基于脑-肠轴理论的足部推拿在脾肾阳虚型血液透析失眠患者中的应用研究

doi:10.3761/j.issn.0254-1769.2025.18.005

摘要/Abstract

摘要：

目的探讨基于脑-肠轴理论的足部推拿在脾肾阳虚型维持性血液透析伴失眠患者中的应用效果，为改善患者的睡眠质量和胃肠道症状提供参考。方法选取2024年4—9月浙江省杭州市某三级甲等综合医院血液净化中心收治的88例脾肾阳虚型维持性血液透析失眠患者作为研究对象，采用随机数字表法分为试验组和对照组，每组各44例。试验组在常规治疗和护理的基础上，实施脑-肠轴理论的足部推拿；对照组采用常规治疗和护理，干预时间均为3个月。比较两组干预前后匹兹堡睡眠质量指数评分、胃肠道症状分级评分量表评分、中医证候积分、5-羟色胺水平和褪黑素水平的差异。结果研究期间，试验组无病例脱落，对照组脱落5例，最终试验组纳入44例，对照组纳入39例。干预后，两组匹兹堡睡眠质量指数评分、胃肠道症状分级评分量表评分、中医证候积分均低于干预前，且试验组低于对照组；干预后，两组5-羟色胺水平、褪黑素水平均高于干预前，且试验组高于对照组，差异均具有统计学意义（均P<0.001）。结论基于脑-肠轴理论的足部推拿可改善脾肾阳虚型维持性血液透析伴失眠患者胃肠道症状和中医证候，并提高其睡眠质量。

关键词: 脑-肠轴, 足部推拿, 血液透析, 失眠, 中医护理学

Abstract:

Objective To explore the application effect of foot massage based on the brain-gut axis theory in patients with spleen-kidney yang deficiency syndrome undergoing maintenance hemodialysis and suffering from insomnia，and to provide references for improving patients’ sleep quality and gastrointestinal symptoms. Methods A total of 88 patients with spleen-kidney yang deficiency syndrome undergoing maintenance hemodialysis and suffering from insomnia，who were treated at a Blood Purification Center of a tertiary-A general hospital in Hangzhou，Zhejiang Province from April to September 2024，were selected as a study subjects. They were randomly divided into an experimental group and a control group using the random number table method，with 44 cases in each group. The experimental group received foot massage based on the guidance of the brain-gut axis theory in addition to conventional treatment and nursing care，while the control group received conventional treatment and nursing care only. The intervention lasted for 3 months. The differences in the Pittsburgh Sleep Quality Index（PSQI） scores，Gastrointestinal Symptom Rating Scale（GSRS） scores，traditional Chinese medicine（TCM） syndrome scores，and serum 5-hydroxytryptamine and melatonin levels between the 2 groups before and after the intervention were compared. Results During the study period，no cases were lost in the experimental group，while 5 cases were lost in the control group. Ultimately，44 cases were included in the experimental group and 39 cases in the control group. After the intervention，the PSQI scores，GSRS scores，and TCM syndrome scores in both groups were lower than those before the intervention，and those in the experimental group were lower than those in the control group. The serum 5-hydroxytryptamine and melatonin levels were higher than those before the intervention，and the levels in the experimental group were higher than those in the control group，with statistically significant differences （all P<0.001）. Conclusion Foot massage based on the brain-gut axis theory can improve gastrointestinal symptoms and TCM syndromes in patients with spleen-kidney yang deficiency syndrome undergoing maintenance hemodialysis and suffering from insomnia，and enhance their sleep quality.

Key words: Brain-Gut Axis, Foot Massage, Hemodialysis, Insomnia, Traditional Chinese Medicine Nursing

邵雪英, 裴晓丹, 李艳娟, 董玉红, 常立阳, 金静芬. 基于脑-肠轴理论的足部推拿在脾肾阳虚型血液透析失眠患者中的应用研究[J]. 中华护理杂志, 2025, 60(18): 2203-2209.

SHAO Xueying, PEI Xiaodan, LI Yanjuan, DONG Yuhong, CHANG Liyang, JIN Jingfen. Application of foot massage based on the brain-gut axis theory in hemodialysis and insomnia patients with spleen-kidney yang deficiency type[J]. Chinese Journal of Nursing, 2025, 60(18): 2203-2209.

图/表 6

表1 两组一般资料的比较[例（百分比，%）]

Table 1 Comparison of general data between the 2 groups[cases（percentage，%）]

表2 两组干预前后中文版胃肠道症状分级评分量表评分的比较[分，M（P25，P75）]

Table 2 Comparison of GSRS scores before and after 2 intervention groups [scores，M（P25，P75）]

表3 两组干预前后匹兹堡睡眠质量指数评分的比较[分，M（P25，P75）]

Table 3 Comparison of PSQI scores before and after 2 intervention groups [scores，M（P25，P75）]

表4 两组干预前后5-羟色胺水平的比较[ng/L，M（P25，P75）]

Table 4 Comparison of serum 5-HT levels before and after 2 intervention groups[ng/L，M（P25，P75）]

表5 两组干预前后褪黑素水平的比较[ng/L，M（P25，P75）]

Table 5 Comparison of serum MT levels before and after 2 intervention groups[ng/L，M（P25，P75）]

表6 两组干预前后中医证候积分的比较[分，M（P25，P75）]

Table 6 Comparison of TCM syndrome scores before and after 2 intervention groups[scores，M（P25，P75）]

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