更年宁汤加耳穴压豆治疗阴亏火旺型绝经期综合征

Treating Menopausal Syndrome due to Yin Deficiency and Hyperactivity of fire by Geng Nian Ning Decoction and Pressing Seeds on Otopoint

目的：观察自拟方更年宁汤加耳穴压豆治疗肾阴亏虚、心肝火旺型绝经期综合征的临床疗效。方法：将符合诊断标准的104例肾阴亏虚、心肝火旺型绝经期综合征患者随机分成两组,每组52例。治疗组运用自拟方更年宁汤配合耳穴压豆;对照组服用谷维素等治疗。两组均用药3周1疗程,治疗两疗程。结果：治疗组总有效率为94.23%（95% CI=83.51%～98.73%）;而对照组为82.69%（95% CI=72.41%～92.97%）;两组综合疗效比较（u=2.096 7,P=0.036 3）,差异有显著性意义;与对照组比较,在改善症状积分方面,治疗组的抑郁多疑、潮热汗出、耳鸣心悸、头晕健忘（P〈0.01）,皮肤干燥、腰软骨痛（P〈0.05）,优于对照组,阴部干涩、烦躁易怒、失眠多梦（P〉0.05）,差异未达到显著性意义,治疗组对症状评分参数改善优于对照组的次序为抑郁多疑﹥潮热汗出﹥耳鸣心悸﹥头晕健忘﹥皮肤干燥﹥腰软骨痛﹥阴部干涩﹥烦躁易怒﹥失眠多梦;两组治疗前后FSH、LH、E2检测参数比较,差异未达到显著性意义。结论：更年宁汤合耳穴贴压治疗肾阴亏虚、心肝火旺型绝经期综合征优于应用谷维素等西药治疗的证据符合第二类临床随机对照研究的证据条件,其收益为OR=0.29（95% CI=0.07～1.15,跨过1）,NNT=9（95% CI=4.20～143.80,其概率密度函数分布明显偏态）;并可明显改善证候积分参数。

Objective： To observe the clinical efficacy of self-prepared Geng Nian Ning decoction plus pressing seeds on otopoint on menopausal syndrome due to deficiency of kidney-Yin and hyperactivity of heart-and liverfire.Methods： 104 patients met the diagnostic criteria and with menopausal syndrome due to deficiency of kidneyYin and hyperactivity of heart-and liver-fire were randomly divided into two groups,each group was 52 cases.The treatment group was treated by self-prepared Geng Nian Ning decoction combined with pressing seeds on otopoint;while the control group by oryzanol etc.Both groups received medications for two courses,three weeks as a course of treatment.Results： The total effective rate of treatment group was 94.23%（95% CI=83.51%～98.73%）;while the control group was 82.69%（95% CI=72.41%～ 92.97%）; compared the comprehensive efficacy of two groups（u=2.096 7,P=0.036 3）,the differences had marked significance; compared with the control group,in the improvement of symptom score,the treatment group was better than control group in depression and oversensitive suspicious,hectic fever and sweating,tinnitus and palpitations,dizziness and forgetfulness（P〈0.01）,dry skin,waist weak and bone pain（P〈0.01）;in genital dryness, irritability and tetchiness,insomnia and dreaminess（P〉0.05）,the differences did not reach yet the marked significance; improved symptom score parameters in the treatment group were better than in the control group,the order of improved parameters was depression and oversensitive suspicious〉 hectic fever and sweating〉tinnitus and palpitations 〉dizziness and forgetfulness〉dry skin〉waist weak and bone pain〉genital dryness〉 irritability and tetchiness〉insomnia and dreaminess; compared FSH,LH,E2 detection parameters before and after treatment of two groups,the differences did not reach yet the statistical significance.Conclusions： Treating menopausal syndrome due to deficiency of kidney-Yin and hyperactivity of heart-and liver-fire by Geng Nian Ning decoction combined with pressing seeds on otopoint is better than by oryzanol and other western medicine,its evidence meets the evidence conditions of the second clinical randomized control study,its benefits is OR=0.29（95% CI=0.07～ 1.15,across 1）,NNT=9（95% CI=4.20～ 143.80,its probability distribution is significantly skewed）; and it can significantly improve the score parameters of symptoms.