社区中医综合干预模式对肝肾阴虚型围绝经期患者的疗效分析

目的 通过中医药综合疗法对社区肝肾阴虚型围绝经期综合征患者进行干预,改善患者症状。 方法 从上海市嘉定区6个社区各纳入30例肝肾阴虚型围绝经期综合征患者，共计180例，均于2016年2—8月入组。随机分为对照组和干预组，对照组在常规治疗的基础上为患者建立个人档案，心理疏导，每月为患者进行一次健康宣教。干预组在对照组的基础上采用中医综合疗法,包括口服中药、针刺、耳穴及八段锦。3个月疗程结束后对改良后的Kupperman评分进行比较，并评判临床疗效。 结果 疗程结束后，干预组及对照组干预后与干预前比较，改良的Kupperman评分差异均有统计学意义(P＜0.01)，干预后干预组与对照组相比，差异存在统计学意义(P＜0.01)。干预组总有效率为85.71%，对照组为0.00%，差异有统计学意义(P＜0.01)。干预组在潮热出汗、失眠、易激动、抑郁、疲乏、心悸方面较干预前相比，差异有统计学意义(P＜0.01)，在眩晕方面与干预前相比，差异有统计学意义(P＜0.05)；对照组在易激动、抑郁方面与干预前相比，差异有统计学意义(P＜0.01)。 结论 中医综合干预模式对肝肾阴虚型围绝经期综合征患者有明显疗效，能改善诸多症状，值得在社区卫生服务中心推广。 

Effects of TCM comprehensive intervention on liver and kidney Yin deficiency patients with perimenopausal syndrome

Objective To investigate the effect of TCM comprehensive intervention in improving the symptoms of liver and kidney Yin deficiency patients with perimenopausal syndrome. Methods Total 180 liver and kidney Yin deficiency patients with perimenopausal syndrome from 6 communities(30 cases in each) in Jiading District of Shanghai city between February,2016 and August,2016 were enrolled and randomly divided into control group and intervention group.All patients received the routine treatment.The patients in the control had their personal profile,received psychological guidance and health education once a month;while the patients in the intervention group received the TCM comprehensive interventions including traditional Chinese medicine,acupuncture,otopoint pressure-massage and the eight-section brocade exercise.After 3 months of treatment,the modified Kupperman index score of the patients was compared between the two groups and the clinical efficacy was evaluated. Results At the end of treatment,Kupperman scores of both groups were improved obviously as compared with those before the treatment(P<0.01),and the difference between the two groups was statistically significant(P<0.01).The total effective rate was 85.71% in the intervention group and 0 in the control group,the difference was statistically significant(P<0.01).The incidence of sweating,insomnia,irritability,depression,fatigue and palpitations in the intervention group were improved obviously after the treatment,the difference was statistically significant(P<0.01),and so of vertigo(P<0.05);The incidence of irritability and depression in the control group were improved obviously after the treatment with significant differences(P<0.01). Conclusion TCM comprehensive intervention model has obvious curative effect on liver and kidney Yin deficiency patients with perimenopausal syndrome,which can improve many symptoms of patients,and worth of popularizing in community health service center.