赖新生通元法治疗围绝经期诸症经验

随着社会的不断发展,生活、工作等各方面因素的潜在压力使部分人长期处于一种焦虑、压抑的状态;随着我国已逐渐进入老龄化社会,步入更年期的女性数量逐年增加,在面对这些负面情绪,处于更年期的女性往往更难以释怀,也使得近年来在围绝经期中出现围绝经期综合征的女性不断增加,发病年龄更是提前。许多围绝经期女性都有程度不等,轻重不一的围绝经期综合征表现,其可受个体差异性、社会环境复杂性及性格特殊性等各方面因素影响,严重时可影响其日常生活,也因其症状繁多,疗程、疗效与预后均存在明显差异。赖新生教授针对围绝经期诸症病因病机及其治则治法提出三点:①先解外,而后安五脏;②冲任固,任督灌脏腑;③针药合,通督以归元。运用通元法治疗围绝经期诸症,疗效甚佳。

北京市月坛社区妇女更年期相关症状调查

目的了解北京市月坛社区妇女主要更年期症状。方法 2013年9~12月,选取在月坛社区卫生服务中心自愿参加宫颈癌、乳腺癌筛查的妇女为研究对象,应用自行设计的调查问卷调查其一般状况,应用Greene评分表调查更年期相关症状的发生情况。结果被调查妇女更年期症状发生率为71.7%,发生率最高的前5位症状分别是感到疲倦或精力不足（37.3%）,肌肉或关节酸痛（37.2%）,失眠（34.4%）,潮热（29.6%）,对性缺乏兴趣（29.5%）。存在中重度症状者占1.1%~11.4%。不同年龄组间躯体症状和泌尿生殖道症状存在差异,56~岁组及51~岁组较高;不同年龄组间中重度泌尿生殖道症状存在差异,56~岁组及60~64岁组较高。结论城市社区40~64岁妇女更年期症状发生率较高,中重度症状的比例不高。更年期综合征在人群中存在普遍性和趋于轻症的特点,适合在社区开展干预。

Efficacy of transcutaneous electrical acupoint stimulation(TEAS)for menopausal insomnia and its effect on serum hormone levels

Objective:To explore the therapeutic efficacy and mechanism of transcutaneous electrical acupoint stimulation(TEAS)for menopausal insomnia.Methods:A total of 80 patients with menopausal insomnia were randomly divided into a control group and an observation group,with 40 cases in each group.The patients in the control group received conventional Western medication treatment,and the patients in the observation group received TEAS on the basis of conventional Western medication treatment.The treatment for both groups lasted for 4 weeks.Before and after treatment,Pittsburgh sleep quality index(PSQI)and modified Kupperman scale were evaluated,and the serum levels of estradiol(E2)and follicular stimulating hormone(FSH)were measured.The therapeutic efficacy was evaluated after treatment.Results:After treatment,the total effective rate of the observation group was significantly higher than that of the control group(P<0.05);in the control group,the improvement of PSQI score was significant(P<0.05),while the change of modified Kupperman score was insignificant(P>0.05);the PSQI and Kupperman scores in the observation group were significantly improved after treatment(both P<0.05),and there were significant differences between the observation group and the control group in PSQI and Kupperman scores(both P<0.05).After treatment,the serum E2 and FSH levels in the control group were not statistically different from those before treatment(both P>0.05);the serum E2 level was significantly increased(P<0.05),and the FSH level was decreased(P<0.05)in the observation group after treatment,and the between-group differences in serum levels of E2 and FSH were significant(both P<0.05).Conclusion:TEAS plus conventional Western medication in treating menopausal insomnia is effective,and can significantly improve the symptoms of insomnia and menopause,which may be related to the regulation of serum E2 and FSH levels.

Review of acupuncture treatment for perimenopausal syndrome

Objective：To summarize the mechanism of acupuncture in treating perimenopausal syndrome （PMS） from the aspects of reproductive endocrinology, immune system, neuroendocrine, the metabolism of free radicals and bone, and the effect of lipid. Methods： The databases including MEDLINE, EMBASE, CNKI, Wanfang, and CQVIP were searched from the launch of each database to June 2014 for relevant papers involving clinical and laboratory researches about PMS treated with acupuncture. Results： Acupuncture is a safe, effective, and scientific method in treating PMS, and the efficacy is significant. Conclusion： Considering the limits of previous studies, future research should use high technologies such as molecular biology and genetic testing, and adopt multicenter randomized controlled study method to evaluate the efficacy of acupuncture in treating female PMS, and to further explore the mechanism of acupuncture in treating PMS.

