Context • Obstructive sleep apnea/hypopnea syndrome (OSAHS) is among the most prevalent of sleep-related breathing disorders. No long-term follow-up studies have documented the continued success of lifestyle changes in treatment; oral appliances have an approximate 50% success rate; compliance with continuous positive airway pressure is poor, ranging from 50% to 89%; and the success rate of upper-airway surgery is only 66.4%. Therefore, some OSAHS patients seek alternative treatments. Objectives • The study intended to examine the efficacy of traditional Chinese therapeutic massage (tui na) for patients with OSAHS. Design • The research team designed a prospective study. Setting • The study took place at the outpatient clinic of the sleep center at the Kaohsiung Chang Gung Memorial Hospital (Kaohsiung, Taiwan), an academic tertiary medical center. Participants • Participants were 31 patients with moderate to severe OSAHS. Intervention • Each participant received a tui na treatment at multiple acupoints 2 ×/wk for 10 wk for approximately 15 min/session. Outcome Measures • At baseline and 3 mo after treatment, participants completed subjective measures, including (1) quality of life using a 36-item, short-form health survey (SF-36); (2) subjective snoring intensity indicated by bed-partners using a 0-10 visual analog scale (VAS); and (3) excessive daytime sleepiness (EDS) status, using a Chinese version of the Epworth Sleepiness Scale (CESS). The research team completed objective measures, including (1) polysomnography, (2) body mass index, and (3) neck circumference. Results • Twenty patients completed the full course of treatment. The apnea/hypopnea index per hour decreased from 43.8 ± 26.9 to 37.8 ± 31.7 after the treatments, with P = .049 (paired t test). The arousal index and rapid eye movement stage of sleep improved significantly. Statistically significant improvements were observed for the SF-36 on the score for the physical component summary, for its subscale for general health, for the mental component summary, and for 2 of its subscales: vitality and mental health. The VAS and the CESS showed that snoring intensity and EDS decreased significantly, respectively. No major complications occurred. Conclusions • Tui na is a feasible and safe treatment for patients with OSAHS. It can improve the quality of life, sleep architecture, snoring intensity, and EDS in patients with moderate-to-severe OSAHS. In the future, a controlled study should be considered to further investigate the effects of tui na for OSAHS.

译文

:背景•阻塞性睡眠呼吸暂停/呼吸不足综合征(OSAHS)是与睡眠有关的呼吸系统疾病中最普遍的一种。没有长期的随访研究证明治疗改变生活方式的持续成功。口腔用具的成功率约为50%;持续的气道正压顺应性差,范围从50%到89%;上呼吸道手术的成功率仅为66.4%。因此,一些OSAHS患者寻求替代治疗。目的•这项研究旨在检查传统中式按摩(推拿)对OSAHS患者的疗效。设计•研究团队设计了一项前瞻性研究。设置•研究在大学高等医学中心高雄长庚纪念医院(台湾高雄)睡眠中心的门诊进行。参与者•参与者为31例中度至重度OSAHS患者。干预•每位参与者在2次/周的多个穴位上接受推拿治疗,持续10周,每次疗程约15分钟。成果指标•在基线和治疗后3个月,参与者完成了主观指标,包括(1)使用36项简短健康调查(SF-36)的生活质量; (2)卧床伴侣使用0-10视觉模拟量表(VAS)表示的主观打强度; (3)使用中文版的Epworth嗜睡量表(CESS)过度白天嗜睡(EDS)。研究小组完成了客观测量,包括(1)多导睡眠监测,(2)体重指数和(3)颈围。结果•20名患者完成了整个疗程。治疗后每小时呼吸暂停/呼吸不足指数从43.8±26.9降至37.8±31.7,P = .049(配对t检验)。睡眠的觉醒指数和快速眼动阶段显着改善。在SF-36的身体成分摘要,总体健康次级量表,心理成分摘要以及其中的两个量表:活力和精神健康方面,在统计上均观察到了显着改善。 VAS和CESS显示打强度和EDS分别显着降低。无重大并发症发生。结论•推拿对于OSAHS患者是一种可行且安全的治疗方法。它可以改善中度至重度OSAHS患者的生活质量,睡眠结构,打呼intensity强度和EDS。将来,应考虑进行一项对照研究,以进一步研究推拿对OSAHS的影响。

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