针刺联合滋水清肝饮加减治疗围绝经期失眠的临床疗效观察OA
Clinical observation on the therapeutic effect of acupuncture combined with modified Zishui Qinggan Decoction in treating perimenopausal insomnia
目的:观察针刺联合滋水清肝饮加减治疗围绝经期失眠(PMI)的临床疗效.方法:将2024年2月-2024年12月就诊于山西省针灸医院睡眠障碍门诊的62例PMI患者随机分为治疗组和对照组,每组31例,治疗过程中对照组脱落1例.对照组口服滋水清肝饮加减,治疗组在对照组治疗基础上结合针刺百会、神庭、安眠、肝俞、肾俞、心俞、内关、太溪、太冲、神门、三阴交治疗,3次/周.两组均治疗4周.以匹兹堡睡眠质量指数(PSQI)量表评分、改良Kupperman评分、性激素水平为观察指标,根据治疗后PSQI总减分率计算疗效指数,评估总有效率.结果:与治疗前比较,治疗4周后两组患者PSQI量表总分及各项评分、改良Kupperman评分、血清促卵泡激素(FSH)水平均呈现下降趋势,血清雌二醇(E2)水平升高,差异均有统计学意义(P<0.05,P<0.01).治疗4周后,治疗组患者PSQI总分及睡眠质量、睡眠时间、睡眠效率、催眠药物、日间功能障碍评分、Kupperman评分、FSH水平均低于对照组,E2水平高于对照组,差异均有统计学意义(P<0.05,P<0.01).治疗组总有效率(93.55%)高于对照组(73.33%),差异有统计学意义(P<0.05).结论:针刺联合滋水清肝饮加减治疗PMI患者的临床疗效优于单纯中药治疗,可以明显提高患者的睡眠质量和围绝经期症状,改善性激素水平,减少日间功能障碍发生,值得纳入临床治疗方案.
Objective:To observe the clinical efficacy of acupuncture combined with modified Zishui Qinggan Decoc-tion(Nourishing Yin and Clearing Liver Decoction)in treating perimenopausal insomnia(PMI).Methods:Sixty-two PMI patients who visited the Sleep Disorder Clinic of Shanxi Provincial Acupuncture Hospital from February 2024 to December 2024 were randomly divided into a treatment group and a control group,with 31 patients in each group.The control group orally received modified Zishui Qinggan Decoction.The treatment group received acupuncture at Baihui(GV20),Shenting(GV24),Annian(EX-HN),Ganshu(BL18),Shenshu(BL23),Xinshu(BL15),Neiguan(PC6),Taixi(KI3),Taichong(LR3),Shenmen(HT7),and Sanyinjiao(SP6)in addition to the control group's treatment,three times per week.Both groups were treated for 4 weeks.The Pittsburgh Sleep Quality Index(PSQI)score,modified Kupperman index,and sex hormone lev-els were used as observation indicators.The efficacy index was calculated based on the total PSQI score reduction rate after treatment to evaluate the total effective rate.Results:Compared with pre-treatment levels,after 4 weeks of treatment,both groups showed a decreasing trend in the total PSQI score and its component scores,the modified Kupperman index,and se-rum follicle-stimulating hormone(FSH)levels,while serum estradiol(E2)levels increased.All differences were statistically significant(P<0.05,P<0.01).After 4 weeks of treatment,the treatment group had lower total PSQI scores,lower scores in the sleep quality,sleep duration,sleep efficiency,sleep medication,and daytime dysfunction components,lower modified Kup-perman index scores,and lower FSH levels compared to the control group,while E2 levels were higher.All differences were statistically significant(P<0.05,P<0.01).The total effective rate in the treatment group(93.55%)was higher than that in the control group(73.33%),with a statistically significant difference(P<0.05).Conclusion:The clinical efficacy of acupuncture combined with modified Zishui Qinggan Decoction in treating PMI patients is superior to herbal medicine alone.It can sig-nificantly improve patients'sleep quality and perimenopausal symptoms,ameliorate sex hormone levels,and reduce daytime dysfunction.This combined approach is worthy of inclusion in clinical treatment plans.
姚晓倩;侯玉铎;金晓飞;薛聆;曹玉霞;范丽娜
山西中医药大学,山西 晋中 030619山西中医药大学,山西 晋中 030619山西中医药大学,山西 晋中 030619山西中医药大学,山西 晋中 030619山西省针灸医院,山西 太原 030006山西中医药大学,山西 晋中 030619
医药卫生
围绝经期失眠针刺滋水清肝饮临床疗效
perimenopausal insomniaacupunctureZishui Qinggan Decoctionclinical efficacy
《山西中医药大学学报》 2026 (5)
525-530,6
山西省中医药管理局项目(2024ZYYC062)山西中医药大学失眠障碍专病库建设项目(2022PY-ZBK-007)
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