| Objective:To observe the clinical effect of syndrome differentiation and scrapping combined with ear acupoint pressing with bean-pressing in the treatment of perimenopausal insomnia(deficiency of heart and spleen),and to evaluate the effect of this treatment on sleep quality,traditional Chinese medicine(TCM)syndrome,anxiety and menopausal comprehensive symptoms,so as to provide more traditional Chinese medicine combined external treatment for perimenopausal insomnia(deficiency of heart and spleen).Methods:A total of 120 patients with perimenopausal insomnia(deficiency of heart and spleen)were randomly divided into control group(n=30),syndrome syndromic scraping group(n=30),ear acupoint pressing bean group(n=30)and combination group(n=30).The control group was treated with Guipi decoction,1 dose a day,once in the morning and once in the evening.The treatment was given for 6 days and rested for 1 day.The treatment given for 1 week as a course of treatment.On the basis of Guipi decoction,the syndrome differentiation and scraping therapy was applied to the acupoints Sishencong,Baihui,Fengchi,Xinshu,Pishu,Shenmen and S any injiao in the syndrome differentiation and scraping group.The main scraping meridians are the shaoyin heart meridian,the Taiyang bladder meridian,and the Taiyin spleen meridian.Scraping was performed once a week for 4 weeks.On the basis of Guipi decoction,the patients in the auricular point pressing therapy group were treated with auricular point pressing therapy.The eight main points of auricular tip,Shenmen,subcortical,hear,spleen,occipital,sympathetic point and neurasthenia point were applied for pressing therapy.According to the clinical symptoms of the patients,the auricular point was replaced twice a week for 4 weeks.In the combination group,on the basis of Guipi decoction,scraping based on syndrome differentiation and auricular point pressure were applied.At the first visit every week,the patients were treated with scraping based on syndrome differentiation and auricular point sticking,and only the auricular point sticking was replaced at the second visit.Sleep quality index(PSQI),TCM syndrome rating scale,Self-rating Anxiety Scale(SAS)and menopausal syndrome scale were used to evaluate the intervention effect before intervention and one month after intervention.Chi-square test,one-way analysis of variance and non-parametric Kruskal-Wallis test were used for statistical analysis.Results:1,Case completion and dropoutFinally,a total of 102 patients completed this study,including 25 cases in the control group,24 cases in the Buxinpisha group,27 cases in the auricular point pressure bean group and 26 cases in the combined group.2.Baseline comparisonBefore intervention,there were no significant differences in general data,PSQI factor scores and total scores,TCM syndrome scores,SAS scores and menopausal syndrome scores among the four groups(P>0.05),which were comparable.3.Comparison of sleep quality before and after intervention(1)Comparison of PSQI scores1)Analysis by time:after one month of intervention,the PSQI scores of the control group,the Buxinpi scraping group and the auricular acupoint pressure with bean-pressing group were significantly lower than those before intervention except for sleeping pills(P<0.05).After one month of intervention,the item scores and total scores of PSQI in the combined group were significantly lower than those before intervention(P<0.05).2)Analysis according to intervention measures:different intervention measures need to be analyzed in pairs.After one month of intervention,except sleeping drugs,the scores of each item and total score of PSQI in the Buxinpi scraping group,ear acupoint pressing with bean-pressing group and combination group were significantly different from those in the control group(P<0.05).After one month of intervention,the PSQI total score of the Buxinpi scraping group was significantly different from that of the auricular acupressure bean therapy group(P<0.05).After one month of intervention,the scores of "sleep quality","time to fall asleep","sleep time","sleep efficiency",daytime dysfunction" and "PSQI total score" in the combined group were significantly different from those in the Buxinpi scraping group and the auricular acupressure bean-pressing group(P<0.05).(2)comparison of sleep efficacyIn the Guipi decoction group,1 case was cured,6 cases were markedly effective,11 cases were effective,and 6 cases were ineffective,with an effective rate of 76.0%.In the Buxinpi-scraping group,2 cases were cured,7 cases were markedly effective,10 cases were effective,5 cases were ineffective,and the effective rate was 79.1%.In the auricular bean pressure group,2 cases were cured,9 cases were markedly effective,11 cases were effective,and 5 cases were ineffective,with an effective rate of 81.5%.In the combined group,3 cases were cured,10 cases were markedly effective,9 cases were effective,and 4 cases were ineffective,with an effective rate of 84.7%.The four intervention methods can effectively improve the sleep quality of perimenopausal patients with insomnia(deficiency of heart and spleen),and the efficacy is similar.4.comparison of TCM syndromes before and after intervention(1)Comparison of TCM syndrome scores1)Analysis by time:after one month of intervention,the scores of each TCM syndrome item measured in the control group,the Buxinpi scraping group and the auricular acupoint pressure bean-pressing group were significantly lower than those before intervention(P<0.05)except for the scores of "forbearance" and "less food and intolerance".After one month of intervention,the factor scores of each item and the total score of TCM syndromes in the combined group were significantly lower than those before intervention(P<0.05).2)Analysis