针刺联合天王补心丸治疗心肾不交型围绝经期失眠的临床疗效

失眠主要是指患者无法满足自身睡眠质量和睡眠时间,并且影响日常行为社会功能的一种生理障碍,其临床表现为入睡困难、睡后容易惊醒、惊醒后难以复睡、且睡眠质量低下,甚至整夜无法入眠。而围绝经期失眠主要是指妇女在绝经期前后时间段内无法正常睡眠的症状。根据我国临床数据统计显示,经期失眠是围绝经期各类临床症状中最主要也是最常见的临床表现。     

围绝经期妇女抑郁焦虑不同治疗方式与血清性激素 5-羟色胺水平的关系

<正>女性围绝经期综合征是指女性绝经前后因性激素减少所致的一系列躯体及精神心理症状[1]。这一时期70%以上女性易出现烦躁、易怒、易激惹、自卑、兴趣减退、睡眠障碍等情绪变化,程度严重的可导致情绪障碍。围绝经期情绪障碍是指女性在自然绝经前后发生的,以焦虑和抑郁为主要特征的非特异性临床综合征,严重影响更年期女性的心身健康及家     

围绝经期妇女心理状况与睡眠质量的相关性研究

目的探讨围绝经期妇女心理状况与睡眠质量的相关性。方法选取2011年1月至2012年12月就诊于山东省精神卫生中心门诊的601例有睡眠障碍主诉的45—55岁围绝经期女性患者作为研究对象,利用自拟问卷、匹兹堡睡眠质量指数（PSQI）量表和症状自评量表（SCL-90）对601例更年期妇女进行一般情况、睡眠质量及心理健康状况调查。结果601例有睡眠障碍主诉的围绝经期妇女PSQI平均得分（6±4）分,其中27．8％（167／601）存在睡眠质量问题（PSQI总分〉7）。相关分析表明PSQI总分与SCL-90总分存在相关性（r=0．535,P〈0．05）。多因素回归分析提示,躯体化、抑郁、焦虑和偏执可能是影响就诊的围绝经期妇女睡眠质量的影响因素（t值分别为7．25,3．02,2．64,-3．39,均P〈0．01）。结论就诊围绝经期妇女睡眠质量可能受心理健康状况影响。     

鹿胎膏治疗围绝经期失眠症32例疗效观察

围绝经期失眠症是指女性进入绝经前后2~3年内的围绝经期后的入睡困难.临床表现大致有多梦易醒、醒后难以复寐、甚至彻夜不眠、易怒、烦躁、头昏、头痛、注意力不集中、记忆力下降.焦虑同时伴有潮热、心悸、多汗;而其中睡眠障碍最为常见.有资料显示,吉林省农村围绝经期妇女围绝经期症状发生率为88.8%,精神、神经症状如情绪不稳、注意力不集中、记忆力减退及失眠等发生率为65.1%[1].笔者以鹿胎膏治疗围绝经期失眠症32例,效果较满意,现报道如下.     

鹿胎膏治疗围绝经期失眠症32例疗效观察

围绝经期失眠症是指女性进入绝经前后2~3年内的围绝经期后的入睡困难.临床表现大致有多梦易醒、醒后难以复寐、甚至彻夜不眠、易怒、烦躁、头昏、头痛、注意力不集中、记忆力下降.焦虑同时伴有潮热、心悸、多汗;而其中睡眠障碍最为常见.有资料显示,吉林省农村围绝经期妇女围绝经期症状发生率为88.8%,精神、神经症状如情绪不稳、注意力不集中、记忆力减退及失眠等发生率为65.1%[1].笔者以鹿胎膏治疗围绝经期失眠症32例,效果较满意,现报道如下.     

六味地黄丸治疗围绝经期综合征的临床研究进展

围绝经期综合征是女性绝经前后的常见疾病,临床研究发现六味地黄丸治疗该病具有较好的疗效。经典名方六味地黄丸由熟地黄、山茱萸、山药、泽泻、牡丹皮、茯苓6味中药组方,可有效改善患者的血管舒缩、情绪失常、睡眠障碍、脂代谢紊乱、骨质流失等症状,其药效机制可能在于调节患者的雌激素水平,进而改善患者全身症状。综述六味地黄丸治疗围绝经期综合征的临床研究进展,以期为后续临床和实验研究提供参考。     

