针刺联合刮痧疗法治疗围绝经期失眠症的疗效观察

Efficacy Observation of Acupuncture Combined with Scraping Therapy for Perimenopausal Insomnia

目的观察针刺联合刮痧疗法治疗围绝经期失眠症(PMI)的临床疗效。方法将61例PMI患者随机分为联合组31例和对照组30例。对照组采用刮痧疗法进行治疗,联合组在对照组基础上联合针刺治疗。比较两组临床疗效及治疗前后的中医证候积分、匹兹堡睡眠质量指数(PSQI)评分、血清性激素[雌二醇(E2)、促黄体生成素(LH)、卵泡刺激素(FSH)]水平及血清单胺类神经递质[5-羟色胺(5-HT)、去甲肾上腺素(NE)]水平。结果治疗后,联合组总有效率为93.6%,对照组为73.3%,两组比较差异有统计学意义(P<0.05);两组中医证候各方面积分及总分均较治疗前降低(P<0.05),且联合组低于对照组(P<0.05);两组PSQI各因子评分及总分均较治疗前降低(P<0.05),且联合组低于对照组(P<0.05);两组血清E2水平较治疗前升高(P<0.05),LH和FSH水平均较治疗前降低(P<0.05),且联合组优于对照组(P<0.05);两组血清5-HT水平和5-HT/NE比值均较治疗前降低(P<0.05),NE水平较治疗前升高(P<0.05),且联合组优于对照组(P<0.05)。结论针刺联合刮痧疗法可显著改善PMI患者中医证候积分,调节患者内分泌和神经递质的代谢,进而改善睡眠质量,疗效显著。

Objective To observe the clinical efficacy of acupuncture plus scraping therapy in treating perimenopausal insomnia(PMI).Method Sixty-one PMI patients were randomized into an integration group of 31 cases and a control group of 30 cases.The control group received scraping therapy,and the integration group was offered additional acupuncture treatment.The clinical efficacy was compared between the two groups.The symptoms score of traditional Chinese medicine(TCM),Pittsburgh sleep quality index(PSQI)score,serum sex hormone[estradiol(E2),luteinizing hormone(LH)and follicle-stimulating hormone(FSH)]levels,and serum monoamine neurotransmitter[5-hydroxytryptamine(5-HT),norepinephrine(NE)]levels were also compared before and after the treatment.Result After the treatment,the total effective rate was 93.6%in the integration group versus 73.3%in the control group,and the between-group difference was statistically significant(P<0.05).The component and general TCM symptoms scores dropped after the intervention in both groups(P<0.05)and were lower in the integration group than in the control group(P<0.05).The component and general scores of PSQI dropped after the treatment in the two groups(P<0.05)and were lower in the integration group than in the control group(P<0.05).The E2 level increased(P<0.05),and the levels of LH and FSH decreased(P<0.05)after the treatment in both groups,and the integration group showed advantages compared with the control group(P<0.05).The levels of serum 5-HT and 5-HT/NE declined(P<0.05),and the NE level increased(P<0.05)after the intervention in both groups,and the integration group was superior to the control group(P<0.05).Conclusion Acupuncture plus scraping therapy can notably improve the TCM symptoms score and regulate the endocrine and neurotransmitter metabolism to improve sleep quality in treating PMI patients,producing significant efficacy.