成人慢性失眠患者中医证治规律初探

Preliminary Study on The Law of Treatment Based on Syndrome Differentiation of Chronic Insomnia in Adults

目的:对成人慢性失眠的中医证治规律进行初探,为中医临床诊疗提供参考。方法:对118例成人慢性失眠患者的症状、证素、药物进行频率分析,对药物、病位证素与病性证素进行系统聚类分析。结果:症状中入睡困难出现频率最高,其次是早醒、口干、注意力分散、多梦等。病位证素按频率由高至低为心、肾、肝、脾、胃及胆,病性证素为气虚、气滞、阳虚、阴虚、热、湿及血瘀,病位证素与病性证素最常见的组合是心、脾和气虚。在药物选择上,党参使用频率最高,最常见的药物组合为党参、炙甘草、地黄、白芍、黄芩。结论:成人慢性失眠的病位主要在心,与肾、肝、脾、胃及胆密切相关,最常见的病位证素与病性证素的组合是心、脾和气虚,虚实夹杂、以虚为主是成人慢性失眠的病机特点,安神药并非必用药。

Objective:To explore the law of treatment based on syndrome differentiation of chronic insomnia in adults and provide reference of diagnosis and treatment of this disease.Methods:The frequency of symptoms,syndrome elements and drugs of 118 adult patients with chronic insomnia were analyzed,and drugs,the syndrome elements of disease location and the syndrome elements of disease nature were analyzed by cluster analysis.Results:Among the symptoms,the frequency of difficulty in falling asleep is the highest,followed by early awakening,dry mouth,distraction,dreaminess,etc.From high to low,the frequency of the syndrome elements of disease location are heart,kidney,liver,spleen,stomach and gollbladder,the syndrome elements of disease nature are Qi deficiency,Qi stagnation,Yang deficiency,Yin deficiency,heat,dampness and blood stasis.The most common combination of syndrome elements of disease location and disease nature is heart,spleen and Qi deficiency.In drug selection,Codonopsis RadixKnives was used most frequently.The most common drug combination is Codonopsis Radix,prepared Radix Glycyrrhizae,Rehmanniae Radix,Paeoniae Radix Alba,Scutellariae Radix.Conclusion:The main syndrome elements of disease location of chronic insomnia in adults is mainly in heart,which is closely related to kidney,liver,spleen,stomach and gallbladder.The most common combination of syndrome elements of disease location and disease nature is heart,spleen and Qi deficiency.The pathogenesis of chronic insomnia in adults is characterized by the intermingled deficiency and excess,mainly deficiency.Chinese medicine sedatives are not necessary.