Acupoints selection pattern in acupuncture-moxibustion treatment of perimenopausal syndrome from 2007 to 2016

Objective： To discuss the acupoints selection pattern in acupuncture-moxibustion treatment of perimenopausal syndrome（PMS） from 2007 to 2016. Methods： Clinical literatures related to PMS treated with acupuncture-moxibustion published from 2007 to 2016 were collected from Chinese Biomedical Literature Database（CBM）, Chongqing VIP Database（CQVIP）, China National Knowledge Infrastructure（CNKI）, and Wanfang Academic Journal Full-text Database（Wanfang）. The retrieved data underwent descriptive analysis, cluster analysis and association pattern analysis to determine the acupoints selection principle in acupuncture-moxibustion treatment of PMS. Results： The top five acupoints used in acupuncture-moxibustion treatment of PMS were Sanyinjiao（SP 6）, Shenshu（BL 23）, Guanyuan（CV 4）, Baihui（GV 20）, and Shenmen（HT 7）. The leading 4 meridians were Bladder Meridian, Conception Vessel, Spleen Meridian, and Governor Vessel. The clustering analysis showed that the 5 core acupoint groups were：（1） Sanyinjiao（SP 6）;（2） Shenshu（BL 23） and Guanyuan（CV 4）;（3） Baihui（GV 20）, Shenmen（HT 7）, Zusanli（ST 36）, Ganshu（BL 18） and Taichong（LR 3）;（4） Taixi（KI 3）, Pishu（BL 20）, Xinshu（BL 15）, Qihai（CV 6） and Neiguan（PC 6）;（5） Sishencong（EX-HN 1）, Zhongwan（CV 12）, Hegu（LI 4）, Yintang（GV 29）, Fengchi（GB 20）, Zhongji（CV 3） and Feishu（BL 13）. The three most significant acupoints were Sanyinjiao（SP 6）, Shenshu（BL 23） and Guanyuan（CV 4）. Acupoint groups based on syndrome differentiation included：（1） Hegu（LI 4）, Zhongwan（CV 12） and Sishencong（EX-HN 1）;（2） Feishu（BL 13）, Zhongji（CV 3）, Fengchi（GB 20） and Yintang（GV 29）;（3） Xinshu（BL 15）, Pishu（BL 20）, Qihai（CV 6）, Neiguan（PC 6） and Taixi（KI 3）;（4） Ganshu（BL 18）, Zusanli（ST 36）, Shenmen（HT 7）, Taichong（LR 3） and Baihui（GV 20）. The analysis of association pattern elaborated that Shenshu（BL 23） and Sanyinjiao（SP 6） won the highest support rate in the paired groups; Ganshu（BL 18）, Shenshu（BL 23） and Sanyinjiao（SP 6） had the highest support rate among the acupoint groups. Conclusion： The data mining results of acupuncture-moxibustion treatment of PMS substantially conform to the general principle in traditional acupuncture-moxibustion theories, able to reflect the acupoints selection and grouping pattern and provide references for acupuncture-moxibustion treatment of PMS.

Survey on Clinical and Basic Study on Perimenopausal Syndrome Treated by Moxibustion

Objective： To review the general study situation of perimenopausal syndrome treated with moxibustion, and to summarize the therapeutic rules of moxibustion for perimenopausal syndrome. Methods： The literature about clinical and experimental study on moxibustion treatment for perimenopausal syndrome since 1996 was sorted out and analyzed by computer search. Results and Conclusion： Twenty-nine articles were collected upon the criteria of recruitment. Mostly used methods were salt-partitioned and warming needle moxibustion, and the most frequently used meridians were Conception Vessel, Governor Vessel, Spleen Meridian, and Kidney Meridian. In acupoints, Shenque （CV 8）, Guanyuan （CV 4）, Mingmen （GV 4） and Yinbai （SP 1） were used in high freauecy.

