경락마사지가 중년여성의 혈청에스트로겐, 갱년기증상, 피로 및 우울에 미치는 효과

Abstract

본 연구는 경락마사지가 중년여성의 혈청 에스트로겐, 갱년기증상, 피로 및 우울에 미치는 영향을 확인하기 위하여 시도된 비동등성 대조군 전후설계의 유사실험연구이다. 대상자는 최종 월경이 1년 이상 경과한 만 45세부터 60세의 중년여성으로 실험군과 대조군 각각 16명으로 총 32명이었다. 경락마사지는 2006년 6월부터 4주간 1회 20분씩 주 3회 실시하였다. 대상자의 혈청 에스트로겐은 미국 Beckman Coulter사의 자동분석기를 사용하여 Access(Immunoassay system)법으로 분석하였고, 갱년기증상과 피로, 우울은 설문지를 이용하여 조사하였다. 자료수집은 실험처치 전, 처치 2주, 처치 4주에 이루어졌으며, 경락마사지의 지속성을 보기위해 실험군에게는 추후 4주에 한번 더 실시하였다. 수집된 자료는 SPSS Win 11.0 프로그램을 사용하여 분석하였다. 실험군과 대조군의 실험처치 전 동질성 검증은 Fisher's exact test, Mann Whitney U-test를 실시하였다. 실험군과 대조군에 있어서 시간에 따른 변화는 Wilcoxon Sign Rank test를 실시하였고, 실험처치 전․후 두 집단 간의 차이는 평균차를 이용한 Mann Whitney U-test로 분석하였다. 본 연구 결과는 다음과 같다. 1. 혈청 에스트로겐은 실험군에서 대조군에 비해 실험처치 2주(U=25.00, p=.000)와 실험처치 4주(U=73.50, p=.040)에 유의하게 증가하였다. 실험군의 혈청 에스트로겐은 처치 전에 비해 추후 4주에는 유의하게 증가하였으나(Z=-2.02, p=.043), 처치 4주에 비해 추후 4주에 유의하게 감소하여(Z=-2.26, p=.024) 경락마사지의 지속효과는 있으나 그 정도가 감소한 것으로 나타났다. 2. 갱년기증상은 실험군에서 대조군에 비해 실험처치 2주(U=46.50, p=.002)와 실험처치 4주(U=68.00, p=.023)에 유의하게 감소하였다. 실험군의 갱년기증상은 처치 전에 비해 추후 4주에는 유의하게 증가하였으며(Z=-2.11, p=.035), 처치 4주에 비해 추후 4주에는 유의한 변화가 없어서(Z=-1.13, p=.257) 경락마사지의 지속효과가 추후 4주까지 유지 되는 것으로 나타났다. 3. 피로는 실험군에서 대조군에 비해 실험처치 2주(U=64.50, p=.017)와 실험처치 4주(U=76.00, p=.050)에 유의하게 감소하였다. 실험군의 피로 정도는 처치 전과 추후 4주에 유의한 차이가 없어서(Z=-1.60, p=.109) 경락마사지의 지속효과가 없는 것으로 나타났다. 4. 우울은 실험군내에서는 실험처치 2주(Z=-2.39, p=.017)와 실험처치 4주( Z=-2.08, p=.038)에 유의한 감소가 있었으나, 실험군과 대조군 간의 평균차 비교에서는 실험처치 2주(U=84.00, p=.102)와 실험처치 4주(U=90.00, p=.151)에 모두 유의한 차이가 없었다. 실험군의 우울 정도는 처치 전과 추후 4주에 유의한 차이가 없어서(Z=-.74, p=.460) 경락마사지의 지속효과가 없는 것으로 나타났다. 이상을 통해 본 연구에서 실시한 경락마사지가 중년여성의 혈청 에스트로겐 분비 증가와 갱년기증상 및 피로의 개선에 효과가 있었으므로 중년여성을 위한 갱년기관리에 효과적인 간호중재로 활용 가능할 것으로 사료된다.;The purpose of this study was to identify what effects of meridian massage have on serum estrogen, climacteric symptom, fatigue and depression of middle-aged women. The study was a nonequivalent control group pre-post test quasi-experiment design. The subjects were 45-to-60-year-old middle-aged women who had their final menopause more than one year ago. The subjects consisted of 32 women; 16 in the experimental group and 16 in the control group. Meridian massage was performed three times a week, for 20 minutes at each session from Jun. 2006. The serum estrogen of the subjects was analyzed by the method of immunoassay system using an automatic analyzer of Beckman Coulter's. Regarding climacteric symptoms, fatigue and depression, the researches were carried out using questionnaires. Data was collected three times during the whole experiment; pre-treatment, second and fourth week after the treatment. In addition, data was collected 8 weeks after the treatment to find out the continuance. The collected data was analyzed by the SPSS Win 11.0 program. The Pre-treatment homogeneity between the experimental group and control group was analyzed by Fisher's exact test and Mann Whitney U-test. Changes with the passage of time were analyzed by Wilcoxon Sign Rank test. Pre- and post treatment comparison of the mean between two groups was analyzed by Mann Whitney U-test. The findings of this study were as follows: 1. In terms of serum estrogen, the experimental group showed a significant increase in the second week(U=25.00, p=.000) and the fourth week(U=73.50, p=.040) as compared with the control group. The increase of serum estrogen was also found in the experimental group in the fourth week (Z=-2.02, p=.043) in contrast to pre-treatment, but fell down remarkably four weeks later (Z=-2.26, p=.024) as compared with the fourth week after the treatment. This indicated that meridian massage seemed to have lasting effect but it showed a decline. 2. In terms of climacteric symptoms, the experimental group showed a significant decrease in the second week(U=46.50, p=.002) and the fourth week (U=68.00, p=.023) as compared with the control group. The climacteric symptoms of the experimental group increased significantly four weeks later (Z=-2.11, p=.035) as compared with pre-treatment. However, this increase was not found four weeks later (Z=-1.13, p=.257) as compared with the fourth week after the treatment. This showed that the effect of meridian massage continued for four weeks. 3. In terms of fatigue, the experimental group showed a significant decrease in the second week(U=64.50, p=.017) and the fourth week(U=76.00, p=.050) as compared with the control group. As for the fatigue level in the experimental group, there was no difference between pre-treatment and fourth-week treatment(Z=-1.60, p=.109). This indicated that meridian massage had no consistent effect. 4. In terms of depression, the experimental group showed a significant decrease in the second week(Z=-2.39, p=.017) and the fourth week(Z=-2.08, p=.038). In the comparison of the mean between two groups, the experimental group showed no significant difference in the second week(U=84.00, p=.102) and the fourth week(U=90.00, p=.151) as compared with the control group. As for the level of depression, there was no significant difference between pre-treatment and four -week treatment(Z=-.74, p=.460). This demonstrated that meridian massage had no continuous effect. In this study, the meridian massage was effective in increasing serum estrogen secretion, and improving climacteric symptoms and fatigue, which concludes the nursing intervention of the meridian massage plays an essential role in maintaining and improving the climacteric of middle-aged women.