,24(1):24-56. DOI:10.3969/j.issn.1007-5410.2019. 01.002.
[7] 杨蕾,屠燕,朱敏芳,等. 高血压治疗依从性现状调查分析[J]. 广东医学,2018,39(17):2646-2651. DOI:10.3969/j.issn.1001-9448.2018.17.022.
[8] 汲冬冬. 微信手机APP平台下的延伸护理服务对分化型甲状腺癌患者术后康复锻炼依从性及生活质量的影响[J]. 检验医学与临床,2021,18(23):3462-3465. DOI:10.3969/j.issn.1672-9455.2021.23.029.
[9] 陈芷妍,马嘉悦,李泰安,等. 基础性抗荷高效训练方案对飞行学员心境状态和个性特征的影响[J]. 军事医学,2020,44(9):676-680. DOI:10.7644/j.issn.1674-9960.2020. 09.007.
[10] Litwin M, Kułaga Z. Obesity, metabolic syndrome, and primary hypertension[J]. Pediatr Nephrol, 2021, 36(4): 825-837. DOI:10.1007/s00467-020-04579-3.
[11] Kario K, Nomura A, Harada N, et al. Efficacy of a digital therapeutics system in the management of essential hypertension: the HERB-DH1 pivotal trial[J]. Eur Heart J, 2021, 42(40): 4111-4122. DOI:10.1093/eurheartj/ehab559.
[12] 范玺胜,佘延芬,刘君,等. 刮痧疗法干预新型冠状病毒肺炎恢复期的分析和建议[J]. 河北中医药学报,2020,35(3):54-57.
[13] 陈萌,于永铎,隋楠,等. 基于子午流注理论探讨化瘀通便汤治疗慢传输型便秘的临床研究[J]. 辽宁中医杂志,2020,47(2):143-144. DOI:10.13192/j.issn.1000-1719.2020. 02.046.
[14] 彭饶,廖涛,何凯元,等. 基于子午流注理论的择时穴位按摩法对气血两虚型附骨疽患者负性情绪的影响研究[J]. 现代中西医结合杂志,2021,30(12):1351-1355. DOI:10.3969/j.issn.1008-8849.2021.12.023.
[15] 赵倩倩,李媛媛,陈聪,等. 中医药治疗原发性高血压的作用机制研究现状与展望[J]. 中华中医药杂志,2020,35(4):1914-1916.
[16] Yang M, Lao L. Emerging applications of metabolomics in traditional Chinese medicine treating hypertension: biomarkers, pathways and more[J]. Front Pharmacol, 2019, 10(2): 158. DOI: 10.3389/fphar.2019.00158.
[17] 李传惠,丁玉芳,鲁志霞,等. 吴茱萸穴位贴敷联合刮痧用于原发性高血压的疗效观察[J]. 护理研究,2020,34(14):2544-2547. DOI:10.12102/j.issn.1009-6493.2020.14.022.
[18] 刘彬,章琼,邓娟娟,等. 子午流注择时循经刮痧干预1级原发性高血压(肝阳上亢型)患者的疗效观察[J]. 湖南中医药大学学报,2020,40(5):630-634. DOI:10.3969/j.issn.1674-070X.2020.05.025.
[19] 曾维轲,潘晓彦,雷建兰,等. 辨证刮痧方案在原发性高血压病(肝阳上亢证)患者中应用疗效观察[J]. 辽宁中医药大学学报,2021,23(4):135-138. DOI:10.13194/j.issn.1673- 842x.2021.04.030.
[20] 朱海利,陈燕,刘佳,等. 刮痧疗法辅助治疗原发性高血压临床疗效的Meta分析[J]. 中医药导报,2020,26(13):151-155.
[21] 刘建邵,唐小君,饶娟娟,等. 完形心理治疗对高血压合并抑郁患者的抑郁情绪和血压控制效果的影响[J]. 山西医药杂志,2020,49(12):1516-1519. DOI:10.3969/j.issn.0253- 9926.2020.12.016.
[22] 陈雯,丁雯,李冰雪,等. 焦虑和/或抑郁情绪对老年原发性高血压病患者血压影响的Meta分析[J]. 实用心脑肺血管病杂志,2021,29(2):77-83. DOI:10.12114/j.issn.1008-5971. 2021.00.004.
[23] 李忠琼,刘芽青,贺玉兰,等. 辨证施护联合中医情志干预对老年高血压患者心理状态、血压控制及生活质量的影响[J]. 四川中医,2021,39(7):199-202.
[24] Wang YW, Xi ZW, Pu B, et al. Gua sha therapy for chronic low back pain: a protocol for systematic review[J]. Medicine (Baltimore), 2020, 99(40): e20606. DOI:10.1097/MD.0000000000020606.
[25] 宫妍,王东梅,梁月,等. 虎符铜砭刮痧联合揿针对肝火亢盛型高血压患者的治疗效果[J]. 心血管康复医学杂志,2022,31(4):475-479. DOI:10.3969/j.issn.1008-0074.2022. 04.18.
[26] 焦文波,盖凤春,盖国忠. 子午流注理论在现代临床护理中的研究进展[J]. 长春中医药大学学报,2020,36(2):406-408. DOI:10.13463/j.cnki.cczyy.2020.02.057.
[27] 梁雪,张红艳,张傲君. 子午流注理论应用于蜡疗护理寒湿型腰椎间盘突出患者效果评价[J]. 中国医药导报,2022,19(16):191-193,封3.
[28] 石廷琪,张金花. 基于子午流注理论茵陈蒿汤药浴联合神阙穴贴敷对新生儿黄疸的干预效果[J]. 国际医药卫生导报,2021,27(13):2014-2018. DOI:10.3760/cma.j.issn.1007- 1245.2021.13.028.
[29] 邹彬,顾青,顾伟. 刮痧疗法作用机制的实验研究进展[J]. 现代中西医结合杂志,2020,29(28):3189-3192. DOI:10.3969/j.issn.1008-8849.2020.28.026.
[30] Chu ECP, Wong AYL, Sim P, et al. Exploring scraping therapy: contemporary views on an ancient healing-a review[J]. J Family Med Prim Care, 2021, 10(8): 2757-2762. DOI:10.4103/jfmpc.jfmpc_360_21.
[31] Tavakoly Sany SB, Behzhad F, Ferns G, et al. Communication skills training for physicians improves health literacy and medical outcomes among patients with hypertension: a randomized controlled trial[J]. BMC Health Serv Res, 2020, 20(1): 60. DOI:10.1186/s12913- 020-4901-8.