疏肝健脾层级疗法治疗围绝经期失眠症临床研究
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摘要
目的观察疏肝健脾层级疗法(柴胡加龙骨牡蛎汤、归脾汤)对围绝经期失眠症患者睡眠和生活质量的影响。方法采用随机数字表法将围绝经期失眠症患者120例分为观察组和对照组各60例。观察组于治疗初期予柴胡加龙骨牡蛎汤加减,治疗后期予归脾汤加减,每日1剂,水煎服;对照组予艾司唑仑片,每次2片,睡前30 min口服。2组均连续治疗3个月。观察2组治疗前后简明健康调查量表(SF-36)、匹兹堡睡眠质量指数量表(PSQI)评分,雌二醇(E2)、促卵泡激素(FSH)水平及不良反应。结果观察组治疗后SF-36中精力、社会功能、情感职能、生理职能、精神健康、一般健康状态明显改善(P<0.05,P<0.01);对照组精力、社会功能、精神健康明显改善(P<0.05)。与本组治疗前比较,2组PSQI总分明显降低(P<0.05,P<0.01);2组治疗后比较,观察组PSQI总分明显低于对照组(P<0.05)。与本组治疗前比较,观察组E2水平明显改善(P<0.05)。2组治疗后比较,观察组E2水平明显高于对照组(P<0.05)。2组不良反应比较差异有统计学意义(P<0.05)。结论疏肝健脾层级疗法可有效改善围绝经期失眠症患者的生活质量和睡眠质量,改善雌激素水平,且不良反应较小。
Objective To investigate the effects of Shugan Jianpi Multi-level Therapy(Chaihu jia Longgu Muli Decoction and Guipi Decoction) on quality of sleep and life in patients with insomnia in perimenopau se. Methods Totally 120 outpatients with insomnia during perimenopausal period were divided into observation group and control group through random number table method, with 60 cases in each group. The patients in the observation group were treated with Chaihu jia Longgu Muli Decoction and modified Guipi Decoction, one dosage per day, decoction; Patients in the control group took estazolam tablets, twice a day, orally taken 30 min before sleep. The treatment for both groups lasted for three months. The results of short form 36 guestionnaire(SF-36), Pittsburgh sleep quality index(PSQI), estradiol(E2), follicle stimulating hormone(FSH), and adverse reactions in both groups were observed. Results The vitality, social function, role of emotion, physical function, mental health and general health status of SF-36 in the observation group were significantly improved after treatment(P<0.05, P<0.01); The vitality, social function and mental health of the control group were significantly improved(P<0.05). Compared with before treatment, the total scores of PSQI in the two groups were significantly lowered(P<0.05, P<0.01). The total score of PSQI in the observation group was significantly lower than those in the control group(P<0.05). Compared with before treatment, E2 level of the observation group was significantly improved(P<0.05). After treatment, E2 level in the observation group was significantly higher than that in the control group(P<0.05). There was statistical significance in the adverse reactions between the two groups(P<0.05). Conclusion Shugan Jianpi Multi-level Therapy can effectively improve quality of sleep and life in patients with insomnia in perimenopause and estrogen levels with less adverse reactions.
Objective To investigate the effects of Shugan Jianpi Multi-level Therapy(Chaihu jia Longgu Muli Decoction and Guipi Decoction) on quality of sleep and life in patients with insomnia in perimenopau se. Methods Totally 120 outpatients with insomnia during perimenopausal period were divided into observation group and control group through random number table method, with 60 cases in each group. The patients in the observation group were treated with Chaihu jia Longgu Muli Decoction and modified Guipi Decoction, one dosage per day, decoction; Patients in the control group took estazolam tablets, twice a day, orally taken 30 min before sleep. The treatment for both groups lasted for three months. The results of short form 36 guestionnaire(SF-36), Pittsburgh sleep quality index(PSQI), estradiol(E2), follicle stimulating hormone(FSH), and adverse reactions in both groups were observed. Results The vitality, social function, role of emotion, physical function, mental health and general health status of SF-36 in the observation group were significantly improved after treatment(P<0.05, P<0.01); The vitality, social function and mental health of the control group were significantly improved(P<0.05). Compared with before treatment, the total scores of PSQI in the two groups were significantly lowered(P<0.05, P<0.01). The total score of PSQI in the observation group was significantly lower than those in the control group(P<0.05). Compared with before treatment, E2 level of the observation group was significantly improved(P<0.05). After treatment, E2 level in the observation group was significantly higher than that in the control group(P<0.05). There was statistical significance in the adverse reactions between the two groups(P<0.05). Conclusion Shugan Jianpi Multi-level Therapy can effectively improve quality of sleep and life in patients with insomnia in perimenopause and estrogen levels with less adverse reactions.
