目的 探讨基于营卫理论择时顺势足浴改善失眠患者"昼不精-夜不瞑"状态的效果.方法 选取符合纳入标准的失眠患者95例,用随机数字表法分为对照组31例、时辰组32例、时辰分方组32例.对照组分别于晚上临睡前(避开酉时)及上午任意时段(避开卯时)实施桂枝汤中药足浴;时辰组分别于卯时、酉时实施桂枝汤中药足浴;时辰分方组于卯时采用桂枝汤加桂枝柴胡足浴晨方,酉时采用桂枝汤加白芍龙骨牡蛎足浴晚方.3组均足浴2次/d,连续干预4周后采用匹兹堡睡眠质量指数量表(PSQI)、Epworth嗜睡量表(ESS)、汉密尔顿焦虑量表(HAMA)、抑郁自评量表(SDS)进行评价.结果 3组患者干预后第4周的PSQI总分、ESS及HAMA得分差异有统计学意义(P<0.05);进一步组间两两比较显示:在PSQI总分、ESS、HAMA得分方面,时辰分方组低于时辰组、对照组,时辰组低于对照组,差异均有统计学意义(P<0.05).结论 基于营卫理论择时顺势足浴在改善失眠患者"昼不精-夜不瞑"状态方面更具针对性和有效性,效果优于常规中药足浴.%Objective To evaluate the effect of complying time and trend foot bath based on theory of nutritive Qi and defensive Qi on the state of Zhoubujing and Yebuming in patients with insomnia. Methods Ninty-five patients were divided into three groups according to random number table. The control group had Guizhitang foot bath before bed except Youshi and anytime in the morning except Maoshi. The time group had Guizhitang foot bath at Youshi and Maoshi. The time and prescription group had Guizhitang with Guizhi and Chaihu foot bath at Maoshi and Guizhitang with Baishao, Longgu and Muli at Youshi. All groups had foot bath twice a day. After 4-week intervention, the sleep quality, daytime sleepiness, anxiety and depression were evaluated with Pittsburgh Sleep Quality Index (PSQI), Epworth Sleeping Scale (ESS), Hamilton Anxiety Scale (HAMA) and Self-rating Depression Scale (SDS). Results The total scores of PSQI, ESS and HAMA were of significant differences among the three groups ( P<0.05). Further comparisons among the three groups showed that the scores of PSQI, ESS and HAMA in the time and prescription group were lower than the scores in the time group, and the scores in the time group were lower than those in the control group with significant differences ( P< 0.05). Conclusions Complying time and trend foot bath based on theory of nutritive Qi and defensive Qi can effectively improve the state of Zhoubujing and Yebuming in patients with insomnia and is better than usual foot bath.
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