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围绝经期睡眠障碍的非药物疗法治疗研究进展
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Abstract:
睡眠障碍是围绝经期女性常见症状之一，临床表现为入睡困难，夜间觉醒次数增多，睡眠质量下降等。非药物疗法治疗围绝经期睡眠障碍的方法有针灸、穴位贴敷、穴位埋线等中医外治法、心理疗法、运动疗法等，上述疗法治疗围绝经期睡眠障碍的疗效较为明确。其中中医外治法可单独或与药物等常规方法联合应用，具有整体调节的特色诊疗优势，心理疗法对医师专业技能要求较高。目前关于非药物疗法围绝经期睡眠障碍的研究多以观察临床疗效为主，少见作用机制探讨及大样本临床研究，相关疗法临床操作规范化也有待进一步研究。
Sleep disorder is one of the common symptoms of perimenopause women, which is clinically manifested as difficulty in falling sleep, increasing number of night awakneings, and decreasing sleep quality. Non-drug therapy for perimenopausal sleep disorders include acupuncture and moxibustion, acupoint application, acupoint embedding and other external treatment of traditional Chinese medicine, psychotherapy, exercise therapy, etc. The therapeutic effect of the above therapy for perimenopausal sleep disorders is relatively clear. The external treatment of traditional Chinese medicine can be applied alone or in combination with convetional methods such as drugs, which has the characteristics of diagnosis and treatment advantages of overall regulation. Psychological therapy requires high professional skills of physicians. At present, the research on non-drug therapy for perimenopausal sleep disorders mainly focuses on the observation of clinical efficacy, and rarely discusses the mechanism of action and large-scale clinical studies. The standardization of clinical operation of related therapies also needs further research.
| [1] | 赵媛, 陈庆秋, 蒋成刚. 多导睡眠监测研究围绝经期女性失眠障碍的临床特征[J]. 第三军医大学学报, 2021, 43(19): 1854-1859. |
| [2] | El Khoudary, S.R., Greendale, G., Crawford, S.L., Avis, N.E., Brooks, M.M., Thurston, R.C., et al. (2019) The Menopause Transition and Women’s Health at Midlife: A Progress Report from the Study of Women’s Health across the Nation (SWAN). Menopause, 26, 1213-1227. https://doi.org/10.1097/gme.0000000000001424 |
| [3] | 梁晓仙, 丁晓云, 金运钦, 等. 中国40-65岁女性人群失眠症状流行特征的Meta分析[J]. 中国预防医学杂志, 2021, 22(9): 670-679. |
| [4] | 中华预防医学会更年期保健分会, 中国人体健康科技促进会妇科内分泌和生育力促进专委会, 北京中西医结合学会更年期专业委员会, 等. 绝经相关失眠临床管理中国专家共识[J]. 中国全科医学, 2023, 26(24): 2951-2958. |
| [5] | Haufe, A., Baker, F.C. and Leeners, B. (2022) The Role of Ovarian Hormones in the Pathophysiology of Perimenopausal Sleep Disturbances: A Systematic Review. Sleep Medicine Reviews, 66, Article 101710. https://doi.org/10.1016/j.smrv.2022.101710 |
| [6] | Laudisio, D., Barrea, L., Pugliese, G., Aprano, S., Castellucci, B., Savastano, S., et al. (2020) A Practical Nutritional Guide for the Management of Sleep Disturbances in Menopause. International Journal of Food Sciences and Nutrition, 72, 432-446. https://doi.org/10.1080/09637486.2020.1851658 |
