原发性失眠中医证型与睡眠脑电图参数的相关性研究

Clinical Study on the Relationship between TCM Clinical Symptom Types and Sleep Electroencephalogram Parameters in Patients with Primary Insomnia

目的:探讨原发性失眠中医证型与睡眠脑电图主要参数的相关性。方法:选择符合纳入标准的原发性失眠患者126例,其中阴虚火旺证75例,心脾两虚证34例,心胆气虚证17例。观察各证型一般资料、睡眠脑电图主要参数以及匹兹堡睡眠质量量表(Pittsburgh sleep quality index,PSQI)评分的差异性。结果:原发性失眠中医证型间性别分布比较,差异无统计学意义(P>0.05),均以60岁以上为发病高峰。各证型睡眠脑电图参数睡眠总时间(TSA)、睡眠潜伏期(SL)、觉醒时间(ATA)、睡眠效率(SE)、S1期、S2期、异相睡眠(REM)等指标比较,差异有统计学意义(P<0.05或P<0.01)。阴虚火旺证患者TSA、ATA、SE均低于心胆气虚证,差异有统计学意义(P<0.05);心脾两虚证患者SL、TSA、SE均低于心胆气虚证,差异有统计学意义(P<0.05)。阴虚火旺证患者S1高于心胆气虚证、心脾两虚证(P<0.05),S2、REM均低于心胆气虚证(P<0.05);阴虚火旺证患者S1高于心脾两虚证(P<0.05),S2低于心脾两虚证(P<0.05)。结论:原发性失眠中医各证型与睡眠脑电图TSA、SL、ATA、SE、S1、S2、REM等主要参数,存在相关性;阴虚火旺证与S1、S2、PSQI评分存在密切相关性。

Objective:To observe the relationship between TCM clinical symptom types and sleep electroencephalogram parameters in patients with primary insomnia,and explore the objective indexes of TCM syndrome classification of primary insomnia.Method:126 cases of primary insomnia were selected,including 75 cases of Yin deficiency and fire exuberance syndrome,34 cases of heart-spleen deficiency syndrome and 17 cases of heart-gallbladder Qi deficiency syndrome.The difference of general data of each syndrome type,main parameters of sleep electroencephalogram and scores of Pittsburgh Sleep Quality Index(PSQI)was observed.Results:There are not sex distribution difference among the TCM syndrome types of primary insomnia(P>0.05).The incidence rates peak of TCM syndromes in the three groups are all over 60 years old.The difference is found in the sleep electroencephalogram main parameters among TCM syndrome types,such as total sleep duration(TSA),sleep latency(SL),awakening duration(ATA),sleep efficiency(SE),S1,S2,paradoxical sleep(REM)(P<0.05 or P<0.01).TSA,ATA and SE in patients with Yin deficiency and fire exuberance syndrome were lower than those in patients with heart-gallbladder Qi deficiency syndrome(P<0.05),SL,TSA and SE in patients with heartspleen deficiency syndrome were lower than those in patients with heart-gallbladder Qi deficiency syndrome(P<0.05).The S1 of patients with Yin deficiency and Fire excess syndrome was higher than that of heart-gallbladder Qi deficiency syndrome and heart-spleen deficiency syndrome(P<0.05),the S2 and REM were lower than that of heart-gallbladder Qi deficiency syndrome(P<0.05),the S1 of patients with Yin deficiency and fire excess syndrome was higher than that of heart-spleen deficiency syndrome(P<0.05),and the S2 was lower than that of heart-spleen deficiency syndrome(P<0.05).Conclusion:The key parameters of sleep electroencephalogram are different,such as TSA,SL,ATA,SE,S1,S2,REM,etc,among TCM clinical symptom types of primary insomnia,which provide an objective basic data for TCM classification and dialectical treatment.There is a more close correlation between yin deficiency and fire excess syndrome and S1,S2 of sleep electroencephalogram and PSQI index score.