择时芳香疗法联合平衡火罐对围绝经期失眠患者的干预效果研究

doi:10.3761/j.issn.0254-1769.2025.21.014

摘要/Abstract

摘要：

目的探讨择时芳香疗法联合平衡火罐对肾阴虚型围绝经期失眠患者的护理效果，为中医护理临床实践提供参考依据。方法选取2023年1—9月就诊于杭州市某三级甲等医院中医妇科门诊的肾阴虚型围绝经期失眠患者132例作为研究对象，采用随机数字表法，分为芳香组、平衡火罐组、联合组和对照组，每组各33例。通过文献研究和专家小组会议确定干预方案，并通过预试验修订干预方案。芳香组在常规护理基础上予择时芳香疗法，平衡火罐组在常规护理基础上予择时平衡火罐，联合组在常规护理基础上予择时芳香疗法联合平衡火罐，对照组予常规护理，疗程均为4周。比较干预前后4组匹兹堡睡眠指数、中医证候积分以及不良反应发生情况的差异。结果干预4周后，联合组总有效率为71.87%，高于对照组（P<0.001）和芳香组（P<0.05）；联合组痊愈率为31.25%，高于芳香组的12.50%（P<0.001）和平衡火罐组的12.50%（P<0.001）。干预后芳香组中医证候积分为9.00（5.00，10.00）分、平衡火罐组为8.00（4.00，12.00）分、联合组为9.00（4.00，10.00）分，均低于对照组的12.00（9.00，17.00）分（P<0.001）。结论择时芳香疗法联合平衡火罐能有效改善围绝经期失眠患者的睡眠状况，缓解肾阴虚证，且干预方案具有良好的科学性和可行性。

关键词: 子午流注, 围绝经期, 失眠, 芳香疗法, 平衡火罐, 中医护理学

Abstract:

Objective To explore the effect of midnight-noon ebb-flow timing aromatherapy combined with balanced cupping on Traditional Chinese Medicine（TCM） nursing of perimenopausal insomnia patients with kidney yin deficiency，and to provide references for clinical TCM nursing practice. Methods From January to September 2023，132 patients with perimenopausal insomnia of kidney yin deficiency type who were admitted to the gynecology clinic of traditional Chinese medicine in a tertiary A hospital in Hangzhou were selected as research subjects. They were divided into an aromatic group，a balanced cupping group，a combined group and a control group by random number table method，with 33 cases in each group. The intervention plan was determined through literature research and expert group meetings，and the intervention plan was revised through pre-experiment. The aromatic group was treated with midnight-noon ebb-flow timing aromatherapy on the basis of routine nursing. The balanced cupping group was treated with midnight-noon ebb-flow timing balanced cupping on the basis of routine nursing. The combined group was treated with midnight-noon ebb-flow timing aromatherapy combined with balanced cupping on the basis of routine nursing. The control group was given routine nursing. The course of treatment was 4 weeks. The Pittsburgh Sleep Quality Index（PSQI） score，TCM syndrome score and adverse reactions were compared between the 4 groups before and after intervention. Results After 4 weeks of intervention，the total effective rate of the combined group was 71.87%，which was higher than that of the control group（P<0.001） and the aromatic group（P<0.05）. The cure rate of the combined group was 31.25%，which was higher than 12.50% of the aromatic group（P<0.001） and 12.50% of the balanced cupping group（P<0.001）. After intervention，the TCM syndrome score of the aromatic group was9.00（5.00，10.00），and the balanced cupping group was8.00（4.00，12.00），and the combined group was 9.00（4.00，10.00），which were all lower than12.00（9.00，17.00） in the control group（P<<0.001），and the difference was statistically significant. Conclusion The timing aromatherapy combined with balanced cupping can effectively improve the sleep status of perimenopausal insomnia patients and reduce the syndrome of kidney yin deficiency，and the intervention plan is scientific and feasible.

Key words: Zi Wu Liu Zhu, Perimenopausal, Insomnia, Aromatherapy, Balanced Cupping, Traditional Chinese Medicine Nursing

谢睿, 章启秀, 陈丽丽, 李颖, 宁丽. 择时芳香疗法联合平衡火罐对围绝经期失眠患者的干预效果研究[J]. 中华护理杂志, 2025, 60(21): 2654-2661.

XIE Rui, ZHANG Qixiu, CHEN Lili, LI Ying, NING Li. Study on the effect of timing aromatherapy combined with balanced cupping on perimenopausal insomnia patients[J]. Chinese Journal of Nursing, 2025, 60(21): 2654-2661.

