摘要
【目的】观察补肾调营卫法治疗绝经综合征失眠症的疗效及其治疗前后肠道菌群变化特点。【方法】将72例绝经综合征失眠症患者随机分为治疗组和对照组,每组各36例。治疗组给予二仙合桂枝汤加味方治疗,对照组给予克龄蒙口服治疗,连续服用21 d为1个疗程,停药7 d后开始下一疗程,共治疗3个疗程。观察2组患者治疗前后匹兹堡睡眠质量指数(PSQI)评分、中医证候积分、汉密尔顿焦虑量表(HAMA)评分、性激素水平及肠道菌群的变化情况,统计2组患者的临床疗效和不良反应发生情况。【结果】(1)研究过程中,对照组脱落5例,治疗组脱落7例,最终共有60例患者完成全部疗程的治疗,其中治疗组29例,对照组31例。(2)治疗3个疗程后,治疗组的总有效率为96.55%(28/29),对照组为83.87%(26/31),治疗组的疗效有优于对照组趋势,但组间比较,差异无统计学意义(P>0.05)。(3)治疗后,2组患者的PSQI评分、中医证候积分、HAMA评分均较治疗前明显改善(P<0.01),但治疗后组间比较,差异均无统计学意义(P>0.05)。(4)治疗后,对照组血清雌二醇(E2)水平较治疗前明显提高(P<0.01),血清卵泡刺激素(FSH)和黄体生成素(LH)水平较治疗前明显降低(P<0.01);而治疗组治疗前后血清E2、FSH和LH水平比较,差异均无统计学意义(P>0.05)。组间比较,对照组血清E2水平高于治疗组,但差异无统计学意义(P>0.05),血清FSH和LH水平低于治疗组,差异均有统计学意义(P<0.01)。(5)治疗组的不良反应发生率为11.11%(4/36),明显低于对照组的30.55%(11/36),差异有统计学意义(P<0.05)。(6)在种水平上,治疗组Alistipes finegoldii与PSQI评分、HAMA评分、中医证候积分均呈负相关,Clostridium celatum与中医证候积分呈负相关,Clostridium aldenense与HAMA评分、中医证候积分均呈负相关,以上3个菌种在治疗后的丰度均显著上调(LDA分数>2);对照组中与临床指标相关菌群在治疗后的丰�
Objective To investigate the efficacy of therapy of supplementing kidney and regulating nutritive qi and defensive qi in the treatment of patients with menopausal insomnia and to observe the changes in intestinal flora of the patients before and after treatment.Methods Seventy-two patients with menopausal insomnia were randomly divided into a treatment group and a control group,with 36 cases in each group.The treatment group was treated with Flavored Erxian plus Guizhi Decoction,while the control group was treated with oral use of Climen.Twentyone 21 days constituted one course of treatment,and the next course of treatment was started after 7 days of discontinuation.The treatment for the two groups lasted for 3 courses.The changes in the pittsburgh sleep quality index(PSQI)scores,traditional Chinese medicine(TCM)syndrome scores,Hamilton anxiety scale(HAMA)scores,sex hormone levels and intestinal flora of the two groups were observed before and after the treatment.After treatment,the clinical efficacy and the incidence of adverse effects of the two groups were evaluated.Results(1)During the trial,5 cases fell off from the control group and 7 cases fell off from the treatment group.A total of 60 patients finally completed the full course of treatment,including 29 cases in the treatment group and 31 cases in the control group.(2)After 3 courses of treatment,the overall effective rate of the treatment group was 96.55%(28/29)and that of the control group was 83.87%(26/31),with a trend of stronger efficacy in the treatment group than the control group,but the difference was not statistically significant(P>0.05).(3)After treatment,the PSQI scores,TCM syndrome scores and HAMA scores of the two groups were significantly improved compared with those before treatment(P<0.01),but the differences of the above scores between the two groups after treatment were not statistically significant(P>0.05).(4)After treatment,the serum estradiol(E2)level in the control group was significantly increased compared with that before treatmen
作者
朱敏
毛婷
刘雅倩
周英
ZHU Min;MAO Ting;LIU Ya-Qian;ZHOU Ying(The First Clinical Medical School,Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2023年第7期1660-1671,共12页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
广州市市校(院)联合资助(登峰医院)基础研究项目(编号:202102010400)。
关键词
绝经综合征
失眠症
补肾调营卫法
二仙合桂枝汤加味方
肠道菌群
临床疗效
perimenopause syndrome
insomnia
therapy of supplementing kidney and regulating nutritive qi and defensive qi
Flavored Erxian plus Guizhi Decoction
intestinal flora
clinical efficacy
