针刺联合八段锦治疗围绝经期失眠的临床观察

Clinical Observation of Acupuncture Combined with Baduanjin in the Treatment of Perimenopausal Insomnia

摘要: 目的：观察针刺联合八段锦治疗围绝经期失眠临床疗效的影响。方法：66例围绝经期失眠患者按就诊先后顺序分为实验组与对照组，每组33例。对照组采用常规针刺方法，取照海(双)、申脉(双)、神门(双)、三阴交(双)、安眠(双)、百会、四神聪等针刺治疗，每次留针40 min，1次/日，6次/周，每疗程间隔1日，共治疗4周。实验组在对照组常规针刺的基础上，在医生指导下进行《健身气功•八段锦》，每次30 min，每日早晚各1次，共练习4周。观察两组患者治疗前、治疗后PSQI量表评分以及患者改良Kupperman评分。结果：两组患者治疗前PSQI总分及睡眠时间、睡眠效率、入睡时间、睡眠质量、睡眠障碍、日间功能障碍评分比较差异均无统计学意义(均P > 0.05)，组间具有可比性。治疗结束后28 d两组患者PSQI总分及睡眠时间、睡眠效率、入睡时间、睡眠质量、睡眠障碍、日间功能障碍评分均低于治疗前(均P < 0.05)，且观察组均低于对照组(均P < 0.05)。与治疗前比较，观察组患者潮热出汗、失眠、情绪波动、抑郁疑心、眩晕、疲乏、头痛、心悸，总分显著降低(P < 0.01)，骨关节痛评分明显降低(P < 0.05)；对照组患者失眠、情绪波动积分明显降低。结论：针刺联合八段锦能有效治疗围绝经期失眠质量，延长睡眠时间，具有积极的临床意义。

Abstract: Objective: To observe the effect of clinical efficacy of acupuncture combined with Baduanjin in the treatment of perimenopausal insomnia. Methods: Sixty-six patients with perimenopausal insomnia were divided into the experimental group and the control group in the order of consultation, with 33 cases in each group. The control group was treated with conventional acupuncture by taking Zhaohai (double), Shenmai (double), Shenmen (double), Sanyinjiao (double), Anmian (double), Baihui and Sishencong, each time staying for 40 min, 1 time/day, 6 times/week, with an interval of 1 day for each course of treatment, for a total of 4 weeks. In the experimental group, on the basis of conventional acupuncture in the control group, “Fitness Qigong-Baduanjin” was performed under the guidance of the doctor for 30 min each time, once a day in the morning and once in the evening, for a total of 4 weeks. The pre-treatment and post-treatment PSQI scale scores and the modified Kupperman scores of patients in both groups were observed. Results: There were no statistically significant differences in the total PSQI scores and sleep duration, sleep efficiency, time to sleep, sleep quality, sleep disturbance, and daytime dysfunction scores between the two groups before treatment (all P > 0.05), and the groups were comparable. At 28 d after the end of treatment, the total PSQI score and the scores of sleep time, sleep efficiency, sleep onset time, sleep quality, sleep disorder, and daytime dysfunction in both groups were lower than those before treatment (all P < 0.05), and both observation groups were lower than the control group (all P < 0.05). Compared with before treatment, patients in the observation group had significantly lower hot flashes and sweating, insomnia, mood swings, depression and suspicion, dizziness, fatigue, headache, palpitations, and total score (P < 0.01), and significantly lower bone and joint pain scores (P < 0.05); patients in the control group had significantly lower insomnia and mood swings scores. Conclusion: Acupuncture combined with Baduanjin can effectively treat the quality of perimenopausal insomnia and prolong sleep time, which has positive clinical significance.