更年安神方治疗围绝经期失眠的睡眠质量测评（CPC）分析

发布时间：2018-01-01 16:02

本文关键词：更年安神方治疗围绝经期失眠的睡眠质量测评（CPC）分析　出处：《福建中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的::比较更年安神方治疗围绝经期失眠患者前后病证变化,探讨更年安神方治疗围绝经期失眠的作用环节,为临床应用更年安神方治疗围绝经期失眠提供进一步的理论依据。方法:选取2016年2月至2016年12月在福建省第二人民医院失眠专科门诊就诊的符合课题纳入标准的120例围绝经期失眠患者为研究对象,予更年安神方(中药配方颗粒剂,北京康仁堂药业有限公司生产),连续治疗4周,比较治疗前后匹兹堡睡眠质量指数量表(PSQI)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、围绝经期失眠症状分级量化表积分和心肺耦合(CPC)睡眠质量测评分析指标的差异性,探讨更年安神方治疗围绝经期失眠的作用环节。结果:1、一般资料统计分析:(1)本研究共收集到120例符合纳入、排除标准的病例,总体年龄分布在45-55岁之间。治疗后痊愈8例、显效40例、有效50例、无效22例,所占比例分别为6.67%、33.33%、41.67%、18.33%,总有效率达81.67%。(2)不同疗效结局之间的年龄比较,用单因素方差分析,结果提示:不同疗效结局之间的年龄差异比较无统计学意义(P0.05)。(3)不同疗效结局之间的病程长短比较,用多组连续型资料比较的秩和检验,结果提示:不同疗效结局之间的病程长短差异无统计学意义(P0.05)。2、治疗前后匹兹堡睡眠质量指数量表(PSQI)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)比较:配对秩和检验,结果提示:差异有统计学意义(P0.05)。3、治疗前后围绝经期失眠症状分级量化表积分比较:(1)比较治疗前后围绝经期失眠症状分级量化表总分、主症(睡眠障碍症状)总分、次症(伴随症状)总分:配对秩和检验,结果提示差异有统计学意义(P0.05)。(2)比较治疗前后入睡困难、续睡困难、五心烦热、烘热汗出、烦躁易怒、情绪抑郁、月经周期紊乱、腰膝酸软、头晕、耳鸣、眼花、口干、健忘评分:配对秩和检验,结果提示:入睡困难、续睡困难、五心烦热、烘热汗出、烦躁易怒、情绪抑郁、腰膝酸软、头晕、耳鸣、眼花、口干治疗前后差异有统计学意义(P0.05);而月经周期紊乱、健忘治疗前后差异无统计学意义(P0.05)。4、心肺耦合(CPC)睡眠质量监测指标比较:(1)比较治疗前后睡眠时间长度、初入睡时间、熟睡时间、浅睡时间、醒/做梦时间、呼吸中止指数(AHI)、睡眠品质:配对秩和/t检验,结果提示:初入睡时间、熟睡时间、浅睡时间、醒/做梦时间、睡眠品质治疗前后差异有统计学意义(P0.05);呼吸中止指数(AHI)治疗前后差异无统计学意义(P0.05)。(2)比较熟睡时间与浅睡时间改善情况:熟睡时间改善百分比与浅睡时间改善百分比比较,配对秩和检验,结果提示有统计学差异(P0.05)。结论:1.更年安神方治疗围绝经期失眠疗效确切,并可改善患者的焦虑、抑郁情绪。2.更年安神方能够改善围绝经期失眠患者的五心烦热、烘热汗出、烦躁易怒、情绪抑郁、腰膝酸软、头晕、耳鸣、眼花、口干症状。3.更年安神方对围绝经期失眠患者的睡眠障碍症状和伴随症状均有改善作用。4.更年安神方能够改善围绝经期失眠患者的睡眠时间长度、初入睡时间、熟睡时间、浅睡时间、醒/做梦时间、睡眠品质,其增加熟睡时间的效果优于缩短浅睡时间的效果。
[Abstract]:Objective: To compare Gengnian Anshen Decoction in the treatment of peri menopausal syndrome before and after the change of insomnia patients, to explore more years and treatment effect of perimenopausal insomnia, to provide the theoretical basis for the clinical application of Gengnian Anshen Decoction in the treatment of perimenopausal insomnia. Methods: from February 2016 to December 2016 in Fujian Province People's Hospital Second insomnia clinic the subject included 120 cases of perimenopausal insomnia patients as the research object, with more years of AnShenFang (traditional Chinese medicine granule, Beijing tcmages Pharmaceutical Co., Ltd. production) for 4 consecutive weeks, before and after the treatment of Pittsburgh sleep quality index scale (PSQI), Hamilton Anxiety Scale (HAMA), Hamilton depression scale table (HAMD), perimenopausal insomnia symptom classification of quantitative table integral and cardiopulmonary coupling analysis index (CPC) differences in sleep quality assessment, to investigate more years and treatment Effect of perimenopausal insomnia. Results: 1. General data statistical analysis: (1) this study collected a total of 120 patients met the inclusion and exclusion criteria were, the overall age distribution between 45-55 years old. 8 cases were cured, 40 cases markedly effective 50 cases, invalid 22 cases, the proportion respectively. 