摘要
目的:探讨滋肾清心疏肝汤联合穴位贴敷、绝经激素治疗(MHT)围绝经期失眠(PMI)患者的疗效.方法:选取2022年1月～2023年12月收治的102例PMI患者作为研究对象,按照治疗方法分为观察组(n=34)、对照1组(n=34)和对照2组(n=34),对照1组采用MHT治疗,对照2组采用滋肾清心疏肝汤联合穴位贴敷治疗,观察组采用滋肾清心疏肝汤联合穴位贴敷、MHT治疗,比较三组治疗前和治疗后的临床疗效、中医证候积分、皮质醇、糖脂代谢指标[空腹血糖(FPG)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)]、性激素指标[促卵泡生成素(FSH)、促黄体生成素(LH)、雌二醇(E2)]、心理状况[焦虑自评量表(SAS)及抑郁自评量表(SDS)].结果:治疗4周后,观察组的临床疗效优于对照1组和对照2组(P＜0.05),观察组的中医症候积分(心烦不寐、入睡困难、心悸多梦)低于对照1组和对照2组(P＜0.05);治疗4周后,观察组的皮质醇水平高于对照1组和对照2组,FPG、TG、LDL-C水平低于对照1组和对照2组(P＜0.05);随访6个月,观察组的FSH、LH水平低于对照1组和对照2组,E2水平高于对照1组和对照2组(P＜0.05);治疗4周后,观察组的SAS评分、SDS评分低于对照1组和对照2组(P＜0.05).结论:滋肾清心疏肝汤联合穴位贴敷、MHT可有效缓解PMI患者临床症状,改善皮质醇、糖脂代谢水平、性激素水平和心理状况.
Abstract
Objective:To explore the curative effect of Zishen Qingxin Shugan Decoction combined with acupoint application and menopausal hormone therapy(MHT)on patients with perimenopausal insomnia(PMI).Methods:A total of 102patients with PMI were retrospectively enrolled as the research objects between January 2022and December 2023.According to treatment methods,they were divided into observation group(n=34),control group 1(n=34)and control group 2(n=34).The control group l was treated with MHT,control group 2was treated with Zishen Qingxin Shugan Decoction combined with acupoint application,observation group was treated with Zishen Qingxin Shugan Decoction,acupoint application,and MHT.The clinical curative effect,scores of TCM syndromes,cortisol,glucose-lipid metabolism indexes[fasting plasma glucose(FPG),triglyceride(TG),low-density lipo-protein cholesterol(LDL-C)],sex hormones[follicle stimulating hormone(FSH),estradiol(E2),luteinizing hormone(LH)]and psychological state[self-rating anxiety scale(SAS),self-rating depression scale(SDS)]were compared before treat-ment and 1month after treatment between the three groups.Results:After 4weeks of treatment,the total response rate of observation group was better than that of control group 1and control group 2(P＜0.05),scores of TCM symptoms(insomnia,difficulty in falling asleep,palpitation and dreaminess)in observation group were lower than those in control group 1and control group 2(P＜0.05),the cortisol level was higher than that of control group 1and control group 2(P＜0.05),levels of FPG,TG and LDL-C were lower than those in control group 1and control group 2(P＜0.05).After 6months of follow-up,FSH and LH levels in observation group were low-er than those in control group 1and control group 2,and E2levels were higher than those in control group 1and control group 2(P＜0.05).After 4weeks of treatment,SAS and SDS scores in observation group were lower than those in control group 1and control group 2(P＜0.05).Conclusion:Zishen Qingxin Shugan Decoction combined with acupoint application and MHT can effectively relieve clini-cal symptoms,improve cortisol,glucose-lipid metabolism,sex hormones and psychological state in PMI patients.
维普
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