柴胡桂枝龙骨牡蛎汤合甘麦大枣汤治疗围绝经期焦虑失眠临床观察
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摘要
目的观察柴胡桂枝龙骨牡蛎汤合甘麦大枣汤治疗围绝经期焦虑失眠患者的临床效果,评估对抑郁及睡眠的改善作用。方法选择136例围绝经期焦虑失眠女性患者,随机分为对照组和研究组各68例,对照组进行常规治疗,研究组应用柴胡桂枝龙骨牡蛎汤合甘麦大枣汤治疗。评估2组患者临床疗效、治疗前后应用绝经综合征症状评定量表(Kupperman)改良评分法评估患者症状或体征、评估2组中医证候积分、应用焦虑自评量表(SAS)和抑郁自评量表(SDS)评估焦虑、抑郁状况,应用匹兹堡睡眠质量指数(PSQI)评估患者睡眠质量,记录患者入睡时间、夜间睡眠时间和不良反应。结果研究组患者总有效率为89%,高于对照组76%,差异具有统计学意义(P<0.05)。研究组治疗后Kupperman评分、中医证候积分、SAS、SDS评分、PSQI评分和入睡时间均低于对照组(P<0.05)。研究组治疗后夜间睡眠时间为(6.38±0.29)h,长于对照组(5.50±0.33)h,差异具有统计学意义(P<0.05)。研究组患者总不良反应发生率为6%,对照组为26%,2组差异具有统计学意义(P<0.05)。结论应用柴胡桂枝龙骨牡蛎汤合甘麦大枣汤治疗围绝经期焦虑失眠患者,临床疗效显著,患者抑郁焦虑及睡眠质量改善明显,夜间入睡时间显著缩短,睡眠时间延长,具有较高的安全性。
Objective To evaluate the clinical efficacy of Chaihu Guizhi Longgu Muli Decoction combined with Ganmai Dazao Decoction in treatment of peri-menopausal anxiety and insomnia, and to determine patient benefits in terms of improvements in depression and sleep. Methods A total of 136 women with peri-menopausal anxiety and insomnia were randomly divided into the control group and the study group(n=68 each) to receive conventional treatmentor Chaihu Guizhi Longgu Muli Decoction combined with Ganmai Dazao Decoction, respectively. The two groups were evaluatedfor clinical efficacy of the treatment, modified Kupperman scores of menopausal symptoms or signs,TCM syndrome scores, self-rating anxiety scale(SAS) and self-rating depression scale(SDS) scores. Pittsburgh Sleep Quality Index(PSQI) was used to assess the patient′s sleep quality. The patients were recorded for time to falling asleep, nighttime sleep time, and adverse events. Results The total effective rate in the study group was 89%, which was higher than that in the control group(76%), with statistically significant difference(P<0.05). After treatment, the Kupperman score, TCM syndrome score, SAS score, SDS score, PSQI score and time to falling asleep in the study group and control group were statistically significant differences(P<0.05). The night time sleep time of the study group was(6.38±0.29) h, which was longer than that in the control group(5.50±0.33) h(P<0.05). The overall rate of adverse events was 6% in the study group vs 26% in the control group, with statistically significant difference(P<0.05). Conclusion Chaihu Guizhi Longgu Muli Decoction combined with Ganmai Dazao Decoction offers significant clinical ef-ficacy in the treatment of perimenopausal anxiety and insomnia, and may lead to improvements in depression, anxiety and sleep quality, significantly shortened time to falling asleep, longer nighttime sleep time, and meanwhile with better safety.