引文
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[3]卢永屹,潘明.围绝经期失眠症的中医治疗现状[J].江西中医药,2017,48(4):71-73.
[4]谢丽君,李红,吕绍光,等.吕绍光从肝郁论治围绝经期失眠经验[J].中医药通报,2018,17(2):29-31.
[5]陈英群,杨毅勇,陈忆,等.疏肝健脾层级疗法对胃食管反流病急性期和远期的临床观察[J].中国中医急症,2015,24(12):2283-2285.
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[14]栗洪娟,唐赛雪,丁元庆.243例围绝经期失眠证候分析与病机探讨[J].成都中医药大学学报,2014,37(2):67-68,75.
[15]顾明芳,夏佳娜,俞延波.围绝经期妇女更年期症状与睡眠质量的关系[J].浙江医学,2017,39(11):915-917.
[16]杨芸.围绝经期失眠病人的心理状态及影响因素分析[J].中国健康教育,2015,31(8):804-806.
[17]郭丽华.围绝经期非器质性失眠妇女肝郁病理与IL-1β、TNF-α的关系[D].福州:福建中医药大学,2015.
[18]章程,张元兵.柴胡加龙骨牡蛎汤治疗失眠症研究概况[J].实用中西医结合临床,2013,13(6):92-94.
[19]颜乾麟.苍术有行气解郁之功[J].中医杂志,1997,38(1):6-7.
[20]郭祖文,赵奇焕,颜新,等.颜德馨运用黄连经验[J].辽宁中医杂志,2013,40(4):642-644.
[2]彭晓明,丁晓华.围绝经期失眠症的治疗新进展[J].西部中医药,2018,31(2):141-145.
[3]卢永屹,潘明.围绝经期失眠症的中医治疗现状[J].江西中医药,2017,48(4):71-73.
[4]谢丽君,李红,吕绍光,等.吕绍光从肝郁论治围绝经期失眠经验[J].中医药通报,2018,17(2):29-31.
[5]陈英群,杨毅勇,陈忆,等.疏肝健脾层级疗法对胃食管反流病急性期和远期的临床观察[J].中国中医急症,2015,24(12):2283-2285.
[6]曹泽毅.中华妇产科学[M].2版.北京:人民卫生出版社,2005:2537.
[7]中华医学会精神科分会.中国精神障碍分类与诊断标准[M].3版.济南:山东科学技术出版社,2001:118-119.
[8]中华人民共和国卫生部.中药新药临床研究指导原则:第三辑[M].北京:人民卫生出版社,1997:98.
[9]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:19-20.
[10]李俊,刘朝杰,李宁秀,等.生命质量评价量表SF-36中国量化标准研究[J].华西医科大学学报,2001,32(1):36-38.
[11]汪向东,王希林,马弘,等.心理卫生评定量表手册(增订版)[M].北京:中国心理卫生杂志,1999:375-378.
[12]陈燕芬,卢军,周宗民,等.围绝经期失眠症患者中医体质与中医证型相关性研究[J].中国中医药现代远程教育,2018,16(3):59-62.
[13]张娅,黄俊山,吴松鹰,等.围绝经期失眠症中医证候分布及其特点[J].中医杂志,2013,54(18):1574-1576.
[14]栗洪娟,唐赛雪,丁元庆.243例围绝经期失眠证候分析与病机探讨[J].成都中医药大学学报,2014,37(2):67-68,75.
[15]顾明芳,夏佳娜,俞延波.围绝经期妇女更年期症状与睡眠质量的关系[J].浙江医学,2017,39(11):915-917.
[16]杨芸.围绝经期失眠病人的心理状态及影响因素分析[J].中国健康教育,2015,31(8):804-806.
[17]郭丽华.围绝经期非器质性失眠妇女肝郁病理与IL-1β、TNF-α的关系[D].福州:福建中医药大学,2015.
[18]章程,张元兵.柴胡加龙骨牡蛎汤治疗失眠症研究概况[J].实用中西医结合临床,2013,13(6):92-94.
[19]颜乾麟.苍术有行气解郁之功[J].中医杂志,1997,38(1):6-7.
[20]郭祖文,赵奇焕,颜新,等.颜德馨运用黄连经验[J].辽宁中医杂志,2013,40(4):642-644.