图/表 5

表1 择时芳香疗法联合平衡火罐干预方案终稿

Table 1 The final draft of midnight-noon ebb-flow timing aromatherapy combined with balanced cupping intervention program

表2 四组一般资料的比较

Table 2 Comparison of general data of 4 groups

表3 四组干预前后匹兹堡睡眠指数得分的比较（分，$\bar{x} \pm s$）

Table 3 Multiple comparison of PSQI scores before and after intervention in 4 groups（score， $\bar{x} \pm s$）

表4 四组干预前后中医证候积分的比较（分，$\bar{x} \pm s$）

Table 4 Multiple comparison of TCM syndrome score before and after intervention in 4 groups（score，$\bar{x} \pm s$）

表5 4组临床疗效的比较[例（百分比，%）]

Table 5 Comparison of clinical efficacy of 4 groups[cases（percentage，%）]

参考文献 27

[1]	郑双林. 广州市天河区40岁-60岁女性围绝经期情况调查及相关影响因素分析[D]. 广州: 南方医科大学, 2023.
	Zheng SL. Investigation on perimenopausal period of women aged 40-60 in Tianhe district of Guangzhou and analysis of related influencing factors[D]. Guangzhou: Southern Medical Uni-versity, 2023.
[2]	Thurston RC, Chang YF, Kline CE, et al. Trajectories of sleep over midlife and incident cardiovascular disease events in the study of women’s health across the nation[J]. Circulation, 2024, 149(7):545-555. DOI PMID
[3]	Madari S, Golebiowski R, Mansukhani MP, et al. Pharmacologi-cal management of insomnia[J]. Neurotherapeutics, 2021, 18(1):44-52.
[4]	杜萍, 曾丽, 高清梅, 等. 针刺十三鬼穴联合黄连阿胶汤对围绝经期失眠患者神经递质、性激素水平及主客观睡眠质量的影响[J]. 西部中医药, 2025, 38(4):144-148.
	Du P, Zeng L, Gao QM, et al. Effects of needling at thirteen ghost points combined with Huanglian Ejiao decoction on the levels of neurotransmitter,sex hormone,subjective and objective sleep quality in perimenopausal insomnia patients[J]. West J Tradit Chin Med, 2025, 38(4):144-148.
[5]	刘敏如. 中医妇科学[M]. 2版. 北京: 人民卫生出版社, 2007.
	Liu MR. Traditional Chinese gynecology[M]. 2nd ed. Beijing: People’s Medical Publishing House, 2007.
[6]	吴有艳, 单雪娇, 窦湘芸, 等. 中西医治疗慢性失眠的非药物方法研究进展[J]. 世界睡眠医学杂志, 2021, 8(7):1288-1296.
	Wu YY, Shan XJ, Dou XY, et al. Research progress on non drug treatment of chronic insomnia with traditional Chinese and western medicine[J]. World J Sleep Med, 2021, 8(7):1288-1296.
[7]	李玉坤, 刘大胜, 任聪, 等. 中医芳香疗法的研究进展[J]. 中国中医急症, 2020, 29(1):178-181.
	Li YK, Liu DS, Ren C, et al. Research progress of aromathe-rapy in traditional Chinese medicine[J]. J Emerg Tradit Chin Med, 2020, 29(1):178-181.
[8]	郑魁山. 子午流注与灵龟八法[M]. 兰州: 甘肃人民出版社,1983.
	Zheng KS. Meridian Liuzhu and eight methods of Linggui[M]. Lanzhou: Gansu People’s Publishing House,1983.
[9]	张晶. 子午流注择时芳香疗法联合穴位按摩干预肾阴虚型围绝经期综合征的临床护理观察[D]. 哈尔滨: 黑龙江中医药大学, 2021.
	Zhang J. Clinical nursing observation on the intervention of meridian flow injection and timed aromatherapy combined with acupoint massage on perimenopausal syndrome of kidney Yin deficiency type[D]. Harbin: Heilongjiang University of Chinese Medicine, 2021.
[10]	卢亚玲, 邢晓燕, 董朝妮, 等. 子午流注择时耳穴贴压结合中医情志干预对围绝经期失眠患者睡眠质量、情绪状态及神经递质水平的影响[J]. 临床医学研究与实践, 2023, 8(20):138-141.
	Lu YL, Xing XY, Dong ZN, et al. Effects of midnight-noon ebb-flow timing auricular point sticking combined with traditional Chinese medicine emotional intervention on sleep quality,emotional state and neurotransmitter level of patients with perimenopausal insomnia[J]. Clin Res Pract, 2023, 8(20):138-141.
[11]	马丁. 妇产科疾病诊疗指南[M]. 3版. 北京: 科学出版社, 2013.
	Ma D. Guidelines for diagnosis and treatment of gynecological diseases[M]. 3rd ed. Beijing: Science Press, 2013.
[12]	谢幸, 苟文丽. 妇产科学[M]. 8版. 北京: 人民卫生出版社, 2013.
	Xie X, Gou WL. Obstetrics and gynecology[M]. 8th ed. Beijing: People’s Medical Publishing House, 2013.
[13]	中华医学会精神科分会. CCMD-3中国精神障碍分类与诊断标准[M]. 3版. 济南: 山东科学技术出版社, 2001.
	Psychiatric Branch of Chinese Medical Association. CCMD-3 classification and diagnostic criteria of mental disorders in China[M]. 3rd ed. Jinan: Shandong Science & Technology Press, 2001.
