作者：王馨，陈鹤，王寅，蔡玉梅，刘睿

单位：

1.黑龙江中医药大学附属第二医院针灸科2.中国中医科学院广安门医院中医适宜技术门诊3.黑龙江中医药大学附属第二医院医保科4.中国中医科学院广安门医院南区肿瘤科

Units：

1.Department of Acupuncture and Moxibustion, the Second Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin 150001, China 2.TCM Apply Technique Clinic, China Academy of Chinese Medical Sciences, Guang'anmen Hospital, Beijing 100053, China 3.Department of Medical Insurance, the Second Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin 150001, China 4.Department of Oncology, China Academy of Chinese Medical Sciences, Guang'anmen Hospital (South Campus) , Beijing

关键词：

神经外科手术; 中医综合睡眠干预; 睡眠质量; 认知; 运动功能; 双重差分法;

Keywords：

Neurosurgical procedures; Sleep intervention of traditional Chinese medicine; Sleep quality; Cognition; Motor function; Differences-in-differences

CLC：

DOI：

10.12114/j.issn.1008-5971.2023.00.132

Funds：

黑龙江省中医药科研项目（ZHY18-127）

摘要：

目的 采用双重差分法分析中医综合睡眠干预对颅脑手术患者睡眠质量及功能状态的影响。方法 选取2019年7月至2022年6月于黑龙江中医药大学附属第二医院行颅脑手术的患者122例作为研究对象，采用随机数字表法将患者分为对照组和观察组，各61例。对照组患者予以常规干预；观察组患者在对照组基础上接受中医睡眠综合干预，包括耳穴压豆、五音治疗、推拿按摩、情志调节等，两组均连续干预至出院，并随访观察3个月。干预前及干预后1个月、3个月，采用匹茨堡睡眠质量指数（PSQI）评价患者睡眠质量，采用功能独立性评价量表（FIM）中的认知功能版块和运动功能版块评价患者认知、运动功能。采用Stata 15.0建立双重差分法回归模型以分析干预方案对睡眠质量及功能状态的影响。结果 干预前，两组PSQI评分比较，差异无统计学意义（P>0.05）；干预后1个月、3个月，观察组PSQI评分低于对照组（P<0.05）。干预前，两组FIM认知功能版块、运动功能版块评分比较，差异无统计学意义（P>0.05）；干预后1个月、3个月，观察组FIM认知功能版块、运动功能版块评分高于对照组（P<0.05）。双重差分法分析结果显示，干预后，两组PSQI评分、FIM认知功能版块评分、FIM运动功能版块评分差分效应值分别为1.990、2.489、3.154，差异有统计学意义（P<0.05）；两组PSQI评分、FIM认知功能版块评分、FIM运动功能版块评分双重差分效应值分别为2.306、1.900、2.111，差异有统计学意义（P<0.05）。结论 中医综合睡眠干预可改善颅脑手术患者睡眠质量，促进认知、运动功能恢复。

Abstract：

Objective To explore the the impact of comprehensive sleep intervention of traditional Chinese medicine on sleep quality and functional status in patients undergoing craniocerebral surgery using the differences-in-differences. Methods A total of 122 patients who underwent craniocerebral surgery in the Second Hospital of Heilongjiang University of Traditional Chinese Medicine from July 2019 to June 2022 were selected. The patients were divided into control group (61 cases) and observation group (61 cases) by random number table method. The control group was given routine intervention, the observation group was given comprehensive sleep intervention of traditional Chinese medicine on the basis of the control group, including ear point pressure bean, five tone treatment, massage, and emotional adjustment. Both groups were continuously intervened until discharge, and were followed up for 3 months. Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality, the cognitive and motor function plates of Function Independent Measure (FIM) was used to evaluate the cognitive and motor function before intervention, 1 month and 3 months after intervention. Stata 15.0 was used to establish a differences?in-differences regression model to analyze the effects of intervention programs on sleep quality and functional status. Results Before intervention, there was no significant difference in PSQI score between the two groups (P > 0.05) . One month and 3 months after intervention, PSQI score in observation group was lower than that in control group (P < 0.05) . Before intervention, there was no significant difference in FIM cognitive function score and FIM motor function score between the two groups (P > 0.05) . One month and 3 months after intervention, FIM cognitive function score and FIM motor function score in observation group were higher than those in control group (P < 0.05) . The result of the differences-in-differences analysis showed that after intervention, the difference effect sizes of PSQI score, FIM cognitive function score and FIM motor function score in the two groups were 1.990, 2.489 and 3.154, respectively, the difference was statistically significant (P < 0.05) ; the differences-in-differences effect values of PSQI score, FIM cognitive function score and FIM motor function score in the two groups were 2.306, 1.900 and 2.111, respectively, the difference was statistically significant (P < 0.05) . Conclusion The comprehensive sleep intervention of traditional Chinese medicine can improve the sleep quality of patients undergoing craniocerebral surgery and promote cognitive and motor function recovery.

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