女性更年期失眠的中医治疗研究
Research on Traditional Chinese Medicine Treatment for Female Menopausal Insomnia
摘要: 女性绝经前后,由于卵巢功能退化、性激素水平波动或分泌减少,会导致内分泌失调和植物神经功能紊乱,从而出现更年期综合征。临床表现为烘然汗出、失眠多梦、焦虑烦躁、抑郁等症状,其中失眠最为常见。更年期失眠已经成为女性普遍面临的健康问题,其原因多种多样,包括激素水平变化、心理压力增加和生活方式改变等。中医将更年期失眠归为“不寐”范畴,并与“肾、心、肝”的功能密切相关。主要病因病机包括肾气衰退、肾阴亏虚、心肝火旺和心神失宁。中药和针灸等中医治疗方法对此具有较好的疗效。本文旨在探讨女性更年期失眠的病因病机和中医治疗方法,为更多女性提供帮助。
Abstract: Due to ovarian function degradation, sex hormone level fluctuations, or secretion reductions before and after menopause, women may experience endocrine disorders and autonomic nervous system dysfunction, leading to menopausal syndrome. Clinical manifestations include sudden sweating, insomnia and dreaminess, anxiety and irritability, depression, etc., among which insomnia is the most common. Menopausal insomnia has become a common health issue faced by women, caused by various factors such as hormonal changes, increased psychological pressure, and lifestyle modifications. In traditional Chinese medicine, menopausal insomnia falls under the category of “insomnia” and is closely related to the functions of the “kidneys, heart, and liver”. The main etiology and pathogenesis include kidney qi decline, kidney yin deficiency, heart and liver fire exuberance, and disturbance of the mind. Traditional Chinese medicine treatments like herbal remedies and acupuncture have shown promising effects. This article aims to explore the etiology, pathogenesis, and traditional Chinese medicine treatments for female menopausal insomnia to provide assistance to more women.
文章引用:杨加宁, 张立然. 女性更年期失眠的中医治疗研究[J]. 中医学, 2025, 14(1): 30-35. https://doi.org/10.12677/tcm.2025.141006

参考文献

[1] 程国良, 钱彦方, 李静, 等. 失眠机制研究进展[J]. 世界睡眠医学杂志, 2016, 3(3): 174-179.
[2] 吕鑫, 合浩, 李晓霞, 等. HPA轴与失眠障碍的相关性研究进展[J]. 世界睡眠医学杂志, 2019, 6(7): 1009-1012.
[3] Bonvento, G., Lacombe, P., MacKenzie, E.T., Rouquier, L., Scatton, B. and Seylaz, J. (1990) Differential Effects of Electrical Stimulation of the Dorsal Raphe Nucleus and of Cervical Sympathectomy on Serotonin and Noradrenaline Concentrations in Major Cerebral Arteries and Pial Vessels in the Rat. Journal of Cerebral Blood Flow & Metabolism, 10, 123-126. [Google Scholar] [CrossRef] [PubMed]
[4] Uchida, K., Tateda, T. and Hino, H. (2002) Novel Mechanism of Action Hypothesized for Stellate Ganglion Block Related to Melatonin. Medical Hypotheses, 59, 446-449. [Google Scholar] [CrossRef] [PubMed]
[5] Xie, C., Tan, M., Li, Y., Chen, Q., Shen, Y. and Liu, Z. (2023) Chronic Exposure to Environmentally Relevant Concentrations of Carbamazepine Interferes with Anxiety Response of Adult Female Zebrafish through GABA/5-HT Pathway and HPI Axis. Comparative Biochemistry and Physiology Part C: Toxicology & Pharmacology, 266, Article ID: 109574. [Google Scholar] [CrossRef] [PubMed]
[6] Monti, J.M. (2011) Serotonin Control of Sleep-Wake Behavior. Sleep Medicine Reviews, 15, 269-281. [Google Scholar] [CrossRef] [PubMed]
[7] 林炳岐, 李峰, 马捷, 等. 基于GABA能系统通路探讨失眠的机制[J]. 现代生物医学进展, 2018, 18(3): 565-568.
[8] 王芳, 李经才, 徐峰, 等. 褪黑素对睡眠的调节作用及与脑内氨基酸递质的关系[J]. 中国现代应用药学, 2000(6): 467-469.
[9] Rondanelli, M., Opizzi, A., Monteferrario, F., Antoniello, N., Manni, R. and Klersy, C. (2011) The Effect of Melatonin, Magnesium, and Zinc on Primary Insomnia in Long-Term Care Facility Residents in Italy: A Double-Blind, Placebo-Controlled Clinical Trial. Journal of the American Geriatrics Society, 59, 82-90. [Google Scholar] [CrossRef] [PubMed]
[10] 魏士雄, 徐波, 刘琼, 等. 探讨女性更年期失眠的中医发病机制及防治[J]. 时珍国医国药, 2018, 29(3): 653-655.
