针刺联合低频重复经颅磁刺激治疗围绝经期肝郁化火型睡眠障碍临床观察

Clinical Observation on Acupuncture Combined with Low Frequency Repetitive Transcranial Magnetic Stimulation in the Treatment of Perimenopausal Sleep Disorder with Depression of the Liver Generating Pathogenic Fire Type

目的观察针刺联合低频重复经颅磁刺激(Repetitive transcranial magnetic stimulation,rTMS)治疗围绝经期肝郁化火型睡眠障碍的临床疗效。方法选取2019年6月—2020年6月就诊于韶关市第一人民医院康复医学科的围绝经期肝郁化火型睡眠障碍患者80例,随机分为试验组和对照组,各40例。试验组给予针刺联合低频rTMS治疗,对照组予口服艾司唑仑片治疗,采用匹茨堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)及改良Kupperman量表在治疗前及治疗4周后进行评分及疗效评价。结果治疗后2组PSQI总分、改良Kupperman评分均较治疗前下降,且以试验组下降明显(P<0.01);治疗后,2组睡眠效率评分对比,差异有统计学意义(P<0.05),试验组睡眠质量、睡眠时间、睡眠障碍和日间功能障碍评分对比对照组改善明显(P<0.01),2组入睡时间评分对比,差异无统计学意义(P>0.05);试验组总有效率90.0%(36/40)明显高于对照组总有效率67.5%(27/40),差异具有统计学意义(P<0.05)。结论针刺联合低频rTMS治疗围绝经期肝郁化火型睡眠障碍临床疗效肯定、治疗方式接受度高。

Objective To observe the clinical effect of acupuncture combined with low frequency repetitive transcranial magnetic stimulation(LF rTMS)on perimenopausal sleep disorder with liver depression and fire.Methods The 80 patients who met the diagnosis of perimenopausal liver depression and fire-type sleep disorder were randomly divided into experimental group and control group.The experimental group was treated with acupuncture combined with LF rTMS,while the control group was treated with Estazolam tablets.The Pittsburg Sleep Quality Index(PSQI)scale and modified Kupperman scale were used to evaluate the scores and efficacy before and 4 weeks after treatment.Results After treatment,PSQI total score and Kupperman score in the two groups all decreased,especially in the experimental group(P<0.01).After treatment,there were statistically significant differences in sleep efficiency scores between the two groups(P<0.05).The scores of sleep quality,sleep time,sleep efficiency,sleep disorder and daytime dysfunction in the experimental group were significantly improved compared with the control group(P<0.01).The total effective rate of experimental group(90.0%,36/40))was significantly higher than that of control group(67.5%,27/40)),and the difference was statistically significant(P<0.05).Conclusion Acupuncture combined with LF rTMS has positive clinical efficacy and high acceptance of treatment for perimenopausal sleep disorder with liver depression and fire.