本文關鍵詞：柴胡桂枝龍骨牡蠣湯加減結合耳穴貼壓治療圍絕經期失眠（腎虛肝郁型）的臨床研究　出處：《長春中醫(yī)藥大學》2016年碩士論文　論文類型：學位論文

  更多相關文章： 柴胡桂枝龍骨牡蠣湯 耳穴貼壓 圍絕經期失眠

【摘要】：目的:通過臨床觀察,探討柴胡桂枝龍骨牡蠣湯加減方配合耳穴貼壓治療圍絕經期失眠的機理及優(yōu)勢,為其在臨床上治療圍絕經期失眠提供理論依據(jù)。方法:以2014年1月-2016年12月到中國中醫(yī)科學研究院廣安門中醫(yī)院和北京市昌平區(qū)中西醫(yī)結合醫(yī)院國醫(yī)館就診的圍絕經期失眠患者198例作為本次的研究對象。按照隨機排列數(shù)字表的方式對所納入的患者進行編號,并隨機分為三組,對照組65例,實驗一組(采用中成藥進行治療)66例,實驗二組(柴胡桂枝龍骨牡蠣湯加減方聯(lián)合耳穴貼壓療法進行治療)67例,對三組患者治療前后的中醫(yī)癥候評分、治療總療效、睡眠質量、性激素水平、不良反應以及遠期隨訪效果進行記錄并比較。結果:(1)對照組有1例患者中途轉院,實際統(tǒng)計64例,實驗一組2例失訪,實際統(tǒng)計64例,實驗二組1例失訪,2例沒有完全進行耳穴貼壓而剔除,實際統(tǒng)計64例;(2)治療前三組患者的中醫(yī)證候評分差別無統(tǒng)計學意義(P0.05),三組患者治療后中醫(yī)證候評分均低于治療前,之后實驗一組和實驗二組均低于對照組,且實驗二組低于實驗一組,均有P0.05,差別具有統(tǒng)計學意義;(3)治療前,三組患者的睡眠質量、睡眠時間、入睡時間、日間功能、睡眠效率和睡眠障礙各個方面的差異均無統(tǒng)計學意義(P0.05);每組患者治療后的各項指標與治療前比較,各比較項目的數(shù)值均低于治療前,實驗一組和實驗二組的各項治療后數(shù)值與對照組比較均降低,實驗二組低于實驗一組,均有P0.05,差異具有統(tǒng)計學意義;(4)三組患者治療前,FSH、LH、E2水平差異無統(tǒng)計學意義,P0.05;治療后,實驗一組和實驗二組的FSH低于對照組,實驗二組低于實驗一組,實驗一組和實驗二組的LH低于對照組,實驗二組和實驗一組的E2水平高于對照組,且實驗二組高于實驗一組,均有P0.05,差異具有統(tǒng)計學意義;(5)實驗二組的總有效率高于實驗一組和對照組,而實驗一組的有效率高于對照組,均有P0.05,差異具有統(tǒng)計學意義;(6)實驗二組不良反應發(fā)生率低于對照組和實驗一組,實驗一組低于對照組,且P0.05,差異具有統(tǒng)計學意義;(7)對照組有8例患者復發(fā),復發(fā)的發(fā)生率為12.50%,而實驗一組和實驗二組均只有1例患者復發(fā),復發(fā)率均為1.56%,低于對照組,且卡方值為8.451,P0.05,差異具有統(tǒng)計學意義。結論:柴胡桂枝龍骨牡蠣湯加減結合耳穴貼壓的方式治療女性圍絕經期失眠具有顯著的優(yōu)勢,優(yōu)于單純中藥組及中成藥組。耳穴貼壓療法通過與臟腑和經絡的聯(lián)系,能有效地改善圍絕經期失眠女性中醫(yī)證候及血清內分泌激素的分泌,且無毒副作用及其他不良反應。遠期療效較好,是一種較被認可的治療方式,可在臨床治療中推廣使用。
[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.
【學位授予單位】：長春中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R246.6

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本文編號：1383014