大豆异黄酮维E软胶囊治疗围绝经期综合症80例

目的：探讨大豆异黄酮维E软胶囊治疗围绝经期综合症的临床效果及其作用机制。方法运用对大豆异黄酮维E软胶囊对80例围绝经期综合症患者进行治疗，采用Kupper-man症状评分标准判定临床疗效，并抽血检测治疗前后患者血清 E2、FSH、LH、P等指标，进行治疗前后的对照观察。结果经4个月的治疗后，患者的症状得到明显改善，Kupperman 评分显著下降；与治疗前相比患者的 E2、P 明显升高，FSH、LH明显降低，且具有统计学差异（P＜0.05）；HAMD积分及情绪、睡眠障碍、精神性抑郁及躯体性抑郁因子均明显低于治疗前（P＜0.05）。结论大豆异黄酮维E软胶囊能够有效改善围绝经期综合症患者的临床症状，疗效机制可能与调节围绝经期综合症患者体内激素水平有关。     

曲唑酮对围绝经期伴有焦虑抑郁患者睡眠障碍的影响

目的:探讨曲唑酮对围绝经期伴有焦虑抑郁患者睡眠质量的影响.方法:以我院收治的围绝经期伴有焦虑抑郁患者94例作为研究对象.随机分组:对照组47例,采用氯硝西泮治疗;观察组47例,采用曲唑酮治疗.疗程结束之后评估两组治疗效果,并进行对比.结果:与对照组相比,观察组汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、匹兹堡睡眠量表(PSQI)评分明显更低,差异显著(P<0.05).结论:曲唑酮在围绝经期伴有焦虑抑郁治疗中的应用能够有效改善焦虑、抑郁症状以及睡眠障碍,值得推广.     

围绝经期女性情绪障碍的临床研究

围绝经期情绪障碍是指女性在自然绝经前后发生的,以焦虑、抑郁为主要特征的非特异性心理综合征[1],发病率约32%[2],在基层医院十分常见。本研究着重探讨心理社会因素对围绝经期情绪障碍的影响,以及与性激素变化等因素之间的相互关系,为开展围绝经期女性心身保健提供有效对策。     

围绝经期女性发生抑郁的影响因素分析

围绝经期的女性会出现精神、心理、神经、内分泌和代谢失衡等问题,引起各器官系统的症状和体征者占87．15％［1］。围绝经期妇女受到围绝经期综合征症状的严重困扰,而出现的情绪障碍,使其痛苦不堪［2］。因此,对围绝经期女性抑郁的现状研究,尤其是可干预因素的探讨对实施干预研究提供依据。     

住院肿瘤病人睡眠障碍现状及影响因素分析

目的 客观评价住院肿瘤病人的睡眠质量,分析住院肿瘤病人睡眠质量问题发生原因,并提出针对性护理措施.方法利用匹兹堡睡眠质量指数(PSQI)量表对住院治疗的448例肿瘤病人进行睡眠质量评价,通过调查问卷方法对睡眠质量影响因素进行全面调查,应用单因素和多因素Logistic回归模型筛选出睡眠障碍(PSQI评分≥7)的影响因素,并以此为据提出护理策略.结果 住院肿瘤病人睡眠障碍发生率为56.92%,平均PSQI分数为(10.7±1.3)显著高于睡眠良好者(P<0.05);经单因素和多因素Logistic回归分析显示:年龄小、经济负担重、恐惧、疼痛、化疗反应重、远处转移、环境噪音为睡眠障碍发生的危险因素.结论 住院肿瘤病人多容易出现睡眠障碍,其发生原因多种多样,积极给予针对性干预措施对于改善睡眠质量有积极意义.     

Pharmacological and Non-pharmacological Treatments of Sleep Disorders in Parkinson's Disease

Sleep disorders are one of the most common non-motor symptoms in Parkinson''s disease (PD). It can cause a notable decrease in quality of life and functioning in PD patients, as well as place a huge burden on both patients and caregivers. The most cited sleep disorders in PD included insomnia, restless legs syndrome (RLS), rapid eye movement (REM), sleep behavior disorders (RBD), excessive daytime sleepiness (EDS) and sleep disordered breathing (SDB), which can appear alone or several at the same time. In this review, we listed the recommended pharmacological treatments for common sleep disorders in PD, and discussed the recommended dosages, benefits and side effects of relative drugs. We also discussed non-pharmacological treatments to improve sleep quality, including sleep hygiene education, exercise, deep brain stimulation, cognitive behavior therapy and complementary therapies. We tried to find proper interventions for different types of sleep disorders in PD, while minimizing relative side effects.     

