头部刮痧联合五音疗法在肝郁气滞型慢性疲劳综合征中的应用
| 作者: |
1夏美玲,
2夏美芳,
1吴玉娟,
1刘秀银
1 广州中医药大学深圳医院(深圳市福田区中医院)治未病科，广东 深圳 518034 2 深圳市福田区慢性病防治院明月社康中心，广东 深圳 518048 |
| 通讯: |
夏美玲
Email: 2184846679@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2018.06.025 |
| 基金: | 深圳市福田区卫生公益性科研项目(FTWS2015035) |
摘要
目的：探讨头部刮痧联合五音疗法在肝郁气滞型慢性疲劳综合征(chronic fatigue syndrome，CFS)中的应用价值。方法：选取2016年5月至2018年1月深圳市福田区中医院60例肝郁气滞型CFS患者，随机分为实验组和对照组，每组30例。对照组采用常规康复方案，主要包括心理指导、认知行为疗法和分级运动疗法，每周就诊1次。实验组在常规康复方案基础上，给予头部刮痧联合五音疗法，头部刮痧刮法采用四神延、颞三片、维风双带和项丛刮，每3~4天1次，每周2次；五音疗法选用角调式乐曲，每天1次，每周5次。2组均以治疗4周为1疗程。两组干预前后，采用疲劳量表(Fatigue Scale-14，FS-14)评估疲劳程度，焦虑自评量表(Self-rating Anxiety Scale，SAS)和抑郁自评量表(Self-rating Depression Scale，SDS)评估负性情绪状况，匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index，PSQI)评估患者睡眠质量，临床症状积分评估CFS临床症状严重程度，评定临床疗效。结果：干预前，两组一般资料、疲劳、负性情绪、睡眠质量和临床症状指标差异无统计学意义(均P>0.05)。干预后，实验组FS-14评分脑力疲劳(2.7±0.7 vs 3.2±0.8，t=2.576，P=0.013)、躯体疲劳(3.6±1.3 vs 4.4±1.2，t=2.477，P=0.016)两个维度独立得分和疲劳总分(6.3±1.7 vs 7.6±1.6, t=3.050，P=0.003)均显著低于对照组(P<0.05)，SAS(42.3±4.4 vs 45.0±4.6，t=2.323，P=0.024)和SDS评分(51.6±5.0 vs 54.3±4.9，t=2.112，P=0.039)显著低于对照组(均P<0.05)，PSQI评分中睡眠质量(0.8±0.3 vs 1.1±0.4，t=3.286，P=0.002)、入睡时间(0.8±0.3 vs 1.0±0.4，t=2.191，P=0.032)、日间功能障碍(1.8±0.4 vs 2.1±0.5，t=2.566，P=0.013)、睡眠障碍(0.9±0.4 vs 1.2±0.5，t=2.566， P=0.013)4个维度独立得分和全部7个维度总分(5.2±2.0 vs 6.4±2.1，t=2.266，P=0.027)均显著低于对照组(P<0.05)，CFS临床症状积分(7.9±3.1 vs 10.2±3.7，t=2.610，P=0.012)显著低于对照组(P<0.05)，临床总体疗效显著优于对照组(Z=2.762，P=0.006)。结论：头部刮痧联合五音疗法可以改善肝郁气滞型慢性疲劳综合征患者睡眠质量、减轻临床症状和负性情绪，进而有助于提高临床疗效。
关键词：
刮痧；五音疗法；慢性疲劳综合征；睡眠质量
Application of head scrape therapy combined five-tone therapy on chronic fatigue syndrome patients with liver qi stagnation syndrome
CorrespondingAuthor: XIA Meiling Email: 2184846679@qq.com
DOI: 10.3978/j.issn.2095-6959.2018.06.025
Foundation: This work was supported by the Health Public Welfare Research Project of Shenzhen Futian District, China (FTWS2015035)
Abstract
Objective: To investigate the effect of head scrape therapy combined five-tone therapy on chronic fatigue syndrome (CFS) patients with liver qi stagnation syndrome. Methods: From May 2016 to January 2018, 60 patients with liver qi stagnation type CFS were randomly divided into an experimental group and a control group (n=30 in each group). The control group adopted the routine rehabilitation program, including psychological guidance, cognitive behavior therapy and graded exercise therapy, for 1 time a week. The experimental group on the basis of conventional rehabilitation program was given the head scraping combined five-tone therapy. The head scraping method using sishenyan, niesanpian, weifengshuangdai, and xiangconggua, for 1 times every 3–4 days, 2 times a week. The five-tone therapy given angular tune music, 1 times a day, 5 times a week. The 2 groups were treated for 4 weeks as 1 courses. Before and after the intervention, the degree of fatigue was assessed by the fatigue scale (FS-14), the negative emotional status was assessed using the Zung Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS), the sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI), and the severity of clinical symptom was assessed by clinical symptom score. The overall clinical efficacy was evaluated at post-treatment. Results: Before the intervention, there was no statistically significant difference in general information, fatigue, negative mood, sleep quality and clinical symptom index between the two groups (P>0.05). After the intervention, the score of mental fatigue (2.7±0.7 vs 3.2±0.8, t=2.576, P=0.013), body fatigue (3.6±1.3 vs 4.4±1.2, t=2.477, P=0.016), and the total fatigue (6.3±1.7 vs 7.6±1.6, t=3.050, P=0.003) were significantly lower than those of the control group (P<0.05 or P<0.01). The SAS (42.3±4.4 vs 45±4.6, t=2.323, P=0.024) and SDS score (51.6±5 vs 54.3±4.9, t=2.112, P=0.039) was significantly lower than the control group (P<0.05). The PSQI score of 4 independent dimensions scores including subjective sleep quality (0.8±0.3 vs 1.1±0.4, t=3.286, P=0.002), go to sleep time (0.8±0.3 vs 1.0±0.4, t=2.191, P=0.032), daytime dysfunction (1.8±0.4 vs 2.1±0.5, t=2.566, P=0.013), sleep disorders (0.9±0.4 vs 1.2±0.5, t=2.566, P=0.013) and all the total score of 7 dimensions (5.2±2 vs 6.4±2.1, t=2.266, P=0.027) were significantly lower than the control group (P<0.05). After the intervention, the clinical symptom score of CFS (7.9±3.1 vs 10.2±3.7, t=2.610, P=0.012) was significantly lower than that of the control group (P<0.05), and the overall clinical efficacy was significantly better than that of the control group (Z=2.762, P=0.006). Conclusion: The head scrape therapy combined five-tone therapy can improve the sleep quality, clinical symptoms, negative mood, and clinical efficacy of chronic fatigue syndrome patients with liver qi stagnation syndrome.
Keywords：
scrape therapy; five-tone therapy; chronic fatigue syndrome; sleep quality