揿针联合黄连阿胶汤治疗肾虚肝郁型围绝经期失眠症临床观察  

Clinical Observation of Press-Needle Combined with Huanglian Ejiao Tang for Perimenopause Insomnia of Kidney Deficiency and Liver Depression Type

作　　者：陈晞 

机构地区：[1]上海市长宁区天山中医院针灸科,上海200051

出　　处：《新中医》2018年第1期115-118,共4页New Chinese Medicine

基　　金：国家中医药管理局"十二五"重点专科建设项目;上海市长宁区中医针灸特色专科建设项目(20152003);上海市"杏林新星"培养计划项目(ZYSNXD011-RC-XLXX-20130041)

摘　　要：目的:观察揿针联合黄连阿胶汤治疗肾虚肝郁型围绝经期失眠症的临床疗效。方法:将120例肾虚肝郁型围绝经期失眠症患者随机分为针药组、中药组和西药组,每组40例。针药组采用揿针联合黄连阿胶汤治疗,中药组采用黄连阿胶汤治疗,西药组予艾司唑仑片治疗。评估3组治疗效果,观察患者治疗前后失眠严重指数量表(ISI)评分的变化,记录中医症状的发生率。结果:针药组总有效率90.0%,中药组总有效率67.5%,西药组总有效率82.5%。针药组的总有效率高于中药组(P<0.05);针药组的总有效率与西药组比较,差异无统计学意义(P>0.05)。治疗后,3组入睡困难、睡眠维持困难、早醒指数评分及ISI总分均较治疗前降低(P<0.01);针药组ISI总分治疗前后差值均高于中药组和西药组(P<0.01),西药组ISI总分治疗前后差值与中药组比较,差异无统计学意义(P>0.05);针药组入睡困难和睡眠维持困难评分治疗前后差值均高于西药组和中药组(P<0.01),西药组2项评分治疗前后差值均高于中药组(P<0.05);针药组早醒指数评分治疗前后差值高于中药组(P<0.05),西药组早醒指数评分治疗前后差值与针刺组和中药组分别比较,差异均无统计学意义(P>0.05)。治疗后,针药组及中药组情绪抑郁、善太息、潮热汗出、急躁易怒、五心烦热发生率均较治疗前降低(P<0.05),且均低于西药组(P<0.05);针药组情绪抑郁、急躁易怒发生率低于中药组(P<0.05)。结论:揿针联合黄连阿胶汤治疗肾虚肝郁型围绝经期失眠症疗效显著,能有效改善患者的睡眠质量。Objective： To observe the clinical effect of press-needle combined with Huanglian Ejiao tang for perimenopause insomnia of kidney deficiency and liver depression type.Methods：Divided 120 patients with perimenopause insomnia of kidney deficiency and liver depression type into press-needle combined with medicine group,Chinese medicine group and western medicine group randomly,40 cases in each group.The press-needle combined with medicine group was given press-needle combined with Huanglian Ejiao tang,Chinese medicine group was given Huanglian Ejiao tang,The western medicine group was given estazolam tablets.Evaluated the curative effect in three groups,observed changes of insomnia severity index（ISI） scores of patients before and after treatment and recorded the incidence of Chinese medicine symptoms.Results： The total effective rate was 90.0% in acupuncture combined with medicine group,67.5% in Chinese medicine group and 82.5% in western medicine group.The total effective rate in acupuncture combined with medicine group was higher than that in Chinese medicine group（P〈0.05）,the total effective rate in acupuncture combined with medicine group was similar to that in western medicine group（P〈0.05）.After treatment,scores of difficulty getting asleep,sleep maintenance difficult and early awakening,as well as ISI total scores in the three groups were lower than those before treatment（P〈0.01）.ISI total scores in acupuncture combined with medicine group were higher than those in Chinese medicine group and western medicine group after treatment（P〈0.01）.There was no significant difference being found in the difference value of ISI total scores in western medicine group and Chinese medicine group before and after treatment（P〈0.05）.The difference value of scores of difficulty getting asleep,and sleep maintenance difficult in acupuncture combined with medicine group before and after treatment was higher than those in western medicine group and Chinese medicine group（P〈0.01）.The dif

关 键 词：失眠 围绝经期 肾虚肝郁型 揿针 黄连阿胶汤 失眠严重指数量表(ISI) 

分 类 号：R256.23[医药卫生—中医内科学] R271.116[医药卫生—中医学]