围绝经期妇女焦虑症心理治疗研究进展

随着社会竞争日益激烈，妇女承受的生理、心理、社会压力越来越大，致使部分女性提早进入围绝经期，出现较为严重的围绝经期焦虑症。围绝经期焦虑症患病率较高，诊断率和治疗率均很低，临床更易误诊为器质性疾病，严重影响妇女的家庭生活和工作。因此，大力发展社区心理治疗，主动与区精神卫生中心合作，形成心理疾病防控网络，可更好地提高妇女在围绝经期的社会功能，促进社区妇女健康，推动社区围绝经期焦虑症心理治疗的迅速发展。     

老年痴呆患者呼吸睡眠障碍的研究

目的探讨轻、中度老年痴呆患者合并呼吸睡眠障碍的睡眠结构。方法选择AD患者60例,分为轻度AD组和中度AD组,每组30例,并将两组分别分为合并呼吸睡眠障碍亚组和未合并呼吸睡眠障碍亚组。采用夜间多导睡眠呼吸检测仪,观察所有患者的睡眠总时间、睡眠效率、S1和S2期睡眠持续时间即其分别占SPT的百分比、血氧饱和度低于90%的时间所占APT比例;并对以上指标进行统计学分析。结果两组患者中,与未合并呼吸睡眠障碍亚组相比,合并呼吸睡眠障碍亚组APT缩短,S1/SPT降低,T<90%/SPT增高(均P<0.05);与轻度AD合并呼吸睡眠障碍亚组的各指标比较,中度AD组APT缩短,S1/SPT和SE下降,T<90%/SPT增高(均P<0.05)。结论 AD合并呼吸睡眠障碍患者的夜间血氧饱和度下降,睡眠结构紊乱。且随AD的加重,患者睡眠结构紊乱加重,血氧饱和度下降严重。     

Sleep disorders

Sleep disorders occupay an important position among the pathologies which may precede the appearance of headache. Some authors consider sleep disorders an expression of a functional, biochemical and/or neurotransmission alteration at central nervous system level. Sleep disorders may be distinguished, according to the Association Sleep Disorders classification in: alteration of the sleep-awake cycle, hypersomnia, parasomnia, insomnia. We observed 1876 normal children ranging from 3 to 14 years of age, 1073 (60.4%) of whom presented sleep disorders. Few studies have been carried out on the incidence of sleep disorders on casistics of healthy children. Date reported in literature state that sleep disorders do not exceed 25% of cases that is not more than one child out of four presents sleep disorders. This percentage is much lower than the 60.4% rate observed by us in children suffering from primary headache. Our results stress the importance of sleep disorders as a cephalalgic risk factor.     

The Management and Alternative Therapies for Comorbid Sleep Disorders in Epilepsy

Background There is a complex and interactive relationship between sleep and epilepsy. Sleep disorders are common in patients with epilepsy, and methods for managing sleep disorders in patients with epilepsy are limited.Objective This review addresses the relationship among sleep, sleep disorders, and epilepsy, focusing on the management of sleep disorders in epilepsy, including some complementary and alternative therapies.Methods The terms related to “sleep” and “epilepsy” were searched in “Pubmed” and “Cochrane Library”.Results Sleep stages differently affect both seizures and interictal epileptiform discharges. Seizures disrupt sleep architecture greatly, especially when occurring during sleep in the night. Insomnia and obstructive sleep apnea (OSA) are the most frequent types of comorbid sleep disorders in patients with epilepsy. Pharmacological agents with both anti-convulsant and sedative effects are the priorities for comorbid sleep disorders in epilepsy. Continuous positive airway pressure (CPAP) therapy is the most effective non-pharmacological method to improve OSA and reduce seizures. Complementary and alternative therapies such as Chinese traditional medicine, cognitive behavioral therapy, meditation, yoga, neurofeedback, and acupuncture may have benefits in reducing seizures and improving sleep quality simultaneously by alleviating stress and seizure triggers; however, evidence-based therapies are still deficient.Conclusion Management of sleep disorders in patients with epilepsy is challenging. Large-scale randomized controlled clinical trials are in demand to guide the treatments in the future.     

