标题：柴胡加龙骨牡蛎汤联合耳穴压豆治疗围绝经期失眠(肾虚肝郁型)的疗效及对患者血清5-HT、DA水平和睡眠质量的影响

      作者：李英 1，惠朋利 2    安康市中医医院治未病中心 1、老年病科 2，陕西 安康 725000

      卷次： 2021年32卷24期

      【摘要】 目的 探讨柴胡加龙骨牡蛎汤联合耳穴压豆治疗围绝经期失眠(肾虚肝郁型)的疗效及对患者血清5-羟色胺(5-HT)、多巴胺(DA)水平和睡眠质量的影响。方法 选择2017年9月至2019年9月安康市中医医院收治的103例围绝经期失眠(肾虚肝郁型)患者为研究对象，按照随机数表法分为观察组53例和对照组50例，对照组患者采用艾司唑仑片治疗，观察组患者在对照组治疗的基础上采用柴胡加龙骨牡蛎汤联合耳穴压豆治疗，7 d为一个疗程，连续治疗3个疗程。比较两组患者治疗前后的匹兹堡睡眠质量指数(PSQI)、抑郁自评量表(SDS)评分、焦虑自评量表(SAS)评分、中医症候积分、血清 5-HT及DA水平和不良反应发生情况。结果 治疗后，两组患者的 PSQI、SDS评分、SAS评分及中医症候积分显著降低，且观察组降低幅度明显大于对照组，差异均有统计学意义(P<0.05)；治疗后，两组患者的 5-HT及DA水平较治疗前明显升高，且观察组明显高于对照组，差异均具有统计学意义(P<0.05)；两组患者治疗期间的不良反应发生率比较差异无统计学意义(P>0.05)。结论 柴胡加龙骨牡蛎汤联合耳穴压豆治疗围绝经期失眠(肾虚肝郁型)可明显改善患者的失眠症状，提高睡眠质量，提升 5-HT及DA水平，值得临床推广应用。
      【关键词】 肾虚肝郁；失眠；柴胡加龙骨牡蛎汤；耳穴压豆；5-羟色胺；多巴胺；睡眠质量
      【中图分类号】 R711.51 【文献标识码】 A 【文章编号】 1003—6350（2021）24—3166—04

Efficacy of Bupleurum Plus Dragon Bone and Oyster Shell Decoction combined with auricular point pressingbean in the treatment of perimenopausal insomnia (kidney deficiency and liver depression type) and influence onserum 5-hydroxytryptamine, dopamine level, and sleep quality.
LI Ying 1, HUI Peng-li 2. Pre-treatment Center 1,Department of Geriatrics 2, Ankang Hospital of Traditional Chinese Medicine, Ankang 725000, Shaanxi, CHINA
【Abstract】 Objective To investigate the efficacy of Bupleurum Plus Dragon Bone and Oyster Shell Decoction(Chaihu plus Longguoyster Decoction) combined with auricular point pressing bean in the treatment of perimenopausalinsomnia (kidney deficiency and liver stagnation type) and the effects on serum 5-hydroxytryptamine (5-HT), dopamine(DA) levels, and sleep quality. Methods A total of 103 patients with perimenopausal insomnia (kidney deficiency andliver depression type) admitted to Ankang Hospital of Traditional Chinese Medicine from September 2017 to September2019 were selected as the research objects, which were divided into an observation group (n=53) and a control group (n=50) according to random number table method. The control group was treated with estazolam tablet, and the observationgroup was additionally treated with Bupleurum Plus Dragon Bone and Oyster Shell Decoction combined with auricularpoint pressing bean, continuously for 3 courses, with 7 days as a course of treatment. Pittsburgh Sleep Quality Index(PSQI), Self-rating Depression Scale (SDS) score, Self-rating Anxiety Scale (SAS) score, TCM symptom score, serum5-HT, DA levels, and incidence of adverse reactions were compared between the two groups before and after treatment.Results After treatment, PSQI, SDS score, SAS score, and TCM syndrome score of the two groups were significantlydecreased, and the decrease range of the observation group was significantly greater than that in the control group (P<0.05). After treatment, the levels of 5-HT and DA in the two groups were significantly higher than those before treat-ment, and the levels in the observation group were significantly higher than those in the control group, with statisticallysignificant differences (P<0.05). There was no significant difference in the incidence of adverse reactions between thetwo groups during treatment (P>0.05). Conclusion Bupleurum Plus Dragon Bone and Oyster Shell Decoction com-bined with auricular point pressing bean in the treatment of perimenopausal insomnia (kidney deficiency and liver de-pression type) can significantly improve the symptoms of insomnia, sleep quality, and 5-HT and DA levels, which isworthy of clinical application.
      【Key words】 Kidney deficiency and liver depression; Insomnia; Bupleurum Plus Dragon Bone and Oyster ShellDecoction; Auricular point pressing bean; 5-hydroxytryptamine; Dopamine; Sleep quality