董氏奇穴埋线联合耳尖放血治疗心肾不交型围绝经期综合征伴失眠的疗效观察OACSTPCD

Objective To observe the clinical efficacy of treating perimenopausal syndrome complicated with insomnia due to disharmony between the heart and kidney with catgut embedding at DONG's extra points plus ear apex bloodletting.Method A total of 207 patients with perimenopausal syndrome complicated with insomnia due to disharmony between the heart and kidney were selected.After 20 cases dropped out,187 patients were recruited and divided into a control group(57 cases),an acupuncture group(65 cases),and a catgut embedding group(65 cases)using the block randomization method.The control group was treated with oral administration of Kun Tai capsules,the acupuncture group was given ordinary acupuncture at DONG's extra points plus ear apex bloodletting,and the catgut embedding group was offered catgut embedding at DONG's extra points plus ear apex bloodletting.The clinical efficacy,recurrence,and adverse reactions were compared among the three groups.Before and after the treatment,the three groups were observed for changes in the Pittsburgh sleep quality index(PSQI)score,symptom score of traditional Chinese medicine(TCM),perimenopausal symptom score,and serum levels of sleep-related factors and hormones[follicle-stimulating hormone(FSH),estradiol(E2),luteinizing hormone(LH),5-hydroxytryptamine(5-HT),brain-derived neurotrophic factor(BDNF),and glial cell line-derived neurotrophic factor(GDNF)].Result The catgut embedding group had a higher total effective rate(P＜0.05)and a lower recurrence rate(P＜0.05)compared to the other two groups;the differences in the adverse reaction rate were statistically insignificant among the three groups(P＞0.05).After the treatment,the PSQI score decreased in all three groups(P＜0.05);the catgut embedding group was lower than the control group in comparing the PSQI scores of sleep quality,sleep latency,sleep duration,sleep disturbance,and daily dysfunction as well as the PSQI global score(P＜0.05);compared to the acupuncture group,the catgut embedding group had lower PSQI scores of sleep duration and sleep efficiency and the global score(P＜0.05).After the intervention,the TCM symptom score dropped in the three groups(P＜0.05)and was significantly lower in the catgut embedding group than in the other two groups(P＜0.05).The perimenopausal symptom score decreased after the treatment in all three groups(P＜0.05)and was lower in the catgut embedding and acupuncture groups than in the control group(P＜0.05).After the treatment,the serum levels of E2,5-HT,BDNF,and GDNF elevated in the three groups(P＜0.05);the catgut embedding group had higher serum levels of 5-HT,BDNF,and GDNF than the control group(P＜0.05)and had a higher serum 5-HT level than the acupuncture group(P＜0.05).Conclusion Catgut embedding at DONG's extra points plus ear apex bloodletting can produce more significant efficacy than oral Chinese medication and acupuncture treatment for perimenopausal syndrome complicated with insomnia due to disharmony between the heart and kidney;this method can improve clinical symptoms and sleep quality and lower recurrence,which may be associated with up-regulating the levels of 5-HT,BDNF,and GDNF.