| [7] | Coborn, J., de Wit, A., Crawford, S., Nathan, M., Rahman, S., Finkelstein, L., et al. (2022) Disruption of Sleep Continuity during the Perimenopause: Associations with Female Reproductive Hormone Profiles. The Journal of Clinical Endocrinology & Metabolism, 107, e4144-e4153. https://doi.org/10.1210/clinem/dgac447 |
| [8] | Yin, W., Borniger, J.C., Wang, X., Maguire, S.M., Munselle, M.L., Bezner, K.S., et al. (2019) Estradiol Treatment Improves Biological Rhythms in a Preclinical Rat Model of Menopause. Neurobiology of Aging, 83, 1-10. https://doi.org/10.1016/j.neurobiolaging.2019.08.029 |
| [9] | 韩茹雪, 杨欣. 围绝经期血管舒缩症状的非激素治疗[J]. 实用妇产科杂志, 2022, 38(1): 29-32. |
| [10] | de Zambotti, M., Colrain, I.M., Javitz, H.S. and Baker, F.C. (2014) Magnitude of the Impact of Hot Flashes on Sleep in Perimenopausal Women. Fertility and Sterility, 102, 1708-1715.e1. https://doi.org/10.1016/j.fertnstert.2014.08.016 |
| [11] | [1] Joffe, H., Crawford, S., Economou, N., Kim, S., Regan, S., Hall, J.E., et al. (2013) A Gonadotropin-Releasing Hormone Agonist Model Demonstrates That Nocturnal Hot Flashes Interrupt Objective Sleep. Sleep, 36, 1977-1985. https://doi.org/10.5665/sleep.3244 |
| [12] | 马堃, 陈燕霞, 董美玲. 从肾虚血瘀与心肾不交论治围绝经期睡眠障碍[J]. 中国中药杂志, 2017, 42(23): 4455-4458. |
| [13] | 何静漪, 王芳, 税晓玲, 等. 非药物干预改善围绝经期失眠症状疗效的网状Meta分析[J]. 中国全科医学, 2023, 26(31): 3963-3974. |
| [14] | 谢晨, 杨文佳, 汪景, 等. 电针干预围绝经期失眠大鼠睡眠觉醒的实验研究[J]. 辽宁中医杂志, 2024, 51(4): 204-209+224-226. |
| [15] | 张熙, 粟胜勇, 林媛媛, 等. 基于阴阳本体结构理论针灸治疗心肾不交型围绝经期失眠30例[J]. 中国针灸, 2022, 42(11): 1297-1298. |
| [16] | 崔晨华, 曲正, 陈玉佳, 等. 针药结合治疗肾虚肝郁型围绝经期女性失眠临床研究[J]. 中华中医药学刊, 2023, 41(11): 78-81. |
| [17] | 王颖, 岳虹妤, 陈颖棋, 等. “健脾培元”穴位埋线法治疗围绝经期肥胖: 随机对照试验[J]. 中国针灸, 2023, 43(3): 294-298. |
| [18] | 金新美, 丁立钧, 夏德鹏, 等. 穴位埋线配合耳穴贴压治疗肝肾亏虚型更年期综合征及其对雌二醇的影响[J]. 中国针灸, 2017, 37(8): 836-839. |
| [19] | 王轶蓉. 创新穴位贴敷疗法对围绝经期女性MRS、E2和FSH影响的临床研究[J]. 辽宁中医杂志, 2017, 44(5): 1043-1046. |
| [20] | 孟方, 龚卫娟, 廖月霞, 等. 耳揿针联合耳尖放血对围绝经期失眠患者睡眠质量、神经内分泌水平的影响[J]. 中国针灸, 2018, 38(6): 575-579. |
| [21] | 项彩芬, 吴晓萍. 耳穴贴压联合性激素替代治疗围绝经期失眠的作用研究[J]. 中国实用妇科与产科杂志, 2022, 38(11): 1142-1145. |
| [22] | 姜仙君, 张小罗. 耳穴压豆辅助性激素替代治疗对围绝经期失眠患者性激素水平和睡眠质量的影响[J]. 中国妇幼保健, 2021, 36(17): 4096-4098. |
| [23] | 袁筱兮. 分时督推调节睡眠剥夺小鼠睡眠-觉醒周期脑电生理特征的探索研究[D]: [硕士学位论文]. 成都: 成都体育学院, 2023. |
| [24] | 岳波, 阚丽君, 谭玉惠. 循经点穴疗法对老年围绝经期妇女睡眠障碍患者睡眠质量与心理状态的影响[J]. 辽宁中医杂志, 2016, 43(11): 2370-2374. |
| [25] | 严春燕. 按摩手法对更年期综合征伴抑郁症患者心理应激、睡眠障碍及生活质量的影响[J]. 中国健康心理学杂志, 2018, 26(10): 1516-1520. |
| [26] | 徐鸣曙. 循经刮痧疗法[M]. 北京: 中国中医药出版社, 2016: 12. |
| [27] | 王阿芹, 段培蓓, 夏超, 等. 刮痧治疗围绝经期综合征临床疗效及安全性系统评价[J]. 中国老年学杂志, 2020, 40(12): 2586-2592. |
| [28] | 孟方, 段培蓓, 胡倩, 等. 刮痧疗法用于围绝经期失眠患者的效果观察[J]. 护理学杂志, 2016, 31(12): 49-52. |
| [29] | 朱燕. 刮痧疗法用于围绝经期心脾两虚型失眠患者的效果分析[J]. 实用妇科内分泌电子杂志, 2020, 7(3): 53+74. |
| [30] | 彭德忠, 王红艳, 申渝泉, 等. 基于子午流注理论的刮痧疗法治疗围绝经期女性失眠的临床研究[J]. 时珍国医国药, 2014, 25(9): 2186-2187. |
| [31] | 施兰来, 杨毅华, 黄荷贤, 等. 火龙罐疗法对心肾不交型围绝经期患者睡眠障碍的影响[J]. 护理学杂志, 2021, 36(12): 56-59. |
