Clinical Observation On Acupuncture Combined With Gengnianjian Decoction In Treating Insomnia Of Kidney Yin Deficiency Type In Perimenopausal Period

Objective:Observing the clinical effect of acupuncture combined with Gengnianjian Decoction on insomnia of kidney-yin deficiency type perimenopausal period,and providing theoretical basis for the treatment of this disease by traditional Chinese medicine.Method:Select the perimenopausal insomnia patients who were treated in the outpatient department of the gynecology department of the Affiliated Hospital of Tianjin Academy of Chinese Medicine from October 2017 to December 2019,and 65 perimenopausal insomnia patients who met the inclusion criteria after screening were selected according to the random allocation method It is divided into a control group（32 cases）and a treatment group（33cases）.The control group is treated with acupuncture alone,acupuncture twice a week,4weeks as a course of treatment,and 3 consecutive courses of treatment;the treatment group is in the acupuncture group On the basis of therapy,add Gengnianjian Decoction,traditional Chinese medicine decoction twice a day,and take it warmly after a meal.The treatment period is the same as the control group.Before and after treatment,the patient’s TCM syndrome score,modified kupperman score,PSQI（Pittsburgh Sleep Quality Index）total score and its scores,three sex hormones FSH（Follicle stimulating hormone）,LH（Luteinizing hormone,luteinizing hormone）,E2（Estradiol,estrogen）,as the evaluation index of clinical efficacy,observe the differences between the two groups before and after treatment.Result:1.Baseline comparison:Before treatment,the two groups of patients were compared in general conditions such as age,course of disease,TCM syndrome score,modified kupperman score and PSQI score,and sex hormone levels（P>0.05）Comparable.2.TCM syndrome score comparison:within-group comparison:TCM syndrome score comparison before and after treatment,the difference is statistically significant（P<0.05）.Comparison between groups:The difference in TCM syndrome scores between the two groups after treatment is statistically significant（P<0.05）,indicating that both groups can reduce TCM syndrome scores,but the effect of acupuncture combined with Gengnianjian Decoction is better than simple acupuncture treatment.Comparison of TCM symptom scores:Comparison within groups:Before and after treatment of TCM symptom scores,the P values of both groups were<0.05,and the difference was statistically significant.Comparison between groups:Comparison of TCM symptom scores between the two groups after treatment,P<0.05,the difference was statistically significant.3.Modified kupperman score comparison:intra-group comparison:after treatment,the kupperman scores of both groups decreased,the difference was statistically significant （P<0.05）;comparison between groups:after treatment,the score improvement between the two groups was compared,the difference was statistically significant Significance （P<0.05）,indicating that both groups can reduce the modified kupperman score,and the effect of acupuncture combined with Gengnianjian decoction is better than simple acupuncture treatment.4.Comparison of total PSQI scores and other scores:Comparison within the group:The total PSQI scores and scores of the control group and the treatment group were significantly lower than before treatment,and the difference was statistically significant （P<0.05）.Comparison between groups:After treatment,there was no statistically significant difference in sleep quality score between the two groups（P>0.05）;the total PSQI score,time to fall asleep,sleeping time,sleeping efficiency,daytime dysfunction improvement,the treatment group was better The group had a significant advantage （P<0.01）;in terms of hypnotic drugs and sleep disorders,the difference was statistically significant（0.01<P<0.05）,indicating that there was not much difference in the improvement of sleep quality between the two groups,and the PSQI total score In terms of time to fall asleep,sleeping time,sleeping efficiency,and improvement of daytime dysfunction,the treatment group had significant advantages.5.Comparison of three levels of sex hormones:intra-group comparison:the comparison of the three levels of sex hormones before and after treatment in the control group,the FSH and LH levels are both P>0.05,the difference is not statistically significant,the E2 level before and after treatment,the difference is statistically significant（P<0.05）,indicating that acupuncture treatment can improve E2 levels,but the improvement of FSH and LH is not obvious;the comparison of the three levels of sex hormones before and after the treatment group,the difference is statistically significant（P<0.05）,indicating that acupuncture combined with menopause Jiantang can improve the sex hormones.Comparison between groups:After treatment,the FSH and E₂level between the two groups were P>0.05,the difference was not statistically significant;the LH level was compared,the difference was statistically significant（P<0.05）,indicating that acupuncture combined with Gengnianjian Decoction Compared with simple acupuncture treatment,the effect of improving LH level is obvious.6.Comparison of overall clinical effectiveness:The total effective rate in the control group is 71.88%,and the total effective rate in the treatment group is 93.94%.The comparison between the two groups is statistically significant（P<0.05）,indicating that acupuncture combined with Gengnianjian decoction Kidney yin deficiency type perimenopausal insomnia is better than simple acupuncture treatment.7.During the clinical study,no adverse events and serious adverse events occurred in either group.Conclusion:1.Acupuncture combined with Gengnianjian Decoction is better than pure acupuncture in treating kidney yin deficiency type perimenopausal insomnia,especially in improving time to fall asleep,sleep time,sleep efficiency and daytime dysfunction.2.Acupuncture combined with Gengnianjian Decoction has certain improvement effects on FSH,LH and E₂.Acupuncture treatment alone can improve patients’E₂level,but the improvement effect on FSH and LH is not obvious.Compared between the two groups,acupuncture combined with Gengnianjian Decoction has obvious effect in improving LH level,and has certain advantages over simple acupuncture.