Relationship between kinesiophobia and somnipathy among inpatients with lumbar degenerative disease after surgery and its impact pathway / 中国实用护理杂志

Objective:To explore the relationship between kinesiophobia and somnipathy among inpatients with lumbar degenerative disease after surgery, and analyze the mediating effects of post-traumatic stress disorder and family care.Methods:A cross-sectional survey method was adopted, from July 2020 to July 2022, a total of 130 lumbar degenerative disease patients from Wuhan Dongxihu District People′s Hospital were enrolled as research object by convenience sampling method. General information questionnaire, Tampa Scale for Kinesiophobia, Pittsburgh Sleep Quality Index, Posttraumatic Stress Checklist-civilian version and Family APGAR index were used for investigation. A structural equation model was established to evaluate the mediating effect of post-traumatic stress disorder, family care on kinesiophobia and somnipathy.Results:The scores of kinesiophobia, somnipathy, post-traumatic stress disorder and family care were (39.95 ± 3.90), (7.63 ± 0.46), (25.99 ± 4.99), (5.67 ± 1.76) points, respectively. There were significant differences in the scores of somnipathy in terms of age, monthly income, course of disease and pain degree ( F values were 3.21 to 10.12, all P<0.05). The dimensions and total scores of somnipathy were positively correlated with kinesiophobia ( r values were 0.347 to 0.800, all P<0.05) and post-traumatic stress disorder ( r values were 0.385 to 0.825, all P<0.05), negatively correlated with the scores of family care ( r values were - 0.653 to - 0.282, all P<0.05); the scores of family care was negatively correlated with kinesiophobia and post-traumatic stress disorder ( r = - 0.695, - 0.637, both P<0.05); the scores of kinesiophobia was positively correlated with post-traumatic stress disorder ( r = 0.773, P<0.05). The indirect effect of kinesiophobia on somnipathy was identified, and the total indirect effect value was 0.44; the indirect effect value of family care and post-traumatic stress disorder was 0.09, which accounted for 12.0% of the total effect. Conclusions:Post-traumatic stress disorder and family care play a multiple mediating role on the relationship between kinesiophobia and somnipathy in patients with lumbar degenerative disease after surgery.

Clinical Trial of Acupuncture Treatment of Gastroesophageal Reflux Disease Accompanied with Somnipathy at Acupoints of Governor Vessel at Back Segment / 针刺研究

OBJECTIVE: To observe the curative effect of needling stimulation of the back segment (10 spots below the spinous processes from T 3 to T 12)of the Governor Vessel in the treatment of gastroesophageal reflux disease(GERD)accompanied with somnipathy. METHODS: A total of 58 patients of GERD accompanied with somnipathy were randomly divided into acupuncture group (n＝28) and medication group (n＝30)according to random number table method. For patients of the acupuncture group, the spots below the spinous processes from T 3 to T 12, including acupoints Shenzhu (GV 12), Shendao (GV 11), Lingtai (GV 10), Zhiyang (GV 9), Jinsuo (GV 8), Zhongshu (GV 7) and non-acupoints (T 4, T 8, T 12) were punctured with filiform needles, once every other day for 8 weeks. Patients of the medication group were ordered to take Omeprazole capsules (20 mg/time), twice a day for 8 weeks. The therapeutic effect was assessed by "Reflux Diagnostic Questionnaire" (RDQ，scores of symptoms of heartburn, retrosternal pain, acid regurgitation and food regurgitation, 0－40 points), GERD symptom scale (scores of symptoms of the digestive system, five-sense organs, cardiovascular system, etc., 0－84 points) and Pittsburgh Sleep Quality Index (PSQI, scores of sleep quality, fall asleep time, sleep duration, sleep efficiency, etc., 0－21 points), respectively. RESULTS: After the treatment, RDQ score, GERD symptom scale score and PSQI score were significantly decreased in both acupuncture and medication groups compared with their own pre-treatment(P<0.01), and the decreased scores of RDQ, GERD scale and PSQI were significantly lower in the acupuncture group than in the medication group (P<0.01). The cured plus markedly effective rates for RDQ in the two groups were 43.3% (13/30) and 71.4% (20/28), respectively, and the effective rates of the medication and acupuncture groups were 56.7% (17/30) and 89.3% (25/28) for GERD scale, and 60.0% (18/30) and 92.9% (26/28) for PSQI, respectively. The cured plus markedly effective rate for RDQ, and the effective rates for GERD scale and PSQI were signi-ficantly higher in the acupuncture group than in the medication group respectively (P<0.05，P<0.01)．. CONCLUSION: Acupuncture stimulation of acupoints of Governor Vessel at the back segment is effective in improving symptoms of GERD patients with somnipathy.

Clinical observation of somnipathy in stroke treated with Warming Meridian and Dissipating Could Lotion by lavipeditum and psychotherapy / 中草药

Objective: To verify the clinical efficacy of Warming Meridian and Dissipating Could Lotion by lavipeditum and psychotherapy on somnipathy in stroke. Methods: Two hundred patients of cerebral infarction or cerebral hemorrhage with scores of PSQI>7 were randomly divided into four groups, 50 cases in each one. Among them, the patients in treatment group were treated with estazolam, 2 mg per night, patients in lavipeditum group were treated with Warming Meridian and Dissipating Could Lotion by lavipeditum, 20-30 min each time, once daily, patients in psychotherapy group were treated with cognitive-behavioral therapy, once every other day, patients combined treatment group were treated with Warming Meridian and Dissipating Could Lotion by lavipeditum and cognitive-behavioral therapy, 4-week treatment was aquired in four groups. The Pinsburgh Sleep Quality lndex (PSQI)/Fugl-meyer assessment (FMA)/Modified Bathel index (MBI) assessment was evaluated before and after 4-week treatment in four groups. Results: The score of PSQI/FMA/MBI in two groups after 4-week treatment was higher than that in prior treatment (P0.05); The score of PSQI in combined treatment group was higher than that in the other groups after 4-week treatment. Conclusion: The therapy of Warming Meridian and Dissipating Could Lotion by lavipeditum and psychotherapy can well improve the somnipathy in stroke.

Acupuncture benefits the motor function of strokes with somnipathy at early stage / 中国康复理论与实践

@#patients with steady vital signs and affected by combined somnipathy at the early stage of stroke were divided into three groups according to the date of admission:the experimental group(Group E)and the control groups(Group C1 and Group C2).The rehabilitation programs to all patients are the same,except the somnipathy,(1) patients of Group E were adopted the method of acupuncture and moxibustion coupled with taping and pressing their ear acupuncture points to improve their quality of sleep,(2) patients of Group C1 were asked to administer orally the traquilizers,and (3) no interference was conducted to the patients of Group C2.After 8 weeks of treatment,it is found that,(1) the speed of recovery of the motor function of the patients of both Group E and Group C1 is faster than that of Group C2 (P<0.01).(2) The total sleeping hours of Group E is significantly compared with that of Group C1(P<0.05).This shows that the long-term effects of the acupuncture therapy on sleep are superior to that of the tranquilizer.It suggests that the acupuncture therapy is an improtant method to treat the sequelae and syndrome of stroke.