| [32] | Feng, H., Pan, A., Zheng, G. and Yu, W. (2022) Clinical Study of Auricular Point Seed Burying Combined with Fire Dragon Pot Moxibustion in Perimenopausal Women with Insomnia. Journal of Obstetrics and Gynaecology Research, 48, 1938-1944. https://doi.org/10.1111/jog.15277 |
| [33] | Nasiri, K., Shriniy, M., Pashaki, N.J., Aghamohammadi, V., Saeidi, S., Mirzaee, M., et al. (2024) The Effect of Foot Bath on Sleep Quality in the Elderly: A Systematic Review. BMC Geriatrics, 24, Article No. 191. https://doi.org/10.1186/s12877-023-04590-x |
| [34] | Aghamohammadi, V., Salmani, R., Ivanbagha, R., Effati Daryani, F. and Nasiri, K. (2020) Footbath as a Safe, Simple, and Non-Pharmacological Method to Improve Sleep Quality of Menopausal Women. Research in Nursing & Health, 43, 621-628. https://doi.org/10.1002/nur.22082 |
| [35] | 孙雪梅, 麻锐, 张莉莉, 等. 潜阳封髓丹联合舒更九味沐足液治疗围绝经期失眠症(肾阴阳两虚证)临床观察[J]. 中国老年学杂志, 2024, 44(4): 837-840. |
| [36] | Zhong, Y., Zheng, Q., Hu, P., Huang, X., Yang, M., Ren, G., et al. (2019) Sedative and Hypnotic Effects of Compound Anshen Essential Oil Inhalation for Insomnia. BMC Complementary and Alternative Medicine, 19, Article No. 306. https://doi.org/10.1186/s12906-019-2732-0 |
| [37] | 刘梦梅. 芳香疗法联合中药对肾虚肝郁型围绝经期综合征临床疗效的观察[D]: [硕士学位论文]. 成都: 西南医科大学, 2022. |
| [38] | 闫学花, 陈书英, 闫利荣, 等. 水突穴体表电刺激联合耳穴贴压治疗围绝经期综合征临床疗效观察[J]. 中国针灸, 2018, 38(10): 1065-1069. |
| [39] | 肖贝, 周仲瑜, 董莉, 等. 阴阳调理灸联合耳穴揿针治疗围绝经期失眠47例[J]. 中国针灸, 2021, 41(12): 1347-1348. |
| [40] | 盖海云, 杭嘉敏, 陈红, 等. 引阳入阴推拿配合中药足浴对围绝经期不寐症患者睡眠质量的应用研究[J]. 四川中医, 2018, 36(7): 196-198. |
| [41] | 任秀亚, 谢薇, 冷羽, 等. 循经拍打操联合耳穴埋豆对围绝经期失眠的影响研究[J]. 现代中西医结合杂志, 2021, 30(5): 543-546+550. |
| [42] | Drake, C.L., Kalmbach, D.A., Arnedt, J.T., Cheng, P., Tonnu, C.V., Cuamatzi-Castelan, A., et al. (2018) Treating Chronic Insomnia in Postmenopausal Women: A Randomized Clinical Trial Comparing Cognitive-Behavioral Therapy for Insomnia, Sleep Restriction Therapy, and Sleep Hygiene Education. Sleep, 42, zsy217. https://doi.org/10.1093/sleep/zsy217 |
| [43] | 肖超群, 牟纯玮, 周霞. 正念冥想训练对围绝经期妇女焦虑、抑郁及睡眠质量的影响[J]. 南方医科大学学报, 2019, 39(8): 998-1002. |
| [44] | 冯帆, 王处渊, 刘学, 等. 中医心理发展治疗的理论与方法溯源[J]. 中医杂志, 2016, 57(22): 1971-1973. |
| [45] | 张晓莹, 夏亲华. 低阻抗意念导入疗法配合中药治疗围绝经期失眠的策略[J]. 中华中医药杂志, 2020, 35(6): 2984-2986. |
| [46] | Qian, J., Sun, S., Wang, M., Sun, Y., Sun, X., Jevitt, C., et al. (2023) The Effect of Exercise Intervention on Improving Sleep in Menopausal Women: A Systematic Review and Meta-Analysis. Frontiers in Medicine, 10, Article 1092294. https://doi.org/10.3389/fmed.2023.1092294 |
| [47] | Zhao, Y., Niu, H. and Liu, S. (2022) Effects of Aerobics Training on Anxiety, Depression and Sleep Quality in Perimenopausal Women. Frontiers in Psychiatry, 13, Article 1025682. https://doi.org/10.3389/fpsyt.2022.1025682 |
| [48] | 赵静. 围绝经期女性接受太极拳运动后骨密度的变化[J]. 中国组织工程研究, 2020, 24(2): 176-180. |
