The Clinical Observation In The Liver-fire Type Of Perimenopausal Insomnia Treated By Acupunture And Medicine

Objective:To observe the clinical efficacy of acupuncture and medicine on perimenopausal liver-fire type insomnia,and explore new ideas for clinical treatment of perimenopausal liver-fire type insomnia.Methods:66 patients who were diagnosed as menopausal liver-fire type insomnia in the Outpatient Department 1 of Gynecology,Second Affiliated Hospital of Heilongjiang University of Chinese Medicine from December 2020 to December 2021 were selected as research objects.They were randomly divided into acupuncture combined with medicine group(33 cases)and medicine group(33 cases).Acupuncture combined with medicine group(hereinafter referred to as acupuncture-medicine group)selected Ganshu and Danshu as major acupuncture points,and Xingjian,Taichong,Shenmen and Sanyinjiao as adjunct acupuncture points.Acupuncture was given once a day and five times a week.Combined with drug treatment,Danzhi Xiaoyao Capsules was taken orally,with 9g each time,twice a day until the end of the treatment cycle.Oral Chinese medicine group(hereinafter referred to as medicine group)simply oral Danzhi Xiaoyao Capsules,9g each time,twice a day.The treatment period of acupuncture-medicine group and medicine group lasted for 4 weeks for a course of treatment,a total of 4 weeks.After the end of the treatment,the patients in acupuncture-medicine group and medicine group were followed up for 4 weeks.Record the score changes of the subjects on the Pittsburgh sleep quality index(PSQI),Modified Kupperman Scale and TCM Syndrome Scale before and after treatment,and Pittsburgh sleep quality index(PSQI)and TCM Syndrome Scale were recorded in the follow-up period after treatment,and the long-term curative effect was observed after the follow-up period.All the data about statistical analysis were processed and analyzed by SPSS22.0 software.Results:1.During treatment,2 cases were dropped out(1 case in medicine group and 1 case in acupuncture-medicine group),and data statistics of 64 cases were carried out.During the follow-up period,5 cases failed to be followed up,and data statistics of 59 cases were carried out.2.Intra-group comparison:(1)PSQI score results: In the two groups,PSQI before treatment,after treatment and four weeks of follow-up were compared,the difference was statistically significant(P < 0.05);(2)Modified Kupperman score scale results:In the two groups,before treatment,after treatment of the modified Kupperman Scale scores were compared,with statistical significance(P< 0.05).(3)TCM Syndrome Scale score results:In the two groups,the scores of TCM syndrome scale after treatment and during follow-up period were compared,with statistical significance.There was no statistical significance in the scores of TCM syndrome scale between the two groups before treatment.3.Inter-group comparison:(1)After treatment,the PSQI scores between the two groups were compared.The results showed that there were significant differences between the two groups in the four dimensions such as sleep quality,sleep time,sleep efficiency and sleep disorder and overall score(P<0.05).The total score in acupuncture-medicine group was better than that in medicine group.There was no significant difference between sleep time and daytime dysfunction(P>0.05).(2)After treatment,the improved Kupperman scores between the two groups were compared,the total score in acupuncture-medicine group better than that in medicine group(P< 0.05).(3)After treatment,the scores of TCM syndromes between the two groups were compared.The results showed that there were significant differences between the two groups in the four items of vexation,insomnia,irritability,chest and hypochondriac pain,bitter mouth and halitosis and the overall scores(P<0.05).The total score in acupuncture-medicine group is better than that in medicine group.The difference between headache,dizziness and dry stool was not statistically significant(P>0.05).(4)During the follow-up period of 4 weeks,the PSQI score and TCM syndrome score between acupuncture-medicine group and medicine group were compared,and the total score of PSQI score and TCM syndrome score in acupuncture-medicine group was better than those in medicine group.4.Comparison of clinical efficacy:After treatment for 4 weeks,the total effective rate in acupuncture-medicine group was 87.50%,while that in medicine group was 75.00%,and the difference was statistically significant(P<0.05).Conclusion:1.Acupuncture combined with Danzhi Xiaoyao Capsules and oral Danzhi Xiaoyao Capsules alone can improve the sleep problems and related clinical symptoms of perimenopausal liver-fire type insomnia.2.Acupuncture combined with Danzhi Xiaoyao Capsules is superior to Danzhi Xiaoyao capsules alone in improving PSQI total score,improved Kupperman score and TCM syndrome score of perimenopausal liver-fire type insomnia,with stable effect.3.Acupuncture combined with Danzhi Xiaoyao Capsules has better continuous efficacy and lower recurrence rate than oral Danzhi Xiaoyao Capsules alone.4.Acupuncture combined with Danzhi Xiaoyao Capsules has more advantages in improving the comprehensive symptoms of perimenopausal liver-fire type insomnia than oral Danzhi Xiaoyao Capsules alone.