更眠安汤联合针刺对肾阴虚型更年期失眠症的疗效

Effect of Gengmian′an Decoction combined with acupuncture on climacteric insomnia of kidney Yin deficiency type

目的探讨更眠安汤联合针刺对肾阴虚型更年期失眠症患者的临床疗效及对血清神经肽Y(NPY)和5-羟色胺(5-HT)水平的影响。方法选取就诊的女性肾阴虚型更年期失眠症患者150例作为研究对象,按照随机数字表法分为观察组与对照组,每组75例。对照组给予佐匹克隆治疗,观察组给予更眠安汤联合针刺治疗,疗程为4周,比较2组患者治疗前后的睡眠质量、中医症状积分、NPY和5-HT、促卵泡成熟激素(FSH)、催乳素(PRL)和雌二醇(E 2)的变化,评价2组患者的疗效和不良反应。结果观察组总有效率为92.00%,对照组总有效率为77.33%,差异有统计学意义(P<0.05)。治疗前2组患者入睡时间和睡眠时间比较差异无统计学意义,治疗后2组患者入睡时间缩短,睡眠时间延长,观察组变化程度大于对照组(P<0.05)。治疗前2组患者FSH、PRL和E 2比较差异无统计学意义,治疗后2组患者FSH减小,E 2增加,观察组变化程度大于对照组(P<0.05),PRL无明显变化。治疗前2组心烦易怒、睡眠不安、腰膝酸软、心悸不安和耳鸣症状积分比较差异无统计学意义,治疗后2组患者上述症状积分均减小,观察组变化程度大于对照组(P<0.05)。治疗前2组患者NPY及5-HT比较差异无统计学意义,治疗后2组患者NPY及5-HT增加,观察组变化程度大于对照组(P<0.05)。观察组不良反应发生率为8.00%,对照组不良反应发生率为6.67%,差异无统计学意义。结论更眠安汤联合针刺能提高肾阴虚型更年期失眠症患者的治疗效果,改善患者的睡眠质量和肾阴虚症状,调节性激素和神经递质的分泌,且未增加患者的不良反应,适合临床应用。

Objective To investigate the effect of Gengman′an Decoction combined with acupuncture on the levels of serum neuropeptide Y(NPY)and 5-hydroxytryptamine(5-HT)in patients with climacteric insomnia of kidney Yin deficiency type.Methods 150 cases of female climacteric insomnia patients with kidney Yin deficiency were selected and randomly divided into observation group and control group,75 cases in each group.The control group were given zopiclone treatment,and the observation group were given Gengmian′an Decoction combined with acupuncture for 4 weeks.The sleep quality,traditional Chinese medicine(TCM)symptom score,NPY,5-HT,follicle stimulating hormone(FSH),prolactin(PRL)and estradiol(E 2)were compared between the 2 groups before and after treatment.The efficacy and adverse reoctions of the 2 groups were evaluated.Results The total effective rate of the observation group was 92.00%,and that of the control group was 77.33%,the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in sleeping time and sleeping latency between the 2 groups.After treatment,the sleeping time of the 2 groups decreased and the sleep latency increased.The change degree of the observation group was greater than that of the control group(P<0.05).Before treatment,there was no significant difference in FSH,PRL and E 2 between the 2 groups.After treatment,FSH decreased and E 2 increased in the 2 groups.The change degree of observation group was greater than that of control group(P<0.05),and PRL had no significant change.Before treatment,there was no significant difference in symptom scores of irritability,restlessness of sleep,soreness and weakness of waist and knee,palpitation and tinnitus.After treatment,the scores of appeal symptoms of the 2 groups decreased,and the change degree of the observation group was greater than that of the control group(P<0.05).There was no significant difference in NPY and 5-HT between the 2 groups before treatment.But after treatment,the NPY and 5-HT of the 2 groups increased,and the change degree of the observation group was greater than that of the control group(P<0.05).The incidence of adverse reactions was 8.00%in the observation group and 6.67%in the control group,with no significant difference.Conclusion Gengmian′an Decoction combined with acupuncture can improve the therapeutic effect of insomnia in climacteric patients with kidney Yin deficiency,improve sleep quality and symptoms of kidney Yin deficiency,regulate the secretion of sex hormones and neurotransmitters,and does not increase the adverse reactions of patients,which is suitable for clinical application.