常规针刺和电针治疗围绝经期综合征的临床研究

发布时间：2018-03-18 11:25

本文选题：围绝经期综合征　切入点：常规针刺　出处：《湖北中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:围绝经期综合征(perimenopausal syndrome,PMS)是女性从中年到老年过渡时期的常见病、多发病,严重影响女性的生理和心理健康,国内外研究表明常规针刺或电针治疗PMS疗效好、不良反应少,本研究旨在进一步观察二者治疗PMS的临床疗效差异及安全性,为临床上针刺方案的选择提供依据。方法:将符合标准的50例PMS患者随机分为两组,分别为常规针刺组(25例)和电针组(25例)。常规针刺组采用常规行针手法加假电针的治疗方式,治疗穴位选取天枢、关元、子宫、三阴交;电针组取穴同常规针刺组,采用电针加假行针(针刺过程中不行手法操作)的方式,疏密波,频率10Hz/50Hz,强度0.5-1.0m A。治疗时留针30 min,每周3次,共治疗8周。观察入组时、治疗第4周、治疗第8周后焦虑自评量表(SAS)、绝经症状评价量表(MRS)、围绝经期生存质量量表(MENQOL)、抑郁自评量表(SDS)评分以及治疗前后血清卵泡刺激素(FSH)、黄体生成素(LH)、雌激素(E2)的变化及不良反应发生情况。结果:1.与本组治疗前的各项评分相比较,常规针刺组治疗第4周、第8周时MRS、MENQOL、SAS、SDS评分均有下降(P0.05);与治疗第4周比,治疗8周时各评分仍有下降(P0.05)。电针组也得到相似的结果,组间比较无统计学差异(P0.05)。2.常规针刺组完成病例23例,治愈1例,显效3例,有效9例,总有效率为56.52%;电针组完成病例23例,治愈1例,显效1例,有效12例,总有效率为60.87%。两组比较差异无统计学意义(P0.05)。3.与本组治疗前比较,常规针刺组在治疗后FSH、LH值有所下降,但差异无统计学意义(P0.05);治疗后E2值有上升趋势,但差异无统计学意义(P0.05)。电针组也得到相似的结果。组间比较无统计学差异(P0.05)。4.两组PMS患者在试验中未出现严重不良反应。结论:1.常规针刺治疗与电针治疗对于PMS患者均有较为肯定的临床疗效,且安全、不良反应少。2.常规针刺治疗与电针治疗可以改善绝经相关症状,改善绝经期抑郁、焦虑症状,提高患者的生活和生存质量,并且随着治疗周期的延长,绝经症状得到进一步改善。二者疗效相当,无明显差异。3.常规针刺治疗与电针治疗未能明显改变患者的激素水平。以上结论有待临床试验进一步验证。
[Abstract]:Objective: peri-menopausal syndrome perimenopausal syndrome (PMSs) is a common disease in women during the transition from middle age to old age. The purpose of this study was to observe the clinical efficacy and safety of the two groups in the treatment of PMS, and to provide the basis for the choice of acupuncture regimen. Methods: 50 patients with PMS who met the criteria were randomly divided into two groups. Routine acupuncture group (n = 25) and electroacupuncture group (n = 25). The conventional acupuncture group was treated by conventional acupuncture manipulation plus false electroacupuncture, and the acupoints were selected as Tianshu, Guanyuan, uterus and Sanyinjiao, and the acupoints in the electroacupuncture group were compared with those in the conventional acupuncture group. Electroacupuncture plus false acupuncture (no manual operation in the process of acupuncture) was used, the frequency was 10 Hz / 50 Hz, the intensity was 0.5-1.0 Ma. The acupuncture was kept for 30 minutes, 3 times a week for 8 weeks. The changes of serum follicle stimulating hormone (FSH), luteinizing hormone (LH), luteinizing hormone (LHN), estrogen (E _ 2) were assessed by self-rating anxiety scale (SAS), postmenopausal symptom evaluation scale (MRS), postmenopausal quality of life scale (MENQOLN), self-rating depression scale (SDS) after 8 weeks of treatment. Results: 1.Compared with the scores before treatment, In the routine acupuncture group, at the 4th week and the 8th week, the scores of MRSU MENQOLN SASX SDS were all decreased (P 0.05), compared with the 4th week of treatment, the scores of each score were still decreased at the 8th week. The results of electroacupuncture group were similar. There was no statistical difference between the two groups (P 0.05). 23 cases were cured, 1 case was cured, 3 cases were effective, 9 cases were effective, and the total effective rate was 56.52% in the routine acupuncture group, while in the electroacupuncture group, 1 case was cured, 1 case was cured, 1 case was effective, 12 cases were effective. The total effective rate was 60.87.The difference between the two groups was not statistically significant (P0.050.3.Compared with that before treatment, the FSH LH value in the routine acupuncture group decreased, but the difference was not statistically significant (P 0.05), the E 2 value increased after treatment. But the difference was not statistically significant (P 0.05). Similar results were obtained in the electroacupuncture group. There was no significant difference between the two groups. There were no serious adverse reactions in the two groups of PMS patients. Conclusion 1. Routine acupuncture and electroacupuncture treatment have no significant adverse effects on PMS. All of them had positive clinical effects. Routine acupuncture and electroacupuncture can improve menopausal symptoms, improve postmenopausal depression and anxiety symptoms, and improve patients' life and quality of life. The symptoms of menopause were further improved, the curative effect was similar, there was no significant difference between them. 3. Routine acupuncture treatment and electroacupuncture treatment could not obviously change the hormone level of the patients. The above conclusions need to be further verified by clinical trials.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.3

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