[11] Liu, M. and Yang, Z. (2023) Research Progress of Traditional Chinese Medicine Treatment of Insomnia. MEDS Chinese Medicine, 5, 135-142.
[12] 吕改兰. 柴胡加龙骨牡蛎汤加减治疗肝郁化火型失眠的效果探讨[J]. 中国实用医药, 2023, 18(12): 25-28.
[13] Cao, J., Zhang, Q., Cui, S., Cui, X., Zhang, J., Zhang, Y., et al. (2010) Hypnotic Effect of Jujubosides from Semen Ziziphi Spinosae. Journal of Ethnopharmacology, 130, 163-166. [Google Scholar] [CrossRef] [PubMed]
[14] 刘彩玲. 酸枣仁汤加减治疗女性更年期失眠38例临床观察[J]. 中医临床研究, 2011, 3(23): 62-63.
[15] 乔传玖, 杨燕, 乔磊. 归脾汤加减对心脾两虚型失眠症患者睡眠质量及血清5-HT、DA水平的影响[J]. 现代医学与健康研究电子杂志, 2020, 4(3): 107-108.
[16] 李秀娟, 韩德元, 于士才. 加味归脾汤治疗女性更年期综合征220例[J]. 河北中医, 2001(11): 839-840.
[17] 赵心含, 胡霖霖. 交泰丸穴位贴敷对心肾不交失眠模型大鼠HPA轴相关激素的影响[J]. 浙江中西医结合杂志, 2024, 34(2): 129-134.
[18] 杨军雄, 张建平, 于建春, 韩景献. 针灸治疗失眠症的临床疗效研究[J]. 中国全科医学, 2013, 16(5): 466-468.
[19] 李艺, 夏勇, 刘世敏, 具紫勇, 史晓岚, 陈妙根, 程玲, 何金森. 电针对围绝经期综合征患者血清性激素的影响[J]. 上海针灸杂志, 2010, 29(4): 199-201.
[20] 陈秀玲, 罗仁瀚. 电针治疗更年期综合征的临床观察[J]. 针灸临床杂志, 2013, 29(8): 35-37.
[21] 单李杰, 李慧丽, 肖文娟, 等. 耳穴压豆治疗心悸疗效观察[J]. 中国中医药信息杂志, 2013, 20(8): 78-79.
[22] 单秋华, 孙冬梅, 吴富东. 耳穴贴压对女性更年期综合征患者血清内分泌素及β-内啡肽的影响[J]. 中国针灸, 2003(11): 47-49.
[23] 刘爱华. 耳穴压豆联合情志护理对围绝经期失眠患者的影响[J]. 中国中医药现代远程教育, 2022, 20(7): 139-141.
[24] 程伟, 陈君, 李剑. 低阻抗意念导入疗法联合穴位敷贴对抑郁症患者失眠严重指数评分、负面情绪和血清5-HT水平的影响[J]. 四川中医, 2022, 40(4): 191-194.
[25] 赵娜, 谢晨, 付聪, 刘臻, 于心同, 杨文佳, 陈云飞. 穴位贴敷对慢性失眠患者睡眠结构的影响[J]. 上海针灸杂志, 2023, 42(9): 917-922.
[26] 郭爱松, 刘春, 李百胜, 等. 穴位埋线对失眠大鼠下丘脑单胺类递质及IL-1β、TNF-α含量的影响[J]. 上海针灸杂志, 2014, 33(7): 672-675.
[27] 章少颖, 徐福, 周海江, 胡迎秋, 诸剑芳, 陈益丹. 穴位埋线治疗气血两虚型失眠症的临床观察[J]. 上海中医药杂志, 2017, 51(4): 63-66.
[28] 俞鑫佳, 王松根. 穴位埋线治疗女性更年期失眠疗效观察[J]. 上海针灸杂志, 2015, 34(4): 323-325.
[29] 张淼苗, 张引, 胡敏, 等. 自助式正念减压疗法改善女性更年期综合征负性情绪的随机对照研究[J]. 同济大学学报(医学版), 2022, 43(2): 254-261.
[30] 隋明凤. 太极拳运动疗法治疗女性更年期综合征36例[J]. 西部中医药, 2012, 25(9): 84-85.
[31] 贾文秀. 瑜伽锻炼对更年期女性抑郁、焦虑情绪及睡眠质量的影响[D]: [硕士学位论文]. 石家庄: 河北师范大学, 2016.
[32] 席思思, 胡哲文, 白文佩. 更年期患者膳食结构及饮食指导的必要性分析[J]. 中国妇幼健康研究, 2017, 28(8): 989-991+1016.