“调神补肾活血”温针灸法干预围绝经期的机制

Mechanism of Warm Needling Moxibustion with"Regulating Spirit,Tonifying Kidney and Activating Blood Circulation"in Intervention of Perimenopausal Syndrome

目的观察“调神补肾活血”温针灸法治疗围绝经期综合征患者的临床疗效,并探讨其起效的作用机制。方法将150例围绝经期综合征患者随机分为温针灸组、中药组和西药组,每组患者各50例。温针灸组予以“调神补肾活血”温针灸法,中药组予以中药汤剂更年安怡方口服,西药组予以西药倍美力片口服治疗。观察3组治疗前后血脂四项[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、性激素三项[血清促卵泡生成素(FSH)、促黄体生成素(LH)、雌二醇(E2)]水平变化以及改良的Kupperman指数(KI)评分变化,并比较3组的临床疗效。结果治疗后,3组患者TC、TG、LDL-C、FSH、LH水平均比治疗前下降,HDL-C、E2水平均比治疗前上升,均有显著性差异(P<0.01);且温针灸组TC、LDL-C、LH水平下降幅度均显著大于中药组和西药组(P<0.01),HDL-C、E2水平上升幅度均显著大于中药组和西药组(P<0.01),TG、FSH水平下降幅度显著大于西药组(P<0.01);治疗后3组患者KI评分均比治疗前显著下降(P<0.01),且温针灸组与中药组KI评分下降幅度显著大于西药组(P<0.01),温针灸组与中药组KI评分下降幅度相比,差异无统计学意义(P>0.05)。温针灸组患者治疗总有效率为90.0%明显高于西药组的74.0%(P<0.01),温针灸组与中药组患者总有效率比较,差异无统计学意义(P>0.05)。结论“调神补肾活血”温针灸法治疗围绝经期综合征综合临床疗效优于中药组和西药组,其作用机制可能与降低血脂、改善雌激素水平有关。

Objective To observe the clinical efficacy of warm needle moxibustion with"regulating spirit,tonifying kidney and activating blood"in the treatment of patients with perimenopausal syndrome and to explore its mechanism.Methods A total of 150 patients with perimenopausal syndrome were randomly divided into a warm needle moxibustion group,a traditional Chinese medicine group and a western medicine group,with 50 patients in each group.The warm needle moxibustion group was treated with warm needle moxibustion method of“regulating spirit,tonifying kidney and activating blood circulation”.The traditional Chinese medicine group was treated with Gengnian Anyi decoction,and the western medicine group was treated with Premarin tablets orally.The changes of four items of blood lipid[total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],three items of sex hormone[estradial(E2),follicle stimulating hormone(FSH),luteinizing hormone(LH)]and the score of modified Kupperman index(KI)were observed before and after treatment,and the clinical effects of the three groups were compared.Results After treatment,the levels of TC,TG,LDL-C,FSH and LH in the three groups were lower than those before treatment,and the levels of HDL-C and E2 were higher than those before treatment,with significant differences(P<0.01).The decline of TC,LDL-C,and LH levels in the warm needle moxibustion group was significantly greater than that of the traditional Chinese medicine group and the western medicine group(P<0.01),and the increase of HDL-C and E2 levels in the warm needle moxibustion group was significantly greater than that of the traditional Chinese medicine group and the western medicine group(P<0.01).The decline of TG and FSH levels was significantly greater than that of the western medicine group(P<0.01).After treatment,the KI score of the three groups decreased significantly compared with those before treatment(P<0.01),and the decline of KI score in warm needle moxibustion group and traditional Chinese medicine group was significantly greater than that in western medicine group(P<0.01).There was no significant difference in the decrease of KI score between warm needle moxibustion group and traditional Chinese medicine group(P>0.05).The total effective rate of warm needle moxibustion group(90.0%)was significantly higher than that of western medicine group(74.0%)(P<0.01).There was no significant difference in the total effective rate between warm needle moxibustion group and traditional Chinese medicine group(P>0.05).Conclusion The comprehensive clinical curative effect of warm needle moxibustion with"regulating spirit,tonifying kidney and activating blood Circulation"group in treating perimenopausal syndrome is better than that of traditional Chinese medicine group and western medicine group.Its mechanism may be related to reducing blood lipid and improving estrogen level.