6.67%, 33.33%, 41.67%, 18.33%, the total effective rate was 81.67%. (2) comparison between different efficacy end age, results suggest that using single factor analysis of variance, age differences between different efficacy outcomes was not statistically significant (P0.05). (3) the curative effect comparison between different outcome duration, and rank test, multiple comparison with continuous data showed that: there was no significant difference between the duration of different therapeutic outcomes (P0.05) before and after treatment.2, Pittsburgh sleep quality index scale (PSQI), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) comparison: Paired rank test. Results: there were statistically significant differences (.3, P0.05) before and after the treatment of perimenopausal insomnia symptoms quantitative grading scale score comparison: (1) before and after the treatment of perimenopausal insomnia symptom classification of quantitative score, main symptoms (sleep disorders) score, secondary symptoms (symptoms) score: paired rank sum test results indicated that the difference was statistically significant (P0.05). (2) before and after the treatment, sleep difficulties, continued sleep difficulties, Fanre, Hongrehanchu, irritability, depression, menstrual cycle disorder, Yaoxisuanruan, dizziness, vertigo, tinnitus, dry mouth, forgetfulness score: paired rank sum test, results showed: sleep difficulties, continued sleep difficulties, Fanre, Hongrehanchu, irritability, depression, Yaoxisuanruan, dizziness, tinnitus, vertigo, dry mouth was statistically significant differences before and after treatment (P0.05); and the menstrual cycle disorders, forgetfulness before and after treatment, no statistical difference The meaning of.4 (P0.05), cardiopulmonary coupling (CPC) comparison of sleep quality monitoring indicators: (1) before and after treatment the length of sleep time, sleep early time, sleeping time, shallow sleep, wake up / dream time, apnea index (AHI), quality of sleep: paired rank and /t test. The results suggest that early the sleeping time, sleeping time, shallow sleep, wake up / dream time, before and after treatment was statistically significant difference (P0.05); quality of sleep apnea index (AHI) showed no significant difference before and after treatment (P0.05). (2) comparison of sleeping time and shallow sleep improvement: sleeping time and improve the percentage of shallow sleep to improve the percentage of comparison, paired rank sum test, results suggest that there were significant differences (P0.05). Conclusion: 1. more years and the treatment of perimenopausal insomnia curative effect, and can improve the patient's anxiety, depression mood.2. Gengnian Anshen Decoction can improve perimenopausal insomnia five Fanre, Hongrehanchu, irritability, depression, Yaoxisuanruan, dizziness, tinnitus, vertigo, sleep disorder symptoms of dry mouth symptoms of.3. and more years on perimenopausal insomnia and associated symptoms were improved in.4. more years and can improve the sleep time length of menopausal insomnia early, sleep time, sleep time, shallow sleep, wake up / dream time, sleep quality, sleeping time is better than the increase effect of shortening shallow sleep effect.

【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R256.23

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