续断安神方联合耳穴针刺治疗肝肾阴虚型围绝经期失眠症的疗效观察  

Clinical Efficacy of Xuduan Anshen Formula Combined with Auricular Acupuncture in the Treatment of Perimenopausal Insomnia of Liver and Kidney Yin Deficiency Type

作　　者：沈志刚 SHEN Zhigang(The Fourth People′s Hospital of Rugao City,Jiangsu Province/Baipu Town Health Center of Rugao City,Rugao 226512,China)

机构地区：[1]江苏省如皋市第四人民医院/如皋市白蒲镇卫生院,如皋226512

出　　处：《世界睡眠医学杂志》2024年第9期1957-1961,共5页World Journal of Sleep Medicine

摘　　要：目的:探讨续断安神方联合耳穴针刺治疗肝肾阴虚型围绝经期失眠症的临床疗效。方法:选取2021年2月至2023年2月江苏省如皋市第四人民医院肝肾阴虚型围绝经期失眠症患者76例作为研究对象,按照随机数字表法分为观察组和对照组,每组38例。观察组给予续断安神方联合耳穴针刺治疗,对照组单独给予耳穴针刺治疗,统计分析2组中医证候积分、症状程度、睡眠质量、睡眠状况、睡眠时间、性激素水平、细胞因子、临床疗效及不良反应发生情况。结果:治疗后,2组患者的睡眠不安、心悸不安、心烦易怒、腰膝酸软、耳鸣积分及总积分、Kupperman评分、失眠严重程度指数量表(ISI)评分和匹兹堡睡眠质量指数(PSQI)量表评分、多导睡眠监测(PSG)睡眠潜伏期(SL)、快眼动睡眠(REM)睡眠潜伏期(RL)、觉醒时间(AWT)、觉醒次数(AT)均低于治疗前(P<0.05),睡眠效率(SE)均高于治疗前(P<0.05),入睡时间均短于治疗前(P<0.05),睡眠时间均长于治疗前(P<0.05),催乳素(PRL)、卵泡刺激素(FSH)、黄体生成激素(LH)、睾酮(T)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均低于治疗前(P<0.05),雌二醇(E 2)、孕酮(P)水平均高于治疗前(P<0.05),观察组患者的睡眠不安、心悸不安、心烦易怒、腰膝酸软、耳鸣积分及总积分、Kupperman评分、ISI评分、PSQI评分、SL、RL、AWT、AT均低于对照组(P<0.05),SE高于对照组(P<0.05),入睡时间短于对照组(P<0.05),睡眠时间长于对照组(P<0.05),PRL、FSH、LH、T、IL-6、TNF-α水平均低于对照组(P<0.05),E 2、P水平均高于对照组(P<0.05)。观察组患者总有效率92.11%(35/38)高于对照组73.68%(28/38)(χ^(2)=4.547,P<0.05)。观察组患者不良反应发生率2.63%(1/38)低于对照组23.68%(9/38)(χ^(2)=7.370,P<0.05)。结论:续断安神方联合耳穴针刺治疗肝肾阴虚型围绝经期失眠症的临床疗效较单独耳穴针刺治疗效果显著。Objective:To explore the clinical efficacy of auricular acupuncture combined with Xuduan Anshen Formula in the treatment of perimenopausal insomnia with liver and kidney yin deficiency type.Methods:A total of 76 patients with liver and kidney yin deficiency type of perimenopausal insomnia in The Fourth People′s Hospital of Rugao City from February 2021 to February 2023 were selected for the study.They were randomly divided into an observation group treated with auricular acupuncture combined with Xuduan Anshen Formula and a control group treated with auricular acupuncture alone,with 38 patients in each group.The study analysed traditional Chinese medicine syndrome scores,symptom severity,sleep quality,sleep status,sleep time,sex hormones,cytokines,clinical efficacy,and incidence of adverse reactions between the two groups.Results:After treatment,the sleep disturbances,palpitations,irritability,lower back and knee soreness,tinnitus score and total score,Kuperman score,ISI score,PSQI score,sleep latency(SL),REM latency(RL),awakening time(AWT),and number of awakenings(AT)of both groups were lower than before treatment(P<0.05).Sleep efficiency(SE)was higher than before(P<0.05),sleep onset time was shorter(P<0.05),and total sleep duration was longer(P<0.05).Levels of prolactin(PRL),follicle-stimulating hormone(FSH),luteinizing hormone(LH),testosterone(T),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)were significantly lower,while estradiol(E 2)and progesterone(P)levels were significantly higher(P<0.05 for all).The observation group showed greater improvements across these measures compared to the control group(P<0.05).The total effective rate of the observation group was 92.11%(35/38),which was higher than the control group′s 73.68%(28/38)(χ^(2)=4.547,P<0.05).The incidence of adverse reactions in the observation group patients was 2.63%(1/38),which was lower than the control group′s 23.68%(9/38)(χ^(2)=7.370,P<0.05).Conclusion:The clinical efficacy of auricular acupuncture combined with Xuduan Anshen

关 键 词：入睡和睡眠障碍 围绝经期 肝肾阴虚型 针刺 耳 续断安神方 植物药疗法 睡眠质量 

分 类 号：R256.230.5[医药卫生—中医内科学] R241.6[医药卫生—中医学] R245.323