345例阻塞性睡眠呼吸暂停低通气综合征患者中医证候分布规律研究

Distribution of Traditional Chinese Medicine Syndromes in Patients with Obstructive Sleep Apnea-hypopnea Syndrome:An Analysis of 345 Cases

【目的】探究成人阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的中医证候分布规律。【方法】收集2019年2月至2020年2月在深圳市中医院就诊的345例OSAHS患者的中医四诊资料,采用系统聚类分析方法探讨OSAHS患者的中医证候分布情况。【结果】(1)共收集关于OSAHS的证候及舌脉象等四诊资料75个,总出现频率为7320次,根据频数分析结果得出睡眠打鼾、张口呼吸、头晕头昏、头身困重、形体肥胖5个主要证候,其分布频率均大于65%;根据频数分析得出OSAHS的主要舌象为:舌胖大、舌边齿痕、苔腻、苔滑、舌黯;主要脉象为:脉滑、脉细、脉弦、脉涩。(2)根据聚类分析得出气滞痰瘀证(占32.22%)、痰湿内阻证(占26.75%)、肺脾气虚证(占23.40%)、痰热内蕴证(占10.33%)、肾阳亏虚证(占7.29%)5个中医证型。【结论】OSAHS患者的中医证型主要以气滞痰瘀证、痰湿内阻证、肺脾气虚证为主,而且不同证型之间多有兼夹,该聚类分析结果可为OSAHS的临床中医诊疗提供客观参考依据。

Objective To investigate the distribution of traditional Chinese medicine(TCM)syndromes in adult patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods The clinical data of 345 OSAHS patients obtained by four TCM diagnostic methods were collected in Shenzhen Traditional Chinese Medicine Hospital from February 2019 to February 2020,and statistical software IBM SPSS Statistics 26 clustering procedures were performed for the investigation of the distribution of TCM syndromes in OSAHS patients.Results(1)A total of 75 items of the diagnostic data of OSAHS patients including syndrome manifestations,tongue and pulse conditions were obtained,with a total frequency of 7320.According to the frequency analysis results,the five main symptoms of sleep snoring,mouth breathing,vertigo and dizziness,heaviness in the head and body,and obesity accounted for more than 65%.The frequency analysis showed that the tongue manifestations of OSAHS patients were mainly characterized by enlarged tongue,tooth-marked tongue,tongue with greasy coating,tongue with slippery fur,and dark tongue,and the pulse condition was characterized by smooth pulse,thready pulse,stringy pulse and unsmooth pulse.(2)The cluster analysis showed that the TCM syndromes of OSAHS patients were classified into qi stagnation with phlegm and blood stasis syndrome(accounting for 32.22%),internal obstruction of phlegm-damp syndrome(accounting for 26.75%),lung and spleen qi deficiency syndrome(accounting for 23.40%),internal accumulation of phlegm-heat syndrome(accounting for 10.33%)and kidney yang insufficiency syndrome(accounting for 7.29%).Conclusion The TCM syndromes of OSAHS patients are predominated by qi stagnation with phlegm and blood stasis syndrome,internal obstruction of phlegm-damp syndrome,and lung and spleen qi deficiency syndrome,and the syndromes usually mingle with each other.The clustering results will provide