围绝经期妇女颈动脉粥样硬化斑块与血脂及糖耐量异常的相关分析

目的探讨围绝经期妇女颈动脉粥样硬化斑块与血脂水平及糖耐量异常(IGT)的关系。方法随机抽取健康体检的围绝经期妇女250名,依据颈动脉超声检查分为:斑块组、无斑块组(即对照组),各组分别检测血脂及糖耐量试验,然后分析两组与血脂水平及糖耐量异常的关系。结果本研究中围绝经期妇女颈动脉粥样硬化斑块形成率为24.8%。围绝经期妇女颈动脉粥样硬化斑块组的血压,体质量指数、血脂水平及糖耐量异常发生率均高于无斑块组,差异具有显著性(P<0.05)。结论颈动脉粥样硬化斑块在围绝经期妇女中有较高的发生率,其中血脂升高和糖耐量异常可能对颈动脉粥样硬化斑块的形成起促进作用。     

重组链激酶与尿激酶治疗急性心肌梗死的对比研究

目的观察重组链激酶（r-SK）与尿激酶（UK）静脉溶栓治疗急性心肌梗死的疗效。方法将93患者随机分成r-SK组48例和UK组45例,均给常规治疗,r-SK组,r-SK150万单位＋5%葡萄糖100mL;UK组,UK150万单位＋5%葡萄糖100mL,观察冠状动脉再通率、不良反应及5周病死率。结果r-SK组总再通率81.25%,6h内再通率为86.49%,与UK组比较,差异均有统计学意义（P〈0.05）;2组在出血、心律失常、过敏、低血压及5周后死亡率上,差异无统计学意义（P〉0.05）。结论r-SK较UK的心肌梗死血管再通率高,药效较好,也具有不良反应和并发症少的特点,是值得临床上推广应用。     

老年急性脑梗死患者睡眠障碍与病变部位的关系

目的 探讨老年急性脑梗死患者睡眠障碍的发生情况及与病变部位的关系,分析其发病机制,为临床诊断和防治提供依据.方法 选择我院神经内科收治的老年急性脑梗死患者154例,采用匹兹堡睡眠质量指数(PSQI)量表评定睡眠情况.所有患者发生急性脑梗死前均无睡眠障碍.结果 154例患者中86例出现睡眠障碍,发生率为55.8％,睡眠障碍主要类型为失眠(包括入睡困难、睡眠减少、片段睡眠、睡眠表浅)、过度睡眠、做噩梦、应用催眠药物促进睡眠等.不同部位脑梗死患者的睡眠障碍发生率依次为皮质下梗死者64.9％(37/57),皮质与皮质下混合硬死者57.6％(19/33),脑干梗死者57.1％(8/14),小脑梗死者42.9％(3/7),以皮质下梗死者睡眠障碍发生率最高.结论 老年急性脑梗死患者睡眠障碍发生率高,且与病变部位有关.     

Management of Sleep Disorders in Children With Neurodevelopmental Disorders: A Review

Neurodevelopmental disorders (NDDs) are defined as a group of disorders caused by changes in early brain development, resulting in behavioral and cognitive alterations in sensory and motor systems, speech, and language. NDDs affect approximately 1–2% of the general population. Up to 80% of children with NDDs are reported to have disrupted sleep; subsequent deleterious effects on daytime behaviors, cognition, growth, and overall development of the child are commonly reported. Examples of NDDs discussed in this review include autism spectrum disorder, cerebral palsy, Rett syndrome, Angelman syndrome, Williams syndrome, and Smith‐Magenis syndrome. The etiology of sleep disorders in children with NDDs is largely heterogeneous and disease specific. The diagnosis and management of sleep disorders in this population are complex, and little high‐quality data exist to guide a consistent approach to therapy. Managing sleep disorders in children with NDDs is critical both for the child and for the family but is often frustrating due to the refractory nature of the problem. Sleep hygiene must be implemented as first‐line therapy; if sleep hygiene alone fails, it should be combined with pharmacologic management. The available evidence for the use of common pharmacologic interventions, such as iron supplementation and melatonin, as well as less common interventions, such as melatonin receptor agonists, clonidine, gabapentin, hypnotics, trazodone, and atypical antipsychotics is reviewed. Further, parents and caregivers should be provided with appropriate education on the nature of the sleep disorders and the expectation for modest pharmacologic benefit, at best. Additional data from well‐designed trials in children with NDDs are desperately needed to gain a better understanding of sleep pharmacotherapy including efficacy and safety implications. Until then, clinicians must rely on the limited available data, as well as clinical expertise, when managing sleep disorders in the population of children with NDDs.