Clinical Study On Perimenopausal Insomnia Of Kidney Deficiency And Liver Depression Type Based On "Hechang Xuanfu" Traditional Chinese Medicine Combined With Auricular Point Sticking And Pressing

Objective Under the guidance of professor Jiang Lijuan’s thought of"Hechang",based on the treatment of"Hechang Xuanfu",the clinical symptoms of perimenopausal insomnia（PMI）patients with kidney deficiency and liver depression,Pittsburgh sleep quality index（PSQI）,modified Kupperman score,follicle stimulating hormone（FSH）,estradiol（E2）The effect of luteinizing hormone（LH）,the improvement of symptoms and long-term efficacy of PMI patients before and after treatment were statistically analyzed,Compare the curative effect difference between Changgeng Zhumian Decoction combined with ear point sticking and pressing and taking Changgeng Zhumian Decoction alone.To sum up a safe,effective,simple treatment that can be popularized in the community and improve the quality of life of PMI patients in the community.Methods Seventy-two cases meeting the inclusion criteria were randomly divided into control group（Chinese medicine Changgeng Zhumian Decoction）and treatment group（Chinese medicine Changgeng Zhumian Decoction+ear point sticking and pressing）with36 cases each.After being enrolled in the group,the treatment was started for 3 courses,and the changes in the integral table of TCM syndromes,PSQI score,modified Kupperman Index score,hormone level（FSH,E2,LH）,blood routine,liver and kidney function,and routine stool and urine routine were monitored before and after treatment.Through statistical analysis of data,the improvement of clinical symptoms and various indicators and clinical safety of the two groups after treatment were evaluated.Results 36 cases meeting the inclusion criteria were collected in each group.During the study and observation period,4 cases were excluded from the treatment group and 5 cases were excluded from the control group.1.TCM syndrome score:（1）TCM syndrome total score evaluation（see Table 8）:the internal comparison of the two groups showed that the total score of TCM syndrome before and after treatment was significantly improved（P<0.05）,Compared between the two groups,the improvement of the total score of TCM syndromes in the treatment group was better than that in the control group（P₁<0.05）.（2）Evaluation of TCM syndrome factor scores（see Table 9）:The internal comparison of the two groups showed that the TCM syndrome factor scores of the two groups were significantly improved before and after treatment（P<0.05）,In comparison between the two groups,after overall treatment,the treatment group was better than the control group in improving insomnia,hot flashes,sweating,irritability,forgetfulness,and five-heart irritability symptoms（P₁<0.05）,There was no statistical difference between the two groups in improving the symptoms of dizziness,tinnitus,palpitation,waist and knee tenderness,dry mouth and dry throat（P₁>0.05）.（3）TCM syndrome effect（see Table 10）:after treatment,5 cases in the treatment group were cured,17 cases were significantly effective,7 cases were effective,and 3 cases were ineffective,In the control group,2 cases were cured,10 cases were markedly effective,14 cases were effective and 5 cases were ineffective,The curative effect of TCM syndrome in the treatment group was better than that in the control group（P<0.05）.2.PSQI score:（1）PSQI total score evaluation（see Table 13）:internal comparison of the two groups showed that the total PSQI score before and after treatment was significantly improved（P<0.05）,Compared between the two groups,the improvement of PSQI total score in the treatment group was better than that in the control group after the overall treatment of the two groups（P₁<0.05）.（2）PSQI factor score evaluation（see Table14）:the PSQI factor scores of the two groups before and after treatment were significantly improved（P<0.05）,Comparison between groups,After overall treatment,the treatment group was better than the control group in improving sleep quality,sleep time and sleep disorder（P₁<0.05）,There was no statistical difference between the two groups in improving sleep time,sleep efficiency and daytime dysfunction（P₁>0.05）.（3）Comprehensive effect of sleep（see Table 15）:after treatment,7 cases in the treatment group were cured,17 cases were markedly effective,6 cases were effective and 2 cases were ineffective,In the control group,3 cases were cured,11 cases were markedly effective,13 cases were effective and 4 cases were ineffective,The comprehensive effect of sleep in the treatment group was better than that in the control group（P<0.05）.3.Kupperman Index score:（1）Kupperman Index total score evaluation（see Table 18）:internal comparison of the two groups showed that the total Kupperman Index score before and after treatment was significantly improved（P<0.05）,Compared between groups,the improvement of Kupperman Index total score in the treatment group was better than that in the control group after the overall treatment of the two groups（P₁<0.05）.（2）Kupperman Index factor score evaluation（see Table 19）:The Kupperman Index is composed of 13symptom factors,compared within the group,the treatment group had significant improvement in hot flashes,sweating,insomnia,mood swings,depression,suspicion,dizziness,fatigue,headache,palpitation,and skin abnormal sensation symptoms before and after treatment（P<0.05）,There was no significant improvement in the symptoms of sensory abnormalities,bone joint and muscle pain,sexual life and urinary tract infection（P>0.05）,In the control group,the symptoms of hot flashes,sweating,insomnia,mood swings,dizziness,fatigue and palpitation were significantly improved before and after treatment（P<0.05）,while the other symptoms were not significantly improved（P>0.05）.In comparison between the two groups,after overall treatment,the treatment group was better than the control group in improving hot flashes,sweating,insomnia,mood swings,depression,suspicion,headache（P₁<0.05）,There was no statistical difference between the two groups in improving sensory abnormalities,dizziness,fatigue,bone and joint pain,muscle pain,palpitation,abnormal skin sensation,sexual life and urinary infection（P₁>0.05）.4.Serum E2,FSH and LH hormone levels（see Table 21）:（1）The internal comparison of the two groups showed that the serum E2,FSH and LH hormone levels were significantly improved before and after treatment（P<0.05）,（2）Compared with the control group,the improvement of serum E2,FSH and LH hormone levels in the treatment group was better than that in the control group after the overall treatment of the two groups（P₁<0.05）.5.Safety indicators:During the study,the safety indicators of the two groups of patients were normal,and there were no treatment-related adverse reactions.6.Long-term curative effect（see Table 22）:Follow-up after 8 weeks of drug withdrawal showed that there were no recurrent cases in the treatment group,with a recurrence rate of 0.0%,In the control group,4 cases recurred,the recurrence rate was19.2%,The long-term effect of the treatment group was better than that of the control group（P<0.05）.Conclusion1.Changgeng Zhumian Decoction combined with ear acupoint sticking can effectively treat perimenopausal insomnia of kidney deficiency and liver depression,significantly improve sleep quality,prolong sleep time,and relieve daytime dysfunction.While significantly improving the sleep condition of patients,it can comprehensively improve perimenopausal symptoms such as hot flashes and sweating,and its effect is better than that of oral Changgeng Zhumian Decoction alone.2.Changgeng Zhumian Decoction combined with ear point sticking and pressing can improve the E2 level of PMI patients to a certain extent,reduce the FSH and LH levels,and has a better effect than oral Changgeng Zhumian Decoction in regulating and improving the level of serum sex hormones.3.Changgeng Zhumian Decoction combined with ear point sticking and pressing is safe and effective in treating PMI patients,and it is not easy to relapse after drug withdrawal,which is worthy of further promotion and application in clinical and community practice.