本文關(guān)鍵詞：更年安神方治療圍絕經(jīng)期失眠的睡眠質(zhì)量測(cè)評(píng)（CPC）分析　出處：《福建中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

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【摘要】：目的::比較更年安神方治療圍絕經(jīng)期失眠患者前后病證變化,探討更年安神方治療圍絕經(jīng)期失眠的作用環(huán)節(jié),為臨床應(yīng)用更年安神方治療圍絕經(jīng)期失眠提供進(jìn)一步的理論依據(jù)。方法:選取2016年2月至2016年12月在福建省第二人民醫(yī)院失眠�？崎T診就診的符合課題納入標(biāo)準(zhǔn)的120例圍絕經(jīng)期失眠患者為研究對(duì)象,予更年安神方(中藥配方顆粒劑,北京康仁堂藥業(yè)有限公司生產(chǎn)),連續(xù)治療4周,比較治療前后匹茲堡睡眠質(zhì)量指數(shù)量表(PSQI)、漢密爾頓焦慮量表(HAMA)、漢密爾頓抑郁量表(HAMD)、圍絕經(jīng)期失眠癥狀分級(jí)量化表積分和心肺耦合(CPC)睡眠質(zhì)量測(cè)評(píng)分析指標(biāo)的差異性,探討更年安神方治療圍絕經(jīng)期失眠的作用環(huán)節(jié)。結(jié)果:1、一般資料統(tǒng)計(jì)分析:(1)本研究共收集到120例符合納入、排除標(biāo)準(zhǔn)的病例,總體年齡分布在45-55歲之間。治療后痊愈8例、顯效40例、有效50例、無效22例,所占比例分別為6.67%、33.33%、41.67%、18.33%,總有效率達(dá)81.67%。(2)不同療效結(jié)局之間的年齡比較,用單因素方差分析,結(jié)果提示:不同療效結(jié)局之間的年齡差異比較無統(tǒng)計(jì)學(xué)意義(P0.05)。(3)不同療效結(jié)局之間的病程長(zhǎng)短比較,用多組連續(xù)型資料比較的秩和檢驗(yàn),結(jié)果提示:不同療效結(jié)局之間的病程長(zhǎng)短差異無統(tǒng)計(jì)學(xué)意義(P0.05)。2、治療前后匹茲堡睡眠質(zhì)量指數(shù)量表(PSQI)、漢密爾頓焦慮量表(HAMA)、漢密爾頓抑郁量表(HAMD)比較:配對(duì)秩和檢驗(yàn),結(jié)果提示:差異有統(tǒng)計(jì)學(xué)意義(P0.05)。3、治療前后圍絕經(jīng)期失眠癥狀分級(jí)量化表積分比較:(1)比較治療前后圍絕經(jīng)期失眠癥狀分級(jí)量化表總分、主癥(睡眠障礙癥狀)總分、次癥(伴隨癥狀)總分:配對(duì)秩和檢驗(yàn),結(jié)果提示差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)比較治療前后入睡困難、續(xù)睡困難、五心煩熱、烘熱汗出、煩躁易怒、情緒抑郁、月經(jīng)周期紊亂、腰膝酸軟、頭暈、耳鳴、眼花、口干、健忘評(píng)分:配對(duì)秩和檢驗(yàn),結(jié)果提示:入睡困難、續(xù)睡困難、五心煩熱、烘熱汗出、煩躁易怒、情緒抑郁、腰膝酸軟、頭暈、耳鳴、眼花、口干治療前后差異有統(tǒng)計(jì)學(xué)意義(P0.05);而月經(jīng)周期紊亂、健忘治療前后差異無統(tǒng)計(jì)學(xué)意義(P0.05)。4、心肺耦合(CPC)睡眠質(zhì)量監(jiān)測(cè)指標(biāo)比較:(1)比較治療前后睡眠時(shí)間長(zhǎng)度、初入睡時(shí)間、熟睡時(shí)間、淺睡時(shí)間、醒/做夢(mèng)時(shí)間、呼吸中止指數(shù)(AHI)、睡眠品質(zhì):配對(duì)秩和/t檢驗(yàn),結(jié)果提示:初入睡時(shí)間、熟睡時(shí)間、淺睡時(shí)間、醒/做夢(mèng)時(shí)間、睡眠品質(zhì)治療前后差異有統(tǒng)計(jì)學(xué)意義(P0.05);呼吸中止指數(shù)(AHI)治療前后差異無統(tǒng)計(jì)學(xué)意義(P0.05)。(2)比較熟睡時(shí)間與淺睡時(shí)間改善情況:熟睡時(shí)間改善百分比與淺睡時(shí)間改善百分比比較,配對(duì)秩和檢驗(yàn),結(jié)果提示有統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論:1.更年安神方治療圍絕經(jīng)期失眠療效確切,并可改善患者的焦慮、抑郁情緒。2.更年安神方能夠改善圍絕經(jīng)期失眠患者的五心煩熱、烘熱汗出、煩躁易怒、情緒抑郁、腰膝酸軟、頭暈、耳鳴、眼花、口干癥狀。3.更年安神方對(duì)圍絕經(jīng)期失眠患者的睡眠障礙癥狀和伴隨癥狀均有改善作用。4.更年安神方能夠改善圍絕經(jīng)期失眠患者的睡眠時(shí)間長(zhǎng)度、初入睡時(shí)間、熟睡時(shí)間、淺睡時(shí)間、醒/做夢(mèng)時(shí)間、睡眠品質(zhì),其增加熟睡時(shí)間的效果優(yōu)于縮短淺睡時(shí)間的效果。
[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.

【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R256.23

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