董氏奇穴埋线联合耳尖放血治疗心肾不交型围绝经期综合征伴失眠的疗效观察  

Efficacy observation of treating perimenopausal syndrome complicated with insomnia due to disharmony between the heart and kidney with catgut embedding at DONG’s extra points plus ear apex bloodletting

作　　者：孙桂芳 茅瑜 张雪锋 郭苏慧 葛艳 SUN Guifang;MAO Yu;ZHANG Xuefeng;GUO Suhui;GE Yan(Shanghai Minhang District Maqiao Community Health Service Center,Shanghai 201111,China)

机构地区：[1]上海市闵行区马桥社区卫生服务中心,上海201111

出　　处：《上海针灸杂志》2024年第10期1081-1090,共10页Shanghai Journal of Acupuncture and Moxibustion

基　　金：上海市闵行区卫健委课题(2021MW12);上海市闵行区科委课题(2021MHZ022);上海市闵行区中医专家社区师带徒项目(2022MW2S011)。

摘　　要：目的观察董氏奇穴埋线联合耳尖放血治疗心肾不交型围绝经期综合征伴失眠的临床疗效。方法选择207例心肾不交型围绝经期综合征伴失眠的患者,脱落20例,最终纳入患者187例,用区组化随机分组的方法分为对照组(57例)、针刺组(65例)和埋线组(65例)。对照组予口服坤泰胶囊治疗,针刺组予普通针刺董氏奇穴联合耳尖放血治疗,埋线组予董氏奇穴埋线联合耳尖放血治疗。比较3组临床疗效、复发情况和不良反应发生情况,观察3组治疗前后匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分、中医证候积分、围绝经期症状评分以及血清睡眠相关因子及激素[卵泡刺激素(follicle-stimulating hormone,FSH)、雌二醇(estradiol,E2)、促黄体生成素(luteinizing hormone,LH)、5-羟色胺(5-hydroxytryptamine,5-HT)、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)、胶质源性神经营养因子(glial cell linederived neurotrophic factor,GDNF)]水平的变化。结果埋线组总有效率高于其余两组(P<0.05),复发率低于其余两组(P<0.05);3组不良反应发生率比较,差异无统计学意义(P>0.05)。治疗后,3组PSQI评分均较治疗前降低(P<0.05);埋线组PSQI的睡眠质量、入睡时间、睡眠时间、睡眠障碍和日间功能障碍评分及总分均低于对照组(P<0.05);埋线组PSQI的睡眠时间和睡眠效率评分及总分低于针刺组(P<0.05)。治疗后,3组中医证候积分均较治疗前降低(P<0.05);埋线组中医证候积分低于针刺组和对照组,差异均具有统计学意义(P<0.05)。治疗后,3组围绝经期症状评分均较治疗前降低(P<0.05);埋线组和针刺组围绝经期症状评分均低于对照组(P<0.05)。治疗后,3组血清E2、5-HT、BDNF和GDNF水平较治疗前升高(P<0.05);埋线组血清5-HT、BDNF和GDNF水平高于对照组(P<0.05),血清5-HT水平高于针刺组(P<0.05)。结论董氏奇穴埋线联合耳尖放血治疗心肾不交型围绝经期综合�Objective To observe the clinical efficacy of treating perimenopausal syndrome complicated with insomnia due to disharmony between the heart and kidney with catgut embedding at DONG’s extra points plus ear apex bloodletting.Method A total of 207 patients with perimenopausal syndrome complicated with insomnia due to disharmony between the heart and kidney were selected.After 20 cases dropped out,187 patients were recruited and divided into a control group(57 cases),an acupuncture group(65 cases),and a catgut embedding group(65 cases)using the block randomization method.The control group was treated with oral administration of Kun Tai capsules,the acupuncture group was given ordinary acupuncture at DONG’s extra points plus ear apex bloodletting,and the catgut embedding group was offered catgut embedding at DONG’s extra points plus ear apex bloodletting.The clinical efficacy,recurrence,and adverse reactions were compared among the three groups.Before and after the treatment,the three groups were observed for changes in the Pittsburgh sleep quality index(PSQI)score,symptom score of traditional Chinese medicine(TCM),perimenopausal symptom score,and serum levels of sleep-related factors and hormones[follicle-stimulating hormone(FSH),estradiol(E2),luteinizing hormone(LH),5-hydroxytryptamine(5-HT),brain-derived neurotrophic factor(BDNF),and glial cell line-derived neurotrophic factor(GDNF)].Result The catgut embedding group had a higher total effective rate(P<0.05)and a lower recurrence rate(P<0.05)compared to the other two groups;the differences in the adverse reaction rate were statistically insignificant among the three groups(P>0.05).After the treatment,the PSQI score decreased in all three groups(P<0.05);the catgut embedding group was lower than the control group in comparing the PSQI scores of sleep quality,sleep latency,sleep duration,sleep disturbance,and daily dysfunction as well as the PSQI global score(P<0.05);compared to the acupuncture group,the catgut embedding group had lower PSQI scores of sleep dur

关 键 词：埋线 放血疗法 针刺疗法 穴 耳尖 围绝经期综合征 失眠 心肾不交 

分 类 号：R246.3[医药卫生—针灸推拿学]