亚健康失眠阴虚火旺证与心脾两虚证症状构成分析

Analysis of Symptom Compositions in Sub-health Insomnia Patients of Yin Deficiency Fire Hyperactivity Syndrome and Xin-Pi Deficiency Syndrome

目的探讨亚健康失眠中医证候特征,明确各证的症状构成,为确定中医证候辨证标准的主、次症及构建辨证方法体系提供参考依据。方法通过对多中心、大样本临床中医证候信息采集,经信息统计处理得出亚健康失眠常见证型、症状构成及其匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)得分情况。结果亚健康失眠心脾两虚证及阴虚火旺证患者最常见的主症是入睡困难、早醒、多梦、时睡时醒、醒后不能再睡、整夜不能睡,两种证型主症比较,差异无统计学意义(P>0.05);两证型的次症具有各自证型一些独特症状,心脾两虚证中有乏力、食后腹胀等脾虚症状,而阴虚火旺证则有口干、五心烦热、烦躁等心肝火旺症状,两种证型次要症状(除心烦懊恼、小便频数外)比较,差异均有统计学意义(P<0.05,P<0.01)。两证型PSQI总分比较,差异无统计学意义(P>0.05),但睡眠障碍因子比较,差异有统计学意义(P<0.05),阴虚火旺证患者睡眠障碍因子更严重。结论亚健康失眠阴虚火旺证和心脾两虚证在证候学上主症差异无统计学意义,但次症上有独特症状,而且在睡眠质量成分上有区别。

Objective To study Chinese medicine syndrome features in sub-health insomnia patients,and to make clear the symptom compositions of each syndrome,thus providing references for main and minor symptoms selection,and establishing a syndrome differentiation system in clinical testing.Methods Chinese medicine syndrome information was collected by multi-centered large-sample clinical data.The information was statistically managed to get common syndrome types,symptoms compositions,and the Pittsburgh Sleep Quality Index（PSQI） scores of sub-health insomnia patients.Results The most common symptoms of sub-health insomnia patients of yin deficiency fire hyperactivity syndrome and Xin-Pi deficiency syndrome cover difficulties in falling asleep,early awakening,dreaminess,sometimes sleeping sometimes awake,failing in falling into sleep when wake up,failing in sleep all night.There was insignificant difference between the two syndrome types（P0.05）.Some unique symptoms occurred in the two syndrome types as minor symptoms.Fatigue,abdominal distension after eating occurred in patients of Xin-Pi deficiency syndrome.Burning sensation of five centers,irritability,etc.occurred in patients of yin deficiency fire hyperactivity syndrome.Significant difference was shown in minor symptoms（except irritability,vexation,frequent urine）（P0.05,P0.01）.No significant difference was shown in PSQI score between the two syndrome types（P0.05）.But significant difference was shown in sleep disturbance factors（P0.05）.Patients of yin deficiency fire hyperactivity syndrome had severe sleep disturbance factors.ConclusionThere was no significant difference in main symptoms between the two syndrome types.Some unique symptoms occurred in the two syndrome types as minor symptoms.There was difference in sleep quality compositions.