经颅微电流刺激疗法结合心理疏导治疗围绝经期妇女睡眠障碍的随机对照研究

Treatment of Sleep Disorder with Cranial Electrotherapy Stimulation Combined with Psychological Counseling in Postmenopausal Women: A Randomized Study

目的：比较经颅微电流刺激疗法结合心理疏导方法在围绝经期妇女失眠治疗中,对于患者围绝经期症状、失眠症状、焦虑、抑郁症状的影响,探讨非药物治疗对于围绝经期患者失眠症状的疗效及意义。方法：随机对照研究,为期8周;评价工具包括改良的Kupperman评分、PSQI、SAS、SDS;139例围绝经期失眠患者随机入组CES＋心理疏导组或心理疏导组,最终有122人完成试验者分析。结果：治疗后4周,CES＋心理疏导组改良的Kupperman评分减分值便〉7分,治疗8周后,减分值达到了12.4分,而心理疏导组在治疗4周后减分值为4分,治疗8周后,减分值为5.6分（P=0.00）;治疗后4周,CES＋心理疏导组PQSI减分值便〉7分,提示失眠症状改善,并随着治疗时间的延长,失眠症状改善更为明显（治疗8周,减分值〉9分）;而心理疏导组在治疗后4周减分值仅为3.7分,治疗8周后,减分值为6分,明显低于CES＋心理疏导组（P=0.00）;治疗后8周,两组患者的抑郁和焦虑症状均有显著减轻,减分率达50%以上。CES＋心理疏导治疗组抑郁焦虑症状改善率平均较心理疏导组高7%~10%（P=0.00）。结论：CES疗法与心理疏导结合,既可以避免药物不良反应,又达到了快速起效和疗效稳定的效果,值得临床推广和使用。

Objective： To compare the effects of sleep disorder with cranial electrotherapy stimulation combined with psychological counseling in postmenopausal women.Methods：139 outpatients with diagnosis of sleep disorder in postmenopausal women were randomly allocated into 2 groups： CES＋ psychological counseling（Group A）,psychological counseling（Group B） for the period of 8 weeks. Kupperman Index（KI）,Pittsburg sleep quality index（PSQI）,Self-Rating Anxiety Scale（SAS）,Self-Rating Depression Scale（SDS） were used to evaluate the outcomes.Results：4 weeks after the beginning of the treatment the reduction of KI of Group A was more than 7,after 8 weeks, the reduction is 12.4,but Group B was 4 at 4 weeks,5.6 at 8 weeks（P=0.00）;After 4 weeks, the reduction of PSQI of Group A was more than 7,after 8 weeks, the reduction was more than 9,but Group B was 3.7 at 4 weeks,6 at 8 weeks（P=0.00）;8 weeks after the treatment, the reduction rate of SAS and SDS was more than 50%,significantly higher than Group B（P=0.00）.Conclusion：Cranial electrotherapy stimulation combined with psychological counseling were avoid of the adverse reaction of drugs,and were worthy of clinical promotion.