摘要
目的:比较耳揿针联合耳尖放血与口服西药治疗围绝经期失眠的疗效差异,以及对患者神经内分泌水平的影响。方法:将90例围绝经期失眠患者随机分为观察组和对照组,每组45例。观察组采用耳揿针联合耳尖放血,穴位选取耳穴肾、心、肝、神门、交感、内分泌和耳尖,两耳交替治疗,每3天更换1次;对照组口服西药艾司唑仑1mg,每日1次,两组均4周为一疗程,连续治疗2个疗程。比较两组治疗前后匹兹堡睡眠质量指数(PSQI)、血清雌激素(E2)、5-羟色胺(5-HT)和去甲肾上腺素(NE)含量。结果:两组治疗后PSQI总分较治疗前均明显下降(均P<0.05),观察组治疗后在睡眠质量、睡眠时间、睡眠障碍、日间功能障碍和总分改善上优于对照组(均P<0.05);两组治疗前后血清E2含量差异均无统计学意义(均P>0.05),治疗后,两组血清5-HT均有不同程度的提高,NE有不同程度的下降(均P<0.05),且观察组血清5-HT的含量明显高于对照组,NE含量低于对照组(均P<0.05);观察组总有效率为95.6%(43/45),明显高于对照组的82.2%(37/45,P<0.05)。结论:耳揿针联合耳尖放血能够改善围绝经期失眠患者的睡眠质量,调节神经递质水平,其作用优于西药艾司唑仑。
Objective To compare the effect differences between auricular intradermal needling combined with erjian（HX6,7i） bloodletting and oral administration of western medicine, and to explore the efficacy of neuroendocrine level in patients with perimenopausal insomnia. Methods Ninety patients were randomized into an observation group and a control group, 45 cases in each one. In the observation group, auricular intradermal needling combined with erjian（HX6,7i）bloodletting were adopted alternately in the two ears. The auricular points were shen（CO（10））, xin（CO（15））, gan（CO12）, shenmen（TF4）, jiaogan（AH6a）, neifenmi（CO18） and erjian（HX6,7i）. The treatment was required once 3 days on the auricular points of one side alternatively. Oral administration of estazolam（1mg each day） was applied in the control group for 2 courses, 4 weeks as 1 course, once a day. The scores of Pittsburgh sleep quality index（PSQI）, the levels of serum estrogen（E2）, 5-hydroxy tryptamine（5-HT） and norepinephrine（NE） were valuated in the two groups before and after treatment. Results After treatment, the total scores of PSQI reduced in the two groups（both P〈0.05）, and the improvements of sleeping quality, sleeping time, sleeping difficulty, daytime dysfunction and the total PSQI score in the observation group were superior to those in the control group（all P〈0.05）. There was no significant difference in serum E2 before and after treatment in the two groups,and between the two groups after treatment（all P〈0.05）. After treatment, 5-HT contents increased and NE levels decreased in the two groups（all P〈0.05）, with better results in the observation group（both P〈0.05）. The total effective rate was 95.6%（43/45） in the observation group, which was higher than 82.2%（37/45） in the control group（P〈0.05）. Conclusion Auricular intradermal needling combined with erjian（HX6,7i） bloodletting can improve the sleep quality of patients with perimenopausal insomnia, and adjust the neurotransmitter level, which achieves better effect than western medication.
作者
孟方
龚卫娟
廖月霞
徐慧文
王潇
MENG Fang;GONG Weijuan;LIAO Yuexia;XU Huiwen;WANG Xiao(School of Nursing, Yangzhou University, Yangzhou 225001, Jiangsu Province, China;School of Nursing, Nanking University of CM)
出处
《中国针灸》
CAS
CSCD
北大核心
2018年第6期575-579,共5页
Chinese Acupuncture & Moxibustion
关键词
围绝经期
失眠
耳揿针
耳尖放血
艾司唑仑
睡眠质量指数
5-羟色胺
perimenopause
insomnia
auricular intradermal needling
erjian （HX6.7i） bloodletting
estazolam
sleep quality index
5-hydroxy tryptamine （5-HT）
