1.北京中医药大学东直门医院通州院区 门诊咨询, 北京, 101121
2.北京中医药大学东直门医院通州院区 老年医学科, 北京, 101121
陈盼, E-mail: chen6221988@126.com
收稿:2026-07-26,
修回:2026-09-08,
录用:2026-09-10,
网络首发:2026-11-13,
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李晶如, 陈盼. 中医刮痧联合头面部疾病推拿护理1例心力衰竭合并失眠患者的体会[DB/OL].中西医结合临床案例库, 2026.
LI Jingru, CHEN Pan. Nursing Experience of Traditional Chinese Medicine Scraping Therapy Combined with Craniofacial Tuina for a Patient with Heart Failure Complicated by Insomnia[DB/OL].Clinical Archives of Integrative Medicine, 2026.
李晶如, 陈盼. 中医刮痧联合头面部疾病推拿护理1例心力衰竭合并失眠患者的体会[DB/OL].中西医结合临床案例库, 2026. DOI: 10.12209/CAIM202607260002.
LI Jingru, CHEN Pan. Nursing Experience of Traditional Chinese Medicine Scraping Therapy Combined with Craniofacial Tuina for a Patient with Heart Failure Complicated by Insomnia[DB/OL].Clinical Archives of Integrative Medicine, 2026. DOI: 10.12209/CAIM202607260002.
总结1例心力衰竭合并失眠患者应用中医刮痧联合头面部推拿的护理经验。患者心功能Ⅳ级,左心室射血分数(LVEF)18%,伴随胸闷喘憋、双下肢水肿及夜眠不安症状,临床予双联抗血小板聚集及强化利尿方案治疗。护理过程中,在系统评估患者心功能状态、容量负荷水平、睡眠质量及潜在安全风险的基础上,实施轻刺激耳部刮痧、头面部推拿中医特色干预,同步配合规范化容量管理、针对性睡眠护理及跌倒、出血风险预防措施。出院前患者胸闷喘憋症状明显减轻,双下肢水肿完全消退,N末端B型利钠肽前体(NT-proBNP)指标回落,匹兹堡睡眠质量指数(PSQI)由12分降至7分,住院期间未发生出血、皮肤损伤及跌倒不良事件。
This paper summarizes the nursing experience of traditional Chinese medicine scraping therapy combined with craniofacial tuina in one patient with heart failure complicated by insomnia. The patient was classified as New York Heart Association (NYHA) class IV cardiac function with a left ventricular ejection fraction (LVEF) of 18%, accompanied by chest tightness, dyspnea, bilateral lower limb edema and disturbed nocturnal sleep. Dual antiplatelet therapy and intensive diuretic regimen were administered clinically. During nursing care, on the basis of systematic assessment of the patient’s cardiac function, volume load, sleep quality and potential safety risks, characteristic traditional Chinese medicine interventions including low-intensity auricular scraping and craniofacial tuina were performed, along with standardized volume management, targeted sleep care, and preventive measures for fall and bleeding risks. Before discharge, the patient’s chest tightness and dyspnea were markedly alleviated, bilateral lower limb edema completely subsided, and the level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) decreased. The Pittsburgh Sleep Quality Index (PSQI) decreased from 12 points to 7 points. No adverse events such as bleeding, skin injury or fall occurred during hospitalization.
刘明波 , 王增武 , 樊静 , 等 . 《中国心血管健康与疾病报告2023》要点解读 [J]. 中国心血管病研究 , 2024 , 22 ( 7 ): 577 - 593 .
Liu M B , Wang Z W , Fan J , et al . Key points of report on cardiovascular health and diseases in China 2023 [J]. Chin J Cardiovasc Res , 2024 , 22 ( 7 ): 577 - 593 . (in Chinese)
中华医学会心血管病学分会 , 中国医师协会心血管内科医师分会 , 中国医师协会心力衰竭专业委员会 , 等 . 中国心力衰竭诊断和治疗指南2024 [J]. 中华心血管病杂志 , 2024 , 52 ( 3 ): 235 - 275 .
Cardiology Branch of the Chinese Medical Association , Cardiology Branch of the Chinese Medical Doctor Association , and Heart Failure Professional Committee of the Chinese Medical Doctor Association , et al . Chinese guidelines for the diagnosis and treatment of heart failure 2024 [J]. Chin J Cardiol , 2024 , 52 ( 3 ): 235 - 275 . (in Chinese)
中华医学会神经病学分会睡眠障碍学组 . 中国成人失眠诊断与治疗指南(2023版) [J]. 中华神经科杂志 , 2024 , 57 ( 6 ): 560 - 584 .
Sleep Disorders Group of the Neurology Branch of the Chinese Medical Association . Guidelines for the Diagnosis and Treatment of Insomnia in Chinese Adults (2023 Edition) [J]. Chinese Journal of Neurology , 2024 , 57 ( 6 ): 560 - 584 . (in Chinese)
张莉 , 覃光球 , 蒋青健 , 等 . 老年慢性心力衰竭患者睡眠障碍影响因素的质性研究 [J]. 临床医学进展 , 2024 ( 10 ): 972 - 978 .
