耳部铜砭刮痧联合气交灸在肺脾气虚型肺癌患者睡眠障碍中的应用研究 [中文引用][英文引用]

目的  探讨耳部铜砭刮痧联合气交灸治疗肺脾气虚型肺癌患者睡眠障碍的效果，为临床护理实践提供参考。方法  采用随机对照单盲设计，选取 2024 年 1 月— 2025 年 6 月在广州市某三级甲等综合医院肿瘤科住院的 126 例肺脾气虚型伴睡眠障碍的肺癌患者为研究对象，采用随机数字表法分为耳部铜砭刮痧组、气交灸组和联合组，各 42 例。3 组均给予常规护理，在此基础上耳部铜砭刮痧组给予耳部铜砭刮痧疗法，气交灸组给予气交灸疗法，联合组同时给予耳部铜砭刮痧联合气交灸的综合干预，每周干预 3 次，干预周期为 4w。比较 3 组干预后总体临床疗效及干预前、干预 2w、干预 4w 后匹兹堡睡眠质量指数量表（Pittsburgh sleep quality index，PSQI）、广泛性焦虑障碍量表（generalized anxiety disorder 7-item scale，GAD-7）、中医证候量表评分。结果  122 例患者完成研究。重复测量方差分析显示，3 组 PSQI、中医证候量表评分的时间主效应、组间主效应及交互效应均具有统计学意义（均 P<0.05），3 组 GAD-7 评分的时间主效应、组间主效应及交互效应差异均无统计学意义（均P>0.05）；干预 2w 及 4w 后，联合组 PSQI、中医证候量表评分优于单一疗法（均 P<0.05）；干预 4w 后联合组睡眠改善总有效率95.1% 与耳部铜砭刮痧组 90.2% 疗效相当，但较气交灸组 75.0% 优。研究过程均未发生不良事件。结论  耳部铜砭刮痧联合气交灸可有效改善肺脾气虚型肺癌患者睡眠质量及中医症状，干预方案具有良好的科学性与可行性，但在缓解焦虑情绪上的应用效果有待进一步验证。

Objective Exploring the effect of auricular copper Guasha combined with Qijiao moxibustion on treatment of sleep disorders in patients with lung-spleen and Qi deficiency type lung cancer，in order to provide a reference for clinical nursing practice. Methods Using a randomised single-blind controlled design，126 lung cancer patients who had sleep disorders and lung-spleen Qi deficiency were enrolled in this study in the Department of Oncology of a Tier-IIIA hospital in Guangzhou between January 2024 and June 2025. The patients were divided into an auricular copper Guasha group，a Qijiao moxibustion group，and a combined group using a randomised numerical table with 42 patients per group. Patients in all groups received routine nursing care. On top of the routine care， the patients in the auricular copper Guasha group received an auricular copper acupuncture and Gua-Sha therapy，those in the Qijiao moxibustion group received Qijiao moxibustion therapy，and those in the combined group received the combined intervention of auricular copper Guasha and acupuncture combined with Qijiao moxibustion. Both interventions were given three times a week for a course of four-weeks. Overall clinical efficacy among the 3 intervention groups was compared，as well as the differences in the Pittsburgh sleep quality index（PSQI），generalised anxiety disorder 7-item scale（GAD-7），and the scores of traditional Chinese medicine symptom scale （TCM）at 3 time points：before intervention，2 weeks after intervention，and 4 weeks after intervention. Results A total of 122 patients completed the intervention. Repeated measure analysis revealed statistically significant at time main effects，between-group main effects， and interaction effects for PSQI and TCM across all 3 groups（all P<0.05）. Conversely，no statistically significant differences were observed from time main effects，between-group main effects or interaction effects in GAD-7 scores across the 3 groups（all P>0.05）. After 2 and 4 weeks of intervention，the combined group showed significantly better scores on the PSQI and TCM compared to the single therapy groups（all P<0.05）. After 4 weeks of intervention，the total effective rate of sleep improvement in the combined group was 95.1%，it was comparable to the efficacy of 90.2% in the auricular copper Guasha group，but better than 75.0% in the Qijiao moxibustion group. No adverse event occurred during the study. Conclusion Auricular copper Guasha combined with Qijiao moxibustion can effectively improve the sleep quality among the lung cancer patients with the symptoms of lung-spleen and Qi deficiency in Chinese medicine. The intervention plan is scientific and feasible，but the application effect in relieving anxiety needs to be further verified.