内养功联合滋阴清热安神汤对女性更年期失眠患者性激素及睡眠质量影响

Effect of Intrinsic-nourishing Exercise Combined with Ziyin Qingre Anshen Decoction(滋阴清热安神汤)on Sex Hormones and Sleep Quality in Women with Menopausal Insomnia

目的探讨内养功联合滋阴清热安神汤对女性更年期失眠患者性激素及睡眠质量影响。方法纳入河北省医疗气功医院符合诊断标准的女性更年期失眠人群88例,按照就诊先后顺序随机分为观察组与对照组,每组各44例,对照组口服艾司唑仑片及滋阴清热安神汤治疗,观察组在对照组基础上加用内养功锻炼,4周为1个疗程,共治疗2个疗程。观察治疗前后的临床疗效,匹兹堡睡眠质量指数(PSQI)评分,改良Kupperman量表评分,中医症状评分,多导睡眠呼吸监测(polysomnography,PSG)指标(入睡时间、总睡眠时间、睡眠效率),血清性激素[雌二醇(E_(2))、卵泡刺激素(FSH)、黄体生成素(LH)]水平,血清miR-155、miR-276a相对表达量。结果观察组治疗后总有效率(79.07%)高于对照组(59.09%)(P<0.05)。两组治疗后心烦不寐、月经周期紊乱、头晕耳鸣、腰膝酸软、五心烦热、口干汗出评分均较治疗前降低,且观察组低于对照组(P<0.05)。两组治疗后FSH、E_(2)水平较治疗前升高,且观察组高于对照组(P<0.05);两组治疗后LH水平与治疗前比较,差异无统计学意义(P>0.05)。两组治疗后PSQI评分、改良Kupperman量表评分均较治疗前降低,且观察组低于对照组(P<0.05)。两组治疗后入睡时间较治疗前降低,且观察组低于对照组(P<0.05);总睡眠时间、睡眠效率较治疗前升高,且观察组高于对照组(P<0.05)。两组治疗后血清miR-155、mi R-276a表达水平较治疗前升高,且观察组高于对照组(P<0.05)。结论内养功联合滋阴清热安神汤治疗女性更年期失眠患者疗效显著,可提高血清性激素水平,增加血清miR-155、miR-276a表达水平,改善睡眠质量。

Objective To explore the effect of intrinsic-nourishing exercise combined with Ziyin Qingre Anshen Decoction(滋阴清热安神汤)on sex hormones and sleep quality in female patients with menopausal insomnia.Methods A total of 88 cases of female menopausal insomnia who met the diagnostic criteria in Hebei medical Qigong hospital were enrolled.They were randomly divided into observation group and control group according to the order of treatment,with 44 cases in each group.The control group was treated with estazolam tablets and Ziyin Qingre Anshen Decoction.In the observation group,the quality of intrinsic-nourishing exercise was added on the basis of the control group.4 weeks constituted a course of treatment,with a total of 2 courses of treatment.To observe the clinical efficacy before and after treatment,Pittsburgh Sleep Quality Index(PSQI)score,modified Kupperman scale score,TCM symptom score,polysomnography(PSG)indicators(sleep time,total sleep time,sleep efficiency),serum sex hormone levels[estradiol(E_(2)),follicle stimulating hormone(FSH),luteinizing hormone(LH)]changes,and the relative expression of mi R-155 and mi R-276 a in serum.Results After treatment,the total effective rate of the observation group(79.07%)was higher than that of the control group(59.09%)(P<0.05).After treatment,the scores of restlessness,insomnia,menstrual cycle disorder,dizziness and tinnitus,soreness and weakness of waist and knees,five heart upsets and heat,dry mouth and sweating in the two groups were all higher than those of the control group.Compared with before treatment,the observation group was lower than the control group(P<0.05).The levels of FSH and E_(2) in the two groups after treatment were higher than those before treatment,and the observation group was higher than the control group(P<0.05);and there was no significant difference of the LH level in the two groups after treatment(P>0.05).PSQI score and modified Kupperman scale score in the two groups after treatment were lower than those before treatment,and the observation group was lower than the control group(P<0.05).The time to fall asleep after treatment in the two groups was longer than before treatment decreased,and the observation group was lower than the control group(P<0.05);the total sleep time and sleep efficiency were higher than those before treatment,and the observation group was higher than the control group(P<0.05).Conclusion Intrinsic-nourishing exercise combined with Ziyin Qingre Anshen Decoction has a significant effect on the treatment of female menopausal insomnia.It can increase serum sex hormone levels,increase serum miR-155 and miR-276 a expression levels,and improve sleep quality.