原发性失眠患者的证素分布规律及相关性研究

Study on the Distribution and Correlation of Syndrome Elements in Patients with Primary Insomnia

目的:探讨原发性失眠患者的中医证素分布规律,为临床诊治提供思路与方法。方法:采用回顾性研究方法,收集本地区120例原发性失眠患者的临床资料,分别对年龄、性别、病程、主诉与症状、证候等因素进行统计分析,得出原发性失眠临床证候要素及证型组合规律,并探讨不同证素与性别的相关性。结果:120例患者中年龄分布以中老年居多,51~60岁组(43例,35.8%);病程>24个月组患者人数占高比例(53例,44.2%);原发性失眠不同证素组合中,双证素组合(87例)患者数量多于三证素组合(33例),其中双证素组合中火热+气滞组合的肝郁化火证数量(26例,21.7%)多于其他组合;病性证素中以火热(83例)、气滞(63例)和痰浊(48例)多见,病位证素中以心(57例)、肝(63例)、脾(26例)多见;位于34例男性患者中前三位的病性证素分别是火热(24例)、痰浊(20例)、气滞(16例),位于86例女性患者中前三位的病性证素分别是火热(59例)、气滞(47例)、气虚(32例),其中气虚、痰浊男女性别病例数比较,P<0.05表示差异具有统计学意义。结论:原发性失眠涉及的主要病位证素是:肝、胆、心、脾、胃、肾;主要病性证素是:火热、气滞、气虚、痰浊、血虚、阴虚,且失眠病机以双证素居多。

Objective:To explore the distribution rules of traditional Chinese medicine syndrome elements in patients with primary insomnia,thereby providing ideas and methods for clinical diagnosis and treatment.Methods:The clinical data of 120 patients with primary insomnia in this area were collected by retrospective research method.The factors such as age,gender,course of disease,chief complaint and symptoms,syndrome were statistically analyzed.And the clinical syndrome elements and pattern combination rules of primary insomnia were obtained.The correlation between different syndrome elements and gender was discussed.Results:The age distribution of 120 patients was mainly middle-aged and elderly,with 43 cases(35.8%)in 51-60 years old group,and 53 cases(44.2%)in disease course>24 months group.Among the different syndrome element combinations of primary insomnia,the number of patients with double syndrome element combination(87 cases)was more than that of three syndrome element combination(33 cases),among which the number of liver stagnation and heat transforming fire syndrome(26 cases,21.7%)of double syndrome element combination was more than other combination.Fire heat(83 cases),Qi Stagnation(63 cases)and phlegm turbidity(48 cases)were more common in the disease nature syndrome elements,heart(57 cases),liver(63 cases)and spleen(26 cases)were more common in disease location syndrome elements;in 34 male patients,the top three syndrome elements were fire heat(24 cases),phlegm turbidity(20 cases),Qi Stagnation(16 cases).In 86 female patients,the top three syndrome factors were fire heat(59 cases),Qi Stagnation(47 cases)and Qi deficiency(32 cases).Among them,the number of cases of qi deficiency and phlegm turbidity between male and female was statistically significant(P<0.05).Conclusion:The main disease location syndrome elements involved in primary insomnia are:liver,gallbladder,heart,spleen,stomach and kidney;the main disease nature syndrome elements are:fire heat,qi stagnation,Qi deficiency,phlegm turbidity,blood deficiency,yin deficiency,and the pathogenesis of insomnia is mostly double syndrome elements.