柴胡桂枝龙骨牡蛎汤加减结合耳穴贴压治疗围绝经期失眠（肾虚肝郁型）的临床研究

发布时间：2018-01-05 12:01

本文关键词：柴胡桂枝龙骨牡蛎汤加减结合耳穴贴压治疗围绝经期失眠（肾虚肝郁型）的临床研究　出处：《长春中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:通过临床观察,探讨柴胡桂枝龙骨牡蛎汤加减方配合耳穴贴压治疗围绝经期失眠的机理及优势,为其在临床上治疗围绝经期失眠提供理论依据。方法:以2014年1月-2016年12月到中国中医科学研究院广安门中医院和北京市昌平区中西医结合医院国医馆就诊的围绝经期失眠患者198例作为本次的研究对象。按照随机排列数字表的方式对所纳入的患者进行编号,并随机分为三组,对照组65例,实验一组(采用中成药进行治疗)66例,实验二组(柴胡桂枝龙骨牡蛎汤加减方联合耳穴贴压疗法进行治疗)67例,对三组患者治疗前后的中医症候评分、治疗总疗效、睡眠质量、性激素水平、不良反应以及远期随访效果进行记录并比较。结果:(1)对照组有1例患者中途转院,实际统计64例,实验一组2例失访,实际统计64例,实验二组1例失访,2例没有完全进行耳穴贴压而剔除,实际统计64例;(2)治疗前三组患者的中医证候评分差别无统计学意义(P0.05),三组患者治疗后中医证候评分均低于治疗前,之后实验一组和实验二组均低于对照组,且实验二组低于实验一组,均有P0.05,差别具有统计学意义;(3)治疗前,三组患者的睡眠质量、睡眠时间、入睡时间、日间功能、睡眠效率和睡眠障碍各个方面的差异均无统计学意义(P0.05);每组患者治疗后的各项指标与治疗前比较,各比较项目的数值均低于治疗前,实验一组和实验二组的各项治疗后数值与对照组比较均降低,实验二组低于实验一组,均有P0.05,差异具有统计学意义;(4)三组患者治疗前,FSH、LH、E2水平差异无统计学意义,P0.05;治疗后,实验一组和实验二组的FSH低于对照组,实验二组低于实验一组,实验一组和实验二组的LH低于对照组,实验二组和实验一组的E2水平高于对照组,且实验二组高于实验一组,均有P0.05,差异具有统计学意义;(5)实验二组的总有效率高于实验一组和对照组,而实验一组的有效率高于对照组,均有P0.05,差异具有统计学意义;(6)实验二组不良反应发生率低于对照组和实验一组,实验一组低于对照组,且P0.05,差异具有统计学意义;(7)对照组有8例患者复发,复发的发生率为12.50%,而实验一组和实验二组均只有1例患者复发,复发率均为1.56%,低于对照组,且卡方值为8.451,P0.05,差异具有统计学意义。结论:柴胡桂枝龙骨牡蛎汤加减结合耳穴贴压的方式治疗女性围绝经期失眠具有显著的优势,优于单纯中药组及中成药组。耳穴贴压疗法通过与脏腑和经络的联系,能有效地改善围绝经期失眠女性中医证候及血清内分泌激素的分泌,且无毒副作用及其他不良反应。远期疗效较好,是一种较被认可的治疗方式,可在临床治疗中推广使用。
[Abstract]:Objective: to explore the mechanism and advantages of Bupleurum Guizhi Longgu oyster decoction combined with auricular point plaster in the treatment of peri-menopausal insomnia through clinical observation. To provide theoretical basis for clinical treatment of peri-menopausal insomnia. From January 2014 to December 2016, a total of 198 patients with peri-menopausal insomnia were admitted to the Guang'an Men traditional Chinese Medicine Hospital of the Chinese Academy of traditional Chinese Medicine and the National Hospital of Integrated Chinese and Western Medicine in Changping District, Beijing. Subjects. The patients were numbered according to the random arrangement of digital tables. They were randomly divided into three groups: control group (n = 65), experimental group (n = 66) and experimental group (n = 67). Three groups of patients before and after treatment of TCM symptoms score, treatment of the total efficacy, sleep quality, sex hormone level. Results one patient in the control group was transferred to hospital in the midway, 64 cases in the actual statistics, 2 cases in the experiment group, and 64 cases in the actual statistics. In group two, 1 case lost visit and 2 cases were not completely removed by auricular point pressing, and 64 cases were actually counted. Before treatment, there was no significant difference in TCM syndromes score between the three groups before treatment, and the TCM syndrome scores of the three groups were lower than those before treatment. Then the experimental group and the second group were lower than the control group, and the experimental group 2 was lower than the experimental group (P0.05), the difference was statistically significant. Before treatment, there were no significant differences in sleep quality, sleep time, sleep time, daytime function, sleep efficiency and sleep disorder between the three groups (P 0.05). Each group of patients after treatment compared with before treatment, the value of each comparison items are lower than before treatment, the experimental group and experimental group two after the treatment of each value decreased compared with the control group. Group 2 was lower than group 1 (P0.05), the difference was statistically significant. (4) there was no significant difference in the level of LHN E 2 between the three groups before treatment (P 0.05). After treatment, the FSH of experimental group 1 and experimental group 2 was lower than that of control group, that of experimental group 2 was lower than that of experimental group 1, and that of experimental group 1 and experimental group 2 was lower than that of control group. The level of E2 in the second group and the first group was higher than that in the control group, and the level of E2 in the second group was higher than that in the first group (P 0.05), the difference was statistically significant. (5) the total effective rate of experimental group 2 was higher than that of experimental group 1 and control group, while the effective rate of experimental group 1 was higher than that of control group (P0.05), the difference was statistically significant. 6) the incidence of adverse reactions in experimental group 2 was lower than that in control group and experimental group 1, and that in experimental group 1 was lower than that in control group, and the difference was statistically significant (P0.05). (7) in the control group, there were 8 cases of recurrence, the incidence of recurrence was 12.50, while only 1 case of the experimental group and the second group were relapsed, the recurrence rate was 1.56%, which was lower than that of the control group. The chi-square value was 8.451g P0.05.The difference was statistically significant. Conclusion: the treatment of insomnia in menopausal period of female patients by reducing the decoction of Bupleurum Guizhi Longgu oyster combined with auricular point plaster has a significant advantage. Auricular acupoint pressing therapy can effectively improve the TCM syndrome and endocrine hormone secretion of women with insomnia in perimenopausal period through the connection with viscera and meridian. And no side effects and other adverse reactions. The long-term effect is better, is a more recognized treatment, can be used in clinical treatment.
【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.6

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