Objective To evaluate the clinical efficacy of Chaihu Guizhi Longgu Muli Decoction combined with Ganmai Dazao Decoction in treatment of peri-menopausal anxiety and insomnia, and to determine patient benefits in terms of improvements in depression and sleep. Methods A total of 136 women with peri-menopausal anxiety and insomnia were randomly divided into the control group and the study group(n=68 each) to receive conventional treatmentor Chaihu Guizhi Longgu Muli Decoction combined with Ganmai Dazao Decoction, respectively. The two groups were evaluatedfor clinical efficacy of the treatment, modified Kupperman scores of menopausal symptoms or signs,TCM syndrome scores, self-rating anxiety scale(SAS) and self-rating depression scale(SDS) scores. Pittsburgh Sleep Quality Index(PSQI) was used to assess the patient′s sleep quality. The patients were recorded for time to falling asleep, nighttime sleep time, and adverse events. Results The total effective rate in the study group was 89%, which was higher than that in the control group(76%), with statistically significant difference(P<0.05). After treatment, the Kupperman score, TCM syndrome score, SAS score, SDS score, PSQI score and time to falling asleep in the study group and control group were statistically significant differences(P<0.05). The night time sleep time of the study group was(6.38±0.29) h, which was longer than that in the control group(5.50±0.33) h(P<0.05). The overall rate of adverse events was 6% in the study group vs 26% in the control group, with statistically significant difference(P<0.05). Conclusion Chaihu Guizhi Longgu Muli Decoction combined with Ganmai Dazao Decoction offers significant clinical ef-ficacy in the treatment of perimenopausal anxiety and insomnia, and may lead to improvements in depression, anxiety and sleep quality, significantly shortened time to falling asleep, longer nighttime sleep time, and meanwhile with better safety.
引文
[1]Martini J,Knappe S,Garthus-Niegel S,et al.Mental disorders in women:natural course during premenstrual phases,peripartum period and perimenopause[J].Fortschr Neurol Psychiatr,2016,84(7):432-449.
[2]张娅,黄俊山,吴松鹰,等.364例围绝经期失眠症患者肾虚肝郁证临床特征[J].中医杂志,2015,56(20):1737-1741.
[3]王飞峰,段金莲,王冰,等.甘麦大枣汤加减治疗肾虚肝郁型围绝经期失眠的临床观察[J].中国中医药科技,2018,25(1):106-107.
[4]董峰.柴胡桂枝加龙骨牡蛎汤加味治疗顽固性失眠128例临床分析[J].中医临床研究,2016,8(34):115-117.
[5]郑艳辉.桂枝加龙骨牡蛎汤治疗围绝经期焦虑性失眠障碍患者的疗效观察[J].中国初级卫生保健,2016,30(11):59-60.
[6]王意敏.综合保健措施对改善围绝经期妇女健康状况的效果分析[J].护理实践与研究,2017,14(22):70-71.
[7]Sassoon SA,de Zambotti M,Colrain IM,et al.Association between personality traits and DSM-Ⅳdiagnosis of insomnia in peri-and postmenopausal women[J].Menopause,2014,21(6):602-611.
[8]黄晓玲,吴淑平.柴胡桂枝加龙骨牡蛎汤加味治疗顽固性失眠90例临床分析[J].中医临床研究,2015,7(5):6-8.
[9]崔军丽.妇女围绝经期心理问题、临床症状及保健措施分析[J].中国妇幼保健,2018,33(3):625-627.
[10]陈明.柴胡加龙骨牡蛎汤证解读及运用[J].中华中医药杂志,2015,30(10):3420-3422.
[2]张娅,黄俊山,吴松鹰,等.364例围绝经期失眠症患者肾虚肝郁证临床特征[J].中医杂志,2015,56(20):1737-1741.
[3]王飞峰,段金莲,王冰,等.甘麦大枣汤加减治疗肾虚肝郁型围绝经期失眠的临床观察[J].中国中医药科技,2018,25(1):106-107.
[4]董峰.柴胡桂枝加龙骨牡蛎汤加味治疗顽固性失眠128例临床分析[J].中医临床研究,2016,8(34):115-117.
[5]郑艳辉.桂枝加龙骨牡蛎汤治疗围绝经期焦虑性失眠障碍患者的疗效观察[J].中国初级卫生保健,2016,30(11):59-60.
[6]王意敏.综合保健措施对改善围绝经期妇女健康状况的效果分析[J].护理实践与研究,2017,14(22):70-71.
[7]Sassoon SA,de Zambotti M,Colrain IM,et al.Association between personality traits and DSM-Ⅳdiagnosis of insomnia in peri-and postmenopausal women[J].Menopause,2014,21(6):602-611.
[8]黄晓玲,吴淑平.柴胡桂枝加龙骨牡蛎汤加味治疗顽固性失眠90例临床分析[J].中医临床研究,2015,7(5):6-8.
[9]崔军丽.妇女围绝经期心理问题、临床症状及保健措施分析[J].中国妇幼保健,2018,33(3):625-627.
[10]陈明.柴胡加龙骨牡蛎汤证解读及运用[J].中华中医药杂志,2015,30(10):3420-3422.
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