连地交泰方加减治疗围绝经期失眠伴心身障碍疗效观察

Observation on curative effect of modified Lian Di Jiao Tai Decoction on perimenopausal insomnia with psychosomatic disorder

目的观察连地交泰方加减治疗对阴虚火旺型围绝经期失眠伴心身障碍患者睡眠质量和焦虑抑郁情绪、围绝经期症状的影响。方法选取2018年10月—2020年12月在北京市和平里医院第一门诊和月经专病门诊就诊的60例阴虚火旺型围绝经期失眠伴心身障碍患者,随机分为对照组和治疗组,每组各30例。2组均给予一般心理疏导。对照组患者同时给予劳拉西泮1 mg每晚睡前30 min服用,治疗组患者同时给予连地交泰方加减治疗,每日1剂,4周为1个疗程。第5周开始逐渐减量,第6周停药。记录2组治疗前、治疗4周、治疗8周后匹兹堡睡眠质量指数(PSQI)、自评抑郁量表(SDS)评分、汉密尔顿焦虑量表(HAMA)评分、改良Kupperman Index(KI)评分,评价2组治疗4周、8周后临床疗效及治疗过程中不良反应发生情况。结果治疗4周后,2组PSQI、HAMA及改良KI评分均较治疗前明显降低(P均<0.05),且治疗组PSQI、改良KI评分均明显低于对照组(P均<0.05);治疗8周后,治疗组PSQI、HAMA及改良KI评分均明显低于治疗前及对照组(P均<0.05)。治疗4周、8周后,治疗组失眠总有效率为90.0%(27/30)和86.7%(26/30),明显高于对照组的76.7%(23/30)和16.7%(5/30),差异有统计学意义(P均<0.05)。对照组不良反应发生率为36.7%(11/30),治疗组为6.7%(2/30),治疗组明显低于对照组(P<0.05)。结论连地交泰方加减可以有效提高阴虚火旺型围绝经期失眠伴心身障碍患者睡眠质量,减轻围绝经期症状,降低焦虑程度,改善心身健康状态。

Objective It is to observe the effects of modified Lian Di Jiao Tai Decoction on sleep quality,anxiety and depression,and perimenopausal symptoms in patients with perimenopausal insomnia of kidney-yin deficiency with effulgent fire type with psychosomatic disorders.Methods A total of 60 patients with perimenopausal insomnia of kidney-yin deficiency with effulgent fire type with psychosomatic disorders were selected in the First Outpatient Clinic and Menstrual Special Outpatient Clinic of Beijing Hepingli Hospital from October 2018 to December 2020.They were randomly divided into a control group and a treatment group,30 cases in each group.Both groups were given general psychological counseling.The patients in the control group were given lorazepam 1 mg at 30 min before going to bed every night,and the patients in the treatment group were treated with Lian Di Jiao Tai Decoction based on the control group,1 dose per day,4 weeks as a course of treatment.The dose was gradually reduced in the 5th week,and was stopped in the 6th week.The scores of Pittsburgh Sleep Quality Index(PSQI),Self-rating Depression Scale(SDS),Hamilton Anxiety Scale(HAMA),modified Kupperman Index(KI)before treatment and after treatment for 4 weeks and 8 weeks,the clinical efficacy and adverse reactions occurred in the two groups after 4 weeks and 8 weeks of treatment were assessed.Results After 4 weeks of treatment,the PSQI,HAMA and modified KI scores of the two groups were significantly lower than those before treatment(all P<0.05),and the PSQI and modified KI scores of the treatment group were significantly lower than those of the control group(all P<0.05);after 8 weeks,the PSQI,HAMA and modified KI scores of the treatment group were significantly lower than those before treatment and of the control group(all P<0.05).After 4 and 8 weeks of treatment,the total effective rates of insomnia in the treatment group were 90.0%(27/30)and 86.7%(26/30),which were significantly higher than those in the control group of 76.7%(23/30)and 16.7%(5/30),the differences were statistically significant(all P<0.05).The incidence of adverse reactions in the control group was 36.7%(11/30),that in the treatment group was 6.7%(2/30),and the treatment group was significantly lower than the control group(P<0.05).Conclusion Modified Lian Di Jiao Tai Decoction can effectively improve the sleep quality,alleviate perimenopausal symptoms,reduce anxiety,and improve psychosomatic healthy status of patients with perimenopausal insomnia of kidney-yin deficiency with effulgent fire type with psychosomatic disorders.