解郁健脾针刺联合艾司唑仑片治疗围绝经期失眠肝郁脾虚证临床观察  

Clinical effect of Jieyu Jianpi acupuncture combined with estazolam tablets on perimenopausal insomnia of liver spleen deficiency

作　　者：薛迎春[1] 陈立[1] 华彩凤[1] XUE Yingchun;CHEN Li;HUA Caifeng(Department of Gynecology,Jiangyin Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangyin,Jiangsu 214400)

机构地区：[1]南京中医药大学江阴附属医院妇科,江苏江阴214400

出　　处：《河北中医》2023年第10期1712-1716,1720,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：江苏省中医药科技发展计划项目(编号:YB201946)。

摘　　要：目的观察解郁健脾针刺联合艾司唑仑片治疗围绝经期失眠肝郁脾虚证临床疗效。方法将90例围绝经期失眠肝郁脾虚证患者按照随机数字表法分为2组,对照组45例予艾司唑仑片,治疗组45例在对照组治疗基础上加解郁健脾针刺治疗,2组均治疗4周。比较2组疗效;比较2组治疗前后性激素黄体生成激素(LH)、雌二醇(E_(2))、卵泡刺激素(FSH)水平变化;比较2组治疗前后匹兹堡睡眠质量指数(PSQI)评分、Kupperman评分、汉密尔顿焦虑量表(HAMA)评分变化;比较2组治疗前后血清睡眠相关单胺类神经递质γ-氨基丁酸(GABA)、5-羟色胺(5-HT)变化;记录2组不良反应发生率。结果治疗组45例,脱落3例;对照组45例,脱落4例。治疗组总有效率95.24%(40/42),对照组总有效率80.49%(33/41),治疗组疗效优于对照组(P<0.05)。2组治疗后LH、FSH水平均较本组治疗前降低(P<0.05),E_(2)水平较本组治疗前升高(P<0.05);治疗后治疗组LH、FSH水平均低于对照组(P<0.05),E_(2)水平高于对照组(P<0.05)。2组治疗2、4周PSQI评分均较本组治疗前降低(P<0.05);治疗组治疗2、4周PSQI评分均低于对照组同期(P<0.05)。2组治疗后Kupperman评分、HAMA评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后血清GABA、5-HT水平均较本组治疗前升高(P<0.05),且治疗组升高更明显(P<0.05)。治疗组不良反应发生率11.90%(5/42),对照组不良反应发生率24.39%(10/41),2组不良反应发生率比较差异无统计学意义(P>0.05)。结论解郁健脾针刺联合艾司唑仑片治疗围绝经期失眠肝郁脾虚证,能提高患者睡眠质量,改善临床症状,缓解焦虑,调节性激素、脑神经递质分泌,安全性高。Objective To observe the clinical effect of Jieyu Jianpi acupuncture combined with estazolam tablets in the treatment of perimenopausal insomnia(liver spleen deficiency).Methods Ninety patients with perimenopausal insomnia(liver spleen deficiency)were randomly allocated to control group(45 cases,4 cases of shedding)and treatment group(45 cases,3 cases of shedding).On the basis of oral estazolam tablets,the patients of the treatment group were additionally given Jieyu Jianpi acupuncture treatment for 4 weeks.The total effective rate,levels of sex hormones(luteinizing hormone[LH],estradiol[E_(2)],follicle stimulating hormone[FSH]),Pittsburgh sleep quality index(PSQI),kupperman index(KI),Hamilton Anxiety Scale(HAMA)score,sleep-related monoamine neurotransmitters(gamma-aminobutyric acid[GABA],5-hydroxytryptamine[5-HT]),and incidence of adverse reactions were included as comparisons between the two groups.Results After treatment,the total effective rate in the treatment group was significantly higher than that in the control group(95.24%[40/42]vs 80.49%[33/41],P<0.05).Significantly lower LH and FSH and significantly higher E_(2) were detected in the both groups(P<0.05),there were significant differences in LH,FSH and E_(2) between groups.The PSQI score on weeks 2 and 4 in the both groups were significantly decreased than those before treatment(P<0.05),which were more pronounced in the treatment group than in the control group(P<0.05).After treatment,the score of KI and HAMA in the both groups were significantly decreased than those before treatment(P<0.05),the improvement in the treatment group was more common(P<0.05).The serum contents of GABA and 5-HT in the both groups were significantly higher than those before treatment(P<0.05),and which in the treatment group were significantly higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the treatment group and the control group(11.90%[5/42]vs 24.39%[10/41],P>0.05).Conclusion Forpatients with pe

关 键 词：围绝经期 失眠症 中药疗法 针刺疗法 

分 类 号：R256.23[医药卫生—中医内科学] R245.31[医药卫生—中医学]