Zhang L , Qin G Q , Jiang Q J , et al . A qualitative study of factors influencing sleep disorders in elderly patients with chronic heart failure [J]. Adv Clin Med , 2024 ( 10 ): 972 - 978 . (in Chinese)
罗鑫 , 苑成梅 . 失眠相关量表汉化及开发现状 [J]. 上海交通大学学报(医学版) , 2023 , 43 ( 11 ): 1436 - 1444 .
Luo X , Yuan C M . Current status of development of Chinese versions of insomnia-related scales [J]. J Shanghai Jiao Tong Univ Med Sci , 2023 , 43 ( 11 ): 1436 - 1444 . (in Chinese)
赵政 , 王效惠 , 徐晓梅 , 等 . 住院老年慢性病共病患者跌倒风险感知与客观风险评估一致性及影响因素研究 [J]. 中国医药导报 , 2024 , 21 ( 29 ): 125 - 129 .
Zhao Z , Wang X H , Xu X M , et al . Study on the consistency and influencing factors of fall risk perception and objective risk assessment in hospitalized elderly patients with chronic diseases comorbidity [J]. China Med Her , 2024 , 21 ( 29 ): 125 - 129 . (in Chinese)
Wu J R , Moser D K , Lin C Y , et al . Depressive symptoms and sleep quality mediate the relationship between race and quality of life among patients with heart failure: a serial multiple mediator model [J]. J Cardiovasc Nurs , 2024 , 39 ( 5 ): 449 - 455 .
胡亚丹 , 张德德 , 周芳 , 等 . 基于气机升降理论温灸刮痧治疗心肾不交型失眠临床研究 [J]. 河北中医 , 2023 , 45 ( 11 ): 1863 - 1866, 1871 .
Hu Y D , Zhang D D , Zhou F , et al . Clinical efficacy analysis of warm moxibustion and scraping therapy for insomnia of heart kidney disharmony type: Based on ascending-descending theory [J]. Hebei J Tradit Chin Med , 2023 , 45 ( 11 ): 1863 - 1866, 1871 . (in Chinese)
刘姝玥 , 李倩 , 付雯琴 , 等 . 针刺联合头面部推拿治疗不寐的临床研究 [J]. 医药前沿 , 2024 , 14 ( 33 ): 119 - 121, 124 .
Liu S Y , Li Q , Fu W Q , et al . Clinical study on acupuncture combined with head and face massage for insomnia [J]. J Front Med , 2024 , 14 ( 33 ): 119 - 121, 124 . (in Chinese)
中国医师协会心血管内科分会 , 中国老年医学学会心电及心功能分会 , 中国心衰中心联盟专家委员会 , 等 . 心力衰竭患者利尿剂抵抗诊断及管理中国专家共识 [J]. 临床心血管病杂志 , 2024 , 40 ( 4 ): 257 - 267 .
Chinese Medical Association Cardiovascular Internal Medicine Branch , Chinese Geriatrics Society Electrocardiology and Cardiac Function Branch , Expert Committee of China Heart Failure Center Alliance , et al . Chinese expert consensus for the diagnosis and management of diuretic resistance in patients with heart failure [J]. J Clin Cardiol , 2024 , 40 ( 4 ): 257 - 267 . (in Chinese)
罗桢蓝 , 胡三莲 , 朱凌燕 , 等 . 慢性心力衰竭患者自我容量管理的最佳证据总结 [J]. 中华护理杂志 , 2022 , 57 ( 7 ): 880 - 886 .
Luo Z L , Hu S L , Zhu L Y , et al . Evidence summary for self volume-management in patients with chronic heart failure [J]. Chin J Nurs , 2022 , 57 ( 7 ): 880 - 886 . (in Chinese)
梁义 , 李爱丽 , 王冰冰 . 个性化心理护理对老年心力衰竭患者睡眠质量与负性情绪的影响 [J]. 中国老年学杂志 , 2022 , 42 ( 9 ): 2273 - 2275 .
Liang Y , Li A L , Wang B B . Effect of personalized psychological nursing on sleep quality and negative emotions of elderly patients with heart failure [J]. Chin J Gerontol , 2022 , 42 ( 9 ): 2273 - 2275 . (in Chinese)
刘加婷 , 邓子银 , 赵丽蓉 , 等 . 护士在临床中应用《住院患者跌倒预防临床实践指南》的质性研究 [J]. 护士进修杂志 , 2023 , 38 ( 12 ): 1118 - 1122 .
Liu J T , Deng Z Y , Zhao L R , et al . Qualitative study of nurses applying the Clinical Practice Guidelines for Fall Prevention in Hospitalized Patients in clinical practice [J]. J Nurses Train , 2023 , 38 ( 12 ): 1118 - 1122 . (in Chinese)
McDonagh T A , Metra M , Adamo M , et al . 2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure [J]. Eur Heart J , 2023 , 44 ( 37 ): 3627 - 3639 .
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