Ear Acupuncture for Perimenopause Syndrome:A Multi-centered Randomized Controlled Trial

Objective： To observe and evaluate the clinical effect of ear acupuncture in treating perimenopause syndrome. Methods： A multi-centered randomized controlled trial was conducted and the enrolled participants were divided into an ear acupuncture group and a control group. The ear acupuncture group was treated by electroacupuncture at auricular points, and the control one was prescribed for Geng Nian An （Menopause Helper） tablets. The therapeutic effects were evaluated after 10-day treatments. Results： For pre-menopausal patients, the total effective rate was 96.8% in the ear acupuncture group, versus 56.3% in the control. For post-menopausal patients, the total effective rate was 85.7% in the ear acupuncture group, versus 53.0% in the control. Conclusion： Both ear acupuncture and Geng Nian An （Menopause Helper） tablets were effective in ameliorating symptoms of perimenopause syndrome, with satisfactory compliance and safety. The clinical effect of ear acupuncture is better than that of Geng Nian An （Menopause Helper） tablets.

Efficacy and safety of electroacupuncture for perimenopausal insomnia: a randomized controlled trial

Objective: To observe the effectiveness and safety of electroacupuncture (EA) plus Luohua Anshen oral liquid for patients with perimenopausal insomnia. Methods: A total of 66 participants who met the inclusion criteria were enrolled in the randomized controlled trial and allocated to a treatment group and a control group at a ratio of 1:1, with 33 cases in each group. Both groups were given Luohua Anshen oral liquid as a basic treatment. The treatment group was additionally given EA every other day, three times a week. Both groups were treated for four weeks and a four-week follow-up was conducted. The scores of Pittsburgh sleep quality index (PSQI), Kupperman index (KI) and traditional Chinese medicine sleep syndrome scale (TCMSSS) were recorded at pre- and post-treatment, and at the follow-up. Meanwhile, adverse effects were monitored and recorded. Results: After four-week treatment, the global scores of PSQI, KI and TCMSSS in both groups declined significantly (all P<0.05), and the decreases in the treatment group were more significant than those in the control group (allP<0.05). The global scores of PSQI, KI and TCMSSS in both groups at the follow-up visit were significantly different from the corresponding baseline (allP<0.05), while insignificantly different from those assessed at post-treatment (allP>0.05). The total effective rate was 93.9% in the treatment group, significantly higher than 72.2% in the control group (P<0.05). No significant adverse event was reported in this trial excepted one patient experienced slight dizziness in the first acupuncture treatment. Conclusion: EA plus Luohua Anshen oral liquid is safe for perimenopausal insomnia with satisfactory short- and long-term effectiveness, and it shows certain advantage compared with using Luohua Anshen oral liquid alone.

Clinical Study on Electroacupuncture for Perimenopause Syndrome

Objective： To observe the clinical effect of electroacupuncture in treating perimenopause syndrome （PMS） and explore its possible action mechanism. Methods： All of 110 cases with PMS were randomized into group A [Guanyuan （CV 4） and Sanyinjiao （SP 6）] and group B [Neiguan （PC 6） and Zusanli （ST 36）], 55 cases in each. After 4-week treatments, the Kupperman Menopausal Index （KMI） was adopted to evaluate the therapeutic effect. Estradiol （E2）, follicle-stimulating hormone （FSH） and luteinizing hormone （LH） were assayed respectively before and after treatments. Results： The KMI decreased by 52.6% in group A, versus 47.4% in group B. The total effective rate was 93.6% in group A, versus 85.7% in group B, and the difference was not significant （P〈0.05）. The content of E2 both increased in the two groups after 4-week treatments （P〈0.05）; the contents of FSH and LH dropped but without statistical difference （P〈0.05）. Conclusion： Both of the two acupoints groups can significantly lower KMI, and effectively increase the contents of E2 in patients with PMS

Combined Acupuncture-moxibustion and Psychotherapy for Perimenopause Syndrome

Objective： To observe the effect of combined acupuncture-moxibustion with psychotherapy in treating perimenopause syndrome. Methods： Eighty patients with perimenopause syndrome were randomized into two groups. Forty-two patients in the treatment group were intervened by acupuncture-moxibustion and psychotherapy, and the other 38 in the control group were treated by acupuncture-moxibustion only. The treatment was given once a day, 15 times constitute a treatment course. The therapeutic effects were evaluated after 3 treatment courses. Results： The total effective rate and the effective rate of the emotional state were both 97.6% in the treatment group, versus 89.5% and 73.7% in the control. The comparison of the total effective rate and the effective rate of the emotional state between the two groups both showed significant difference （P〈0.05）. Conclusion： Acupuncture-moxibusiton has better effect in treating perimenopause syndrome when combined with psychotherapy.