Evaluation Of The Effectiveness Of Treating Perimenopausal Insomnia From The Perspective Of Liver And Kidney And Exploration And Analysis Of Traditional Chinese Medicine Compound Prescriptions

Objective(1)This project conducts a comprehensive and systematic evaluation of the randomized controlled research on the treatment of perimenopausal insomnia from liver and kidney through collection,collation,and analysis of the literature.At the same time,the qualified research is analyzed and compared to objectively evaluate the treatment from the liver and kidney.The effectiveness and safety of perimenopausal insomnia provide reliable evidence-based medicine support.(2)Through data mining of the prescriptions for treating perimenopausal insomnia from liver and kidney,the rules of medication and treatment are summarized,so as to guide clinical syndrome differentiation and provide clinical directions and reference.MethodMeta analysis:Search RCT studies of treating perimenopausal insomnia from liver and kidney according to the inclusion criteria by computer from China National Knowledge Infrastructure(CNKI),VIP Database,China Biomedical Literature Database(CBM),Wanfang Medical Database,Pubmed Database.After the papers are included,the researchers will conduct quality evaluation and establish a database,extract the data and import the information into RevMan5.3 software for Meta analysis.Data Mining:Search studies of traditional Chinese medicine compound documents of treating perimenopausal insomnia from liver and kidney according to the inclusion criteria by computer from China National Knowledge Infrastructure(CNKI),VIP Database,China Biomedical Literature Database(CBM),Wanfang Medical Database,Pubmed Database.After establishing a database,extracting data,standard cleaning and processing the data,the researcher use SPSS Modeler 18.0 and SPSS 25.0 to perform association analysis and cluster analysis,exploring the drug rule of treating perimenopausal insomnia from liver and kidney theory.Results(1)Meta-analysis:Eleven literature studies were included in this study,and a total of 888 patients were treated,including 456 patients in the TCM group and 432 patients in the control group.Among the papers included,1 paper was of high quality and the rest were of low quality.The literature test was heterogeneous,with random effects model and funnel plot showing publication bias.There was statistically significant difference in total effective rate in Meta analysis(OR=4.01,95%CI[2.08,7.72],P<0.05).The difference in PSQI score was statistically significant[OR=-2.63,95%CI[-3.78,-1.48],P<0.05).SPIEGEL score difference was not statistically significant(OR=0.85,95%CI[-2.37,2.09],P>0.05).Adverse reaction heterogeneity test results showed that P=0.49,I2=0%,suggesting that there was no heterogeneity among studies,and the fixed effect model was selected.The difference was statistically significant(OR=0.05,95%CI[0.02,0.11],P<0.05).(2)Data Mining:45 literatures were included in data mining,38 of which were designed by random method,5 of which were non-RCT studies without control group,and 2 of which were empirical articles.The traditional Chinese medicines used more than 10 times were Baishao、Suanzaoren、Shanzhuyu、Gancao、Chaihu、Shudihuang、Shengdihuang、Danggui、Yejiaoteng、Hehuanpi、Fulin、Zhimu、Mudanpi、Yujin、Longgu、Nvzhenzi、Shanyao.Commonly used drugs were tonic drugs,tranquilizers and antipyretic drugs.More common drug four nature was cold,followed by flat,warm.Sweet herbs were used most frequently;bitter drugs were in second place;salty herbs were used the least.Most drugs entered the liver meridian,followed by the kidney meridian and the heart meridian.After association rule analysis,the drug had the highest support degree and confidence degree for Baishao-Suanzaoren and the group of Baishao-Shudihuang,Shanzhuyu.After cluster analysis,the core drug group could be divided into 5 categories.ConclusionsThe treatment of perimenopausal insomnia from liver and kidney has good clinical efficacy and high safety,which is worthy of clinical recommendation.Clinical treatment of perimenopausal insomnia from the liver and kidney,often use Baishao、Suanzaoren、Shudihuang and other traditional Chinese medicine;main prescription often use Liuwei Dihuang pill,Erxian Tang combined with herbs which can sooth the liver and regulate qi,clear heat and purge fire.