针刺结合乐疗治疗女性更年期综合征的临床观察

发布时间：2018-06-19 15:01

本文选题：针刺 + 乐疗　；参考：《云南中医学院》2017年硕士论文

【摘要】：目的:本研究旨在观察、比较和评价针刺结合乐疗、单纯口服西药对治疗肝肾阴虚型女性更年期综合征的临床疗效。为临床治疗女性更年期综合征提供一种心身共治的新方法。方法:按照纳入标准选择病例,采用随机数字表法分为治疗组和对照组,两组各30例。治疗组采用针刺结合乐疗法治疗,对照组采用口服西药“克龄蒙”(戊酸雌二醇片/雌二醇环丙孕酮片)治疗。治疗组每周治疗3次,10次为一疗程,对照组连续服药21天为一疗程;两组均为每个疗程间间隔7天。两组患者分别于治疗前、治疗3个疗程后进行改良kupperman量表(KI)评定,对治疗前后KI得分进行统计学分析对比,并判定疗效。结果:1治疗结束后,治疗组总有效率为96.67%,其中显效19例,有效10例,无效1例。对照组总有效率为90%,其中显效9例,有效18例,无效3例。经统计学分析,其差异有统计学差异(P0.05),提示治疗组总体疗效优于对照组。2治疗结束后两组患者改良kupperman量表(KI)评分均有降低,与治疗前比较,有统计学差异(P0.05)。治疗组KI评分降低较对照组更为显著,组间差异有统计学意义(P0.05),提示治疗组疗效优于对照组。3两组治疗前后组内比较,两组患者在抑郁、焦虑症状上均有改善,抑郁自评量表(SDS)、焦虑自评量表(SAS)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评分均有显著降低,与治疗前相比有统计学差异(P0.05),提示两种治疗方法对改善患者焦虑、抑郁症状均有疗效。治疗后组间比较,治疗组的焦虑自评量表(SAS)、汉密尔顿焦虑量表(HAMA)得分较对照组低,其差异有统计学意义(P0.05),提示治疗组在改善患者焦虑症状上优于对照组;两组抑郁自评量表(SDS)、汉密尔顿抑郁量表(HAMD)得分无统计学差异(P0.05),提示治疗组与对照组在改善患者抑郁症状上疗效相当;4两组治疗前后组内比较,中医症候评分均有降低,与治疗前相比均有统计学差异(P0.05),提示两种治疗方法对改善潮热汗出、急躁易怒、精神抑郁均有疗效。治疗后组间比较,治疗组潮热汗出、急躁易怒两项症状得分较对照组低,其差异有统计学意义(P0.05),提示治疗组在改善上述两项症状上优于对照组;两组精神抑郁一项症状得分无统计学差异(P0.05),提示治疗组与对照组在改善精神抑郁上疗效相当;5两组治疗前后对比,组内血清雌二醇(E2)、促卵泡生成素(FSH)均有变化,E2有所升高,FSH有所降低,均有统计学差异(P0.05),提示两种治疗方法对患者体内血清雌二醇(E2)、促卵泡生成素(FSH)均有影响;治疗后组间比较,治疗组E2、FSH的变化较对照组更明显,其差异有统计学意义(P0.05),提示对患者激素内分泌调整上治疗组优于对照组。结论:1针刺结合乐疗治疗肝肾阴虚型更年期综合征效果显著;2针刺结合乐疗在改善潮热汗出、急躁易怒、焦虑症状以及调整E2、FSH分泌方面疗效优于西药“克龄蒙”(戊酸雌二醇片/雌二醇环丙孕酮片);3针刺结合乐疗在改善抑郁相关症状上与西药“克龄蒙”(戊酸雌二醇片/雌二醇环丙孕酮片)疗效相当。
[Abstract]:Objective: To observe, compare and evaluate the clinical efficacy of acupuncture combined with music therapy and simple oral western medicine in treating female climacteric syndrome of liver kidney yin deficiency syndrome. In order to provide a new method of psychosomatic treatment for the clinical treatment of female climacteric syndrome, a randomized digital table method is used to divide the patients into the treatment group. And the control group, two groups of 30 cases. The treatment group was treated with acupuncture combined with music therapy, and the control group was treated with oral western medicine "Estradiol Valerate Tablets / estradiol propionic progesterone tablet). The treatment group was treated 3 times a week, 10 times a course, and the control group was given a course of 21 days for 21 days. The two groups were all between 7 days interval between each course. Two groups of patients. Before treatment, the modified Kupperman scale (KI) was evaluated after 3 courses of treatment, and the scores of KI were statistically analyzed and compared before and after treatment. Results: the total effective rate of the treatment group was 96.67% after the end of 1 treatment, of which 19 cases were markedly effective, 10 cases were effective and 1 cases were invalid. The total effective rate of the control group was 90%, of which 9 cases were markedly effective, and 18 cases had no effective. The difference between 3 cases was statistically significant (P0.05), suggesting that the overall effect of the treatment group was better than that of the control group after the end of.2 treatment. The improved Kupperman scale (KI) score of the two groups were lower, compared with that before the treatment (P0.05). The decrease of the KI score in the treatment group was more significant than the control group, and the difference between the groups was statistically significant. P0.05, suggesting that the treatment group was better than the control group.3 two groups before and after treatment, two groups were improved in depression, anxiety symptoms, depression self rating scale (SDS), anxiety scale (SAS), Hamilton Depression Scale (HAMD), Hamilton focus scale (HAMA) scores were significantly lower, compared with before the treatment was statistically poor. P0.05, suggesting that two kinds of treatment methods were effective in improving patients' anxiety and depression. After treatment, the scores of anxiety self rating scale (SAS) and Hamilton Anxiety Scale (HAMA) were lower in the treatment group than in the control group, and the difference was statistically significant (P0.05), suggesting that the treatment group was better than the control group in improving the patient's anxiety symptoms; the two groups were inhibited. The self rating Depression Scale (SDS), the Hamilton Depression Scale (HAMD) score had no statistical difference (P0.05), suggesting that the treatment group and the control group were effective in improving the depressive symptoms of the patients; 4 the scores of TCM syndrome were reduced in the two groups before and after the treatment, and there were statistical differences compared with those before the treatment (P0.05), suggesting the two treatment methods to improve the tide. Heat perspiration, irritability, and mental depression had curative effect. After treatment, two symptoms were lower in the treatment group than in the control group. The difference was statistically significant (P0.05), suggesting that the treatment group was better than the control group in improving the above two symptoms; there was no statistical difference between the two groups of depressive symptoms (P0.05). The treatment group and the control group were effective in improving mental depression; 5 the two groups before and after treatment, the serum estradiol (E2) and the follicle stimulating hormone (FSH) were changed, E2 increased, and FSH decreased (P0.05), suggesting that two kinds of treatment methods had serum estradiol (E2) and follicle stimulating hormone (FSH) in the patient's body. After treatment, the changes of E2 and FSH in the treatment group were more obvious than those in the control group. The difference was statistically significant (P0.05), suggesting that the hormone endocrine adjustment in the treatment group was superior to the control group. Conclusion: 1 the effect of acupuncture combined with music therapy on the menopause syndrome of liver kidney yin deficiency syndrome is significant; 2 acupuncture combined with music therapy in improving hot tide sweat and impatience. The effect of irritability, anxiety symptoms and adjustment of E2, FSH secretion is better than the Western Medicine (Estradiol Valerate Tablets / estradiol propionic progesterone), and 3 acupuncture combined with music therapy in improving depression related symptoms is equivalent to the Western Medicine (Estradiol Valerate Tablets / estradiol propionic progesterone tablet).
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R711.75

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