according to intervention measures:different intervention measures were analyzed in pairs.After one month of intervention,except for the factor scores of"forbearance" and "less food and intolerance",the scores of each item and the total score of TCM syndromes in the Buxinpi scraping group,auricular acupoint pressing with bean-pressing group and combination group were significantly different from those in the control group(P<0.05).After one month of intervention,the score of "dizziness and dizziness" in the Buxinpi scraping group was significantly different from that in the auricular acupressure bean therapy group(P<0.05).After one month of intervention,the scores of "difficulty in falling asleep" and "palpitation" in the auricular acupressure bean-pressing group were significantly different from those in the Buxinpi scraping group(P<0.05).After one month of intervention,the scores of "difficulty in falling asleep","palpitations","dizziness","fatigue","facial color is not hua","red tongue,thin white fur,weak pulse" and "total score" in the combined group were significantly different from those in the Buxinpi-scraping group and the auricular acupoint pressing beans group(P<0.05).(2)Comparison of TCM syndromes:in the Guipi decoction group,1 case was cured,4 cases were markedly effective,13 cases were effective,7 cases were ineffective,and the effective rate was 72.0%.In the Buxinpi-scraping group,1 case was cured,5 cases were markedly effective,12 cases were effective,6 cases were ineffective,and the effective rate was 75.0%.In the auricular acupressure bean therapy group,1 case was cured,7 cases were markedly effective,12 cases were effective,8 cases were ineffective,and the effective rate 78.1%.In the combined group,2 cases were cured,8 cases were markedly effective,12 cases were effective,and 4 cases were ineffective,with an effective rate of 84.6%.It is concluded that the four intervention schemes can effectively relieve the symptoms of heart and spleen deficiency in perimenopausal insomnia patients,and the efficacy is equivalent.5.Comparison of SAS scores before and after intervention(1)Analysis by time:SAS scores measured before and after intervention were statistically significant(P<0.05);After one month of intervention,the SAS scores of the control group,the Buxinpi-scraping group,the auricular acupressure bean group and the combination group were significantly lower than those before intervention(P<0.05).(2)Analysis according to intervention measures:after one month of intervention,compared with the control group,the anxiety scores of the Buxinpi scraping group,the auricular acupoint pressing With bean group and the combination group were statistically significant(P<0.05).After one month of intervention,there was no statistically significant difference in the anxiety score between the auricular acupressure bean group and the Buxinpi scraping group(P>0.05).After one month of intervention,the anxiety score of the combined group was statistically significant compared with that of the Buxinpi-scraping group and the auricular acupoint pressing bean group(P<0.05).6.Comparison of modified Kupperman scale scores before and after intervention.(1)Analysis by time:Kupperman scale scores measured before and after intervention were statistically significant(P<0.05);After one month of intervention,the symptom scores of menopausal syndrome in the control group,syndrome differentiation scraping group,auricular acupressure bean-pressing group and combined group were significantly lower than those before intervention(P<0.05).(2)Analysis according to intervention measures:after one month of intervention,compared with the control group,the symptom scores of menopausal syndrome in the syndrome differentiation and scraping group,ear acupoint pressing with bean group and combination group were statistically significant(P<0.05).After one month of intervention,there was no statistically significant difference in the symptom score of menopausal syndrome between the auricular acupressure beas-pressing group and the syndrome differentiation and scraping group(P>0.05).After one month of intervention,the symptom scores of menopausal syndrome in the combined group were statistically significant compared with those in the syndrome differentiation scraping group and ear acupoint pressing with beans group(P<0.05).Conclusions:(1)The four schemes of Guipi decoction group,syndrome differentiation and gua gua group,ear acupoint pressing with bean-pressing group and combination group can effectively improve the sleep quality of perimenopausal insomnia patients(deficiency of heart and spleen),reduce the TCM syndrome of deficiency of heart and spleen,improve anxiety and relieve the symptoms of perimenopausal syndrome,and the incidence of adverse reactions is low.The combination of oral Chinese medicine decoction and two kinds of external treatment of traditional Chinese medicine in the combined group had the best effect.(2)In a short period of time(one month),scraping therapy based on syndrome differentiation has more obvious effects on relieving dizziness and improving total sleep quality than the auricular acupoint pressure therapy group,but the effect of the auricular acupoint pressure therapy is more prominent in shortening the time of falling asleep and relieving palpitations.Guipi decoction combined with gua sha based on syndrome differentiation and ear acupoint pressure with beanpressing is more effective in improving sleep quality,shortening sleep onset time,prolonging sleep time,improving sleep efficiency,reducing daytime dysfunction,comprehensively improving sleep quality,improving traditional Chinese medicine syndromes,and relieving the symptoms of perimenopausal syndrome. |
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