内养功与口服中药结合西医常规疗法治疗围绝经期失眠症的临床研究  

Clinical effect of intrinsic-nourishing exercise and oral Chinese medicine combined with conventional western medicine therapy in the treatment of perimenopause with insomnia

作　　者：耿志月 布立影 周婷婷 焦妍 闫彤 Geng Zhiyue;Bu Liying;Zhou Tingting;Jiao Yan;Yan Tong(Department of Qigong,Hebei Medical Qigong Hospital,Qinhuangdao 066100,China;Department of Traditional Chinese Internal Medicine,Hebei Medical Qigong Hospital,Qinhuangdao 066100,China;Department of Rehabilitation,Hebei Medical Qigong Hospital,Qinhuangdao 066100,China;nd Department of Encephalopathy,North China University of Science and Technology,Tangshan 063210,China;nd Department of Endocrinology,Qinhuangdao Traditional Chinese Medicine Hospital,Qinhuangdao 066000,China)

机构地区：[1]河北省医疗气功医院气功科,秦皇岛066100 [2]河北省医疗气功医院中医内科,秦皇岛066100 [3]河北省医疗气功医院康复理疗科,秦皇岛066100 [4]华北理工大学脑二科,唐山063210 [5]秦皇岛市中医医院内分泌二科,秦皇岛066000

出　　处：《国际中医中药杂志》2023年第3期298-302,共5页International Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2022384)。

摘　　要：目的评价内养功与口服中药结合西医常规疗法治疗围绝经期失眠症的临床疗效。方法前瞻性队列研究。将符合入选标准的2019年6月-2021年6月河北省医疗气功医院60例围绝经期失眠症患者,采用随机数字表法分为2组,每组30例。对照组口服艾司唑仑片,观察组在对照组基础给予内养功与口服中药治疗。2组均4周为1个疗程,共治疗2个疗程。分别于治疗前后进行中医症状评分,采用全自动化学发光免疫分析仪检测雌二醇(E2)、FSH、LH水平,采用匹兹堡睡眠质量指数(PSQI)评估睡眠质量,健康调查简表(SF-36)评估生活质量,记录治疗期间的不良反应,评价临床疗效。结果观察组总有效率为90.0%(27/30)、对照组为66.7%(20/30),2组比较差异有统计学意义(χ^(2)=4.81,P<0.05)。治疗后,观察组睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药应用、日间功能评分低于对照组(t值分别为14.11、12.49、9.88、13.54、9.47、14.11、17.91,P<0.01);失眠多梦、腰膝酸软、五心烦热、疲乏健忘评分低于对照组(t值分别为9.51、13.08、16.17、12.81,P<0.01);E2[(35.16±3.61)mmol/L比(31.06±3.12)mmol/L,t=4.71]水平高于对照组(P<0.01),FSH[(69.61±6.04)U/L比(73.26±7.41)U/L,t=2.09]、LH[(32.21±3.35)U/L比(36.04±3.49)U/L,t=4.34]水平低于对照组(P<0.05或P<0.01)。观察组治疗后4、8周SF-36评分高于对照组(t值分别为6.30、4.36,P<0.01)。治疗期间,观察组不良反应发生率为16.7%(5/30)、对照组为10.0%(3/30),2组比较差异无统计学意义(χ^(2)=0.56,P=0.448)。结论内养功与口服中药结合西医常规疗法治疗可有效提高围绝经期失眠症患者的临床疗效及生活质量,改善其睡眠质量及中医症状,调节机体激素水平。Objective To explore the clinical effect and safety of intrinsic-nourishing exercise and oral Chinese medicine combined with conventional western medicine therapy in the treatment of perimenopause with insomnia.Methods Prospective cohort study.A total of 60 perimenopause with insomnia visiting the Hebei Medical Qigong Hospital were enrolled as the research objects between June 2019 and June 2021.According to random number table method,they were divided into the control group and the observation group,30 in each group.The control group was treated with oral estazolam tablets,while the observation group was treated with intrinsic-nourishing exercise combined with oral Chinese medicine on basis of the control group.All the patients were treated for 4 weeks as a course,and totally 2 courses.The levels of serum estradiol(E2),FSH,and LH were detected by automatic chemiluminescence immunoassay analyzer.Pittsburgh sleep quality Index(PSQI)was used to evaluate sleep quality,and the quality of life was evaluated by the MOS 36-item Short Form Health Survey(SF-36).And the responsive rates,sleep quality,scores of TCM symptoms,and adverse reactions were compared before and after treatment.Results The total response rate of observation group was significantly higher than that of the control group(90.0%vs.66.7%;χ^(2)=4.81,P<0.05).After treatment,PSQI scores of sleep quality,time to fall asleep,sleep duration,sleep efficiency,sleep disturbance,use of hypnotics,and daytime function in the observation group were significantly lower than those in the control group(t=14.11,12.49,9.88,13.54,9.47,14.11,17.91,P<0.01).After treatment,the TCM symptom scores of insomnia with more dreams,waist and knee soreness,five upsets,fatigue and forgetfulness in the observation group were significantly lower than those in the control group(t=9.51,13.08,16.17,12.81,P<0.01).After treatment,the E2[(35.16±3.61)mmol/L vs.(31.06±3.12)mmol/L,t=4.71]in the observation group was significantly higher than that of the control group(P<0.01),while the FSH[(69.6

关 键 词：围绝经期 失眠症 内养功 滋阴清热 中西医结合疗法 

分 类 号：R740[医药卫生—神经病学与精神病学] R711.75[医药卫生—临床医学]