[14]	郑筱萸. 中药新药临床研究指导原则:试行[M]. 北京: 中国医药科技出版社, 2002.
	Zheng XY. Guiding principles for clinical research of new Chinese medicine:trial implementation[M]. Beijing: China Medi-cal Science Press, 2002.
[15]	国家中医药管理局. 中医病证诊断疗效标准[M]. 南京: 南京大学出版社,1994.
	State Administration of Traditional Chinese Medicine. Diagno-stic efficacy standard of Chinese Medicine[M]. Nanjing: Nan-jing University Press,1994.
[16]	陈英, 陈晓洁, 王舒洁, 等. 芳香疗法联合情绪释放技术对失眠乳腺癌患者影响的研究[J]. 中华护理杂志, 2022, 57(6):651-658. DOI
	Chen Y, Chen XJ, Wang SJ, et al. Effect of lavender aromatic therapy combined with emotional freedom techniques on insomnia cancer breast patients with heart and spleen defi-ciency[J]. Chin J Nurs, 2022, 57(6):651-658.
[17]	王璇, 胡景贤, 韩舒羽, 等. 中医五音疗法在肝郁脾虚型自身免疫性肝病患者中的应用研究[J]. 中华护理杂志, 2024, 59(7):789-795. DOI
	Wang X, Hu JX, Han SY, et al. Research on the application of Traditional Chinese Medicine’s five-element music therapy in patients with autoimmune liver disease of liver depression and spleen deficiency type[J]. Chin J Nurs, 2024, 59(7):789-795. DOI
[18]	方泽佳, 陈哲子, 范秀英. 平衡火罐联合气交灸改善心肾不交型失眠的临床疗效[J]. 内蒙古中医药, 2022, 41(5):106-108.
	Fang ZJ, Chen ZZ, Fan XY. Evaluation of the efficacy of balanced cupping combined with Qijiao Moxibustion in treating insomnia patients with heart-kidney incompatibility[J]. Inn Mong J Tradit Chin Med, 2022, 41(5):106-108.
[19]	张凯华. 芳香疗法治疗肝郁脾虚型失眠的临床疗效观察[D]. 北京: 北京中医药大学, 2019.
	Zhang KH. Clinical observation of aromatherapy in treating insomnia with liver depression and spleen deficiency[D]. Bei-jing: Beijing University of Chinese Medicine, 2019.
[20]	Buysse DJ, Reynolds CR, Monk TH, et al. The Pittsburgh Sleep Quality Index:a new instrument for psychiatric practice and research[J]. Psychiatry Res, 1989, 28(2):193-213.
[21]	刘贤臣, 唐茂芹, 胡蕾, 等. 匹兹堡睡眠质量指数的信度和效度研究[J]. 中华精神科杂志, 1996(2):103-107.
	Liu XC, Tang MQ, Hu L, et al. Reliability and validity of the Pittsburgh sleep quality index[J]. Chin J Psychiatry, 1996(2):103-107.
[22]	路桃影, 李艳, 夏萍, 等. 匹兹堡睡眠质量指数的信度及效度分析[J]. 重庆医学, 2014, 43(3):260-263.
	Lu TY, Li Y, Xia P, et al. Analysis on reliability and validity of the Pittsburgh sleep quality index[J]. Chongqing Med, 2014, 43(3):260-263.
[23]	刘美华, 彭剑雄, 罗翠, 等. 机械通气患儿早期活动方案的构建及应用研究[J]. 中华护理杂志, 2022, 57(8):901-907. DOI
	Liu MH, Peng JX, Luo C, et al. Construction and application of an early activity program in children with mechanical ventilation[J]. Chin J Nurs, 2022, 57(8):901-907. DOI
[24]	周瑞娜, 杨莹莹, 程敏. 中药香囊的作用机理与临床应用[J]. 商洛学院学报, 2023, 37(4):69-75.
	Zhou RN, Yang YY, Cheng M. Mechanism of action and clinical application of traditional Chinese medicine sachets[J]. J Shangluo Univ, 2023, 37(4):69-75
[25]	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]. 泸州: 西南医科大学, 2022.
	Liu MM. Clinical observation of aromatherapy combined with traditional Chinese medicine on perimenopausal syndrome of kidney deficiency and liver depression[D]. Luzhou: Southwest Medical University, 2022.
[26]	刘盈, 马莹蕊. 基于“经脉当令”理论评价铜砭刮痧联合平衡火罐缓解腰椎间盘突出症引起疼痛临床疗效观察[J]. 辽宁中医药大学学报, 2020, 22(8):155-158.
	Liu Y, Ma YR. Clinical efficacy of copper sputum scraping combined with balanced cupping in relieving pain caused by lumbar disc herniation based on the theory of meridians dangling[J]. J Liaoning Univ Tradit Chin Med, 2020, 22(8):155-158.
[27]	罗惠芳, 康幼雯, 仝玉珠. 四物汤加减联合平衡火罐治疗对肾虚血瘀型围绝经期综合征的疗效观察[J]. 淮海医药, 2022, 40(5):499-502.
	Luo HF, Kang YW, Tong YZ. Observation on the therapeutic effect of Siwu decoction combined with balanced cupping on perimenopausal syndrome of kidney deficiency and blood stasis[J]. J Huaihai Med, 2022, 40(5):499-502.