滋水清心汤联合揿针治疗心肾不交型绝经期失眠  

Clinical effect of Zishui Qingxin Decoction combined with pressing acupuncture in the treatment of patients with perimenopausal insomnia of heart kidney disjunction type

作　　者：权兴苗[1] 时菁静[1] 宋春侠[1] 刘玉兰[1] 徐立伟[1] 王月 QUAN Xingmiao;SHI Jingjing;SONG Chunxia;LIU Yulan;XU Liwei;WANG Yue(Affiliated Hospital of Chengde Medical College,Chengde 067000,China)

机构地区：[1]承德医学院附属医院,河北承德067000

出　　处：《长春中医药大学学报》2023年第5期533-537,共5页Journal of Changchun University of Chinese Medicine

基　　金：河北省中医药管理局中医药类指令性计划课题(2022155)。

摘　　要：目的探讨滋水清心汤联合揿针治疗心肾不交型绝经期失眠患者的临床疗效。方法选取2019年1月-2022年6月承德医学院附属医院收治的120例心肾不交型绝经期失眠患者为研究对象,采用随机数字表法将患者分为A、B、C、D组,各30例。A组给予艾司唑仑药物治疗;B、C、D组分别在A组基础上给予揿针治疗、滋水清心汤治疗、滋水清心汤联合揿针治疗。比较各组中医证候积分、匹兹堡睡眠质量指数量表(PSQI)、多导睡眠图(PSG),以及血清卵泡刺激素(FSH)、促黄体生成激素(LH)、雌二醇(E2)水平。结果治疗后,A组中医证候积分中仅失眠单项积分下降(P<0.05),心烦心悸、五心烦热、耳鸣头晕3项积分无变化(P>0.05),B、C、D组上述积分均下降,且D组低于B、C组(P<0.05);治疗后,各组PSQI总分均下降,且D组低于A、B、C组(P<0.05);治疗后,各组睡眠潜伏期(SL)、快波睡眠潜伏期(RL)、觉醒次数(AT)、觉醒时间(AWT)、慢波睡眠-S1(NREM-S1)、NREM-S2均下降,睡眠效率(SE)、REM-S3+S4、快波睡眠(REM)均升高,且D组优于A、B、C组(P<0.05);治疗后,A组血清FSH、LH、E2水平无统计学意义(P>0.05),B、C、D组血清FSH、LH均下降,E2水平均升高,且D组优于B、C组(P<0.05)。结论心肾不交型绝经期失眠患者应用滋水清心汤联合揿针治疗,可有效改善临床症状及睡眠状况,调节性激素水平,且安全性良好。Objective To investigate the clinical effect of Zishui Qingxin Decoction combined with pressing acupuncture in the treatment of patients with perimenopausal insomnia of heart kidney disjunction type.Methods A total of 120 patients with perimenopausal insomnia due to heart-kidney disharmony who were admitted to the Affiliated Hospital of Chengde Medical College from January 2019 to June 2021 were selected as the research subjects.The patients were divided into group A,group B,group C,and group D according to random number table method with 30 cases in each group.Group A was treated with estazolam.On the basis of treatment in group A,the patients in group B,group C and group D were treated with thumb-tag needle,Zishui Qingxin Decoction,and Zishui Qingxin Decoction combined with thumb-tag needle,respectively.TCM syndrome scores,Pittsburgh Sleep Quality Index(PSQI)scores,polysomnography(PSG),and the levels of serum follicle-stimulating hormone(FSH)and luteinizing hormone(LH)and estradiol(E2)were compared among the groups.Results After treatment,only insomnia score of group A decreased(P<0.05).The scores for dysphoria and palpitation,dysphoria with feverish sensation in chest,tinnitus and dizziness did not changes(P>0.05).The above scores of group B,group C and group D decreased,and group D was lower than group B and group C(P<0.05).After treatment,the PSQI scores of 4 groups decreased,and group D was lower than group A,group B and group C(P<0.05).After treatment,sleep latency(SL),rapid wave sleep latency(RL),awakening times(AT),awakening time(AWT),slow wave sleep-S1(NREM-S1)and NREM-S2 decreased,while sleep efficiency(SE),NREMS3+S4 and rapid wave sleep(REM)increased among 4 groups,and Group D was superior to group A,group B and group C(P<0.05).There were no statistically signifi cant differences in serum FSH,LH and E2 levels in group A after treatment(P>0.05).After treatment,serum FSH and LH levels decreased,and E2 level increased in group B,group C and group D,and group D was superior to group B and group C(P<0.05).

关 键 词：绝经期 失眠 心肾不交型 滋水清心汤 揿针 

分 类 号：R256.23[医药卫生—中医内科学]