机构地区:[1]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040 [2]黑龙江中医药大学,黑龙江哈尔滨150040
出 处:《中华中医药学刊》2025年第2期1-5,共5页Chinese Archives of Traditional Chinese Medicine
基 金:国家自然科学基金面上项目(81973894,82174421)。
摘 要:目的比较心肾不交证和肝郁气滞证两种不同证型围绝经期睡眠障碍女性改良Kupperman评分表(Kupperman's index,KMI)评分及外周血微观指标的差异。方法采用匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)筛选并收集80例围绝经期睡眠障碍患者作为研究对象,其中心肾不交证40例、肝郁气滞证40例。收集受试者中医证候采集表、KMI量表等信息,采用酶联免疫吸附试验法(Enzyme-linked immunosorbent assay,ELISA)测定各组患者血清炎症因子白细胞介素-1β(Interleukin-1β,IL-1β)和肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、神经递质γ-氨基丁酸(Gamma aminobutyric acid,GABA)和谷氨酸(Glutamic acid,Glu)水平。结果心肾不交组入睡时间、睡眠时间、睡眠效率、睡眠障碍评分以及PSQI总分均大于肝郁气滞组(P<0.05);肝郁气滞组日间功能障碍评分大于心肾不交组(P<0.05);心肾不交组潮热汗出、肌肉、关节痛、心悸、泌尿系症状这4项症状以及KMI总评分均大于肝郁气滞组(P<0.05);肝郁气滞组情绪激动、抑郁、疑心、眩晕、头痛、皮肤蚁行感这5项症状评分大于心肾不交组(P<0.05);肝郁气滞组血清IL-1β和TNF-α水平均高于心肾不交组(P<0.05);心肾不交组血清GABA水平低于肝郁气滞组,而Glu水平高于肝郁气滞组(P<0.05)。结论围绝经期睡眠障碍女性中,心肾不交证较肝郁气滞证总体睡眠状态更差,围绝经期症状程度也更严重,睡眠障碍和围绝经期症状的主要类型亦有所不同,两种证型之间IL-1β、TNF-α、GABA与Glu的表达差异存在统计学意义,可能有助于围绝经期女性睡眠障碍中医辨证分型的客观化和精准化。Objective To compare the disparities in the modified Kupperman's score(KMI)and peripheral blood micro indicators between non-interaction between heart and kidney syndrome and liver depression and Qi stagnation syndrome of perimenopausal women experiencing sleep difficulties.Methods Eighty patients with perimenopausal sleep disorders were selected as research participants using the Pittsburgh Sleep Quality Index(PSQI).Among them,40 patients had non-interaction between heart and kidney syndrome and 40 patients had liver depression and Qi stagnation syndrome.The data,including traditional Chinese medicine syndrome collection forms and KMI scales was gathered.Enzyme-linked immunosorbent assay(ELISA)was used to quantify serum inflammatory markers[interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α)]and neurotransmitter levels[gamma aminobutyric acid(GABA),glutamic acid(Glu)]in two groups.Results The study findings revealed that non-interaction between heart and kidney syndrome had higher values for time to fall asleep,sleep time,sleep efficiency,sleep disorder score and total PSQI score compared to the liver depression and Qi stagnation syndrome group(P<0.05).Additionally,the liver depression and Qi stagnation syndrome group had a higher daytime dysfunction score than the non-interaction between heart and kidney syndrome group(P<0.05).Furthermore,the non-interaction between heart and kidney syndrome group exhibited higher values for hot flashes,sweating,muscle and joint pain,palpitations,urinary system symptoms and total KMI score compared to the liver depression and Qi stagnation syndrome group(P<0.05).Conversely,the liver depression and Qi stagnation syndrome group had higher scores for emotional excitement,depression,suspicion,dizziness,headache and skin ant sensation compared to the non-interaction between heart and kidney syndrome group(P<0.05).Serum levels of IL-1βand TNF-αwere also higher in the liver depression and Qi stagnation syndrome group.The levels in the non-interaction between heart and kidney sy
关 键 词:围绝经期 睡眠障碍 中医辨证分型 炎症因子 神经递质
分 类 号:R271.116[医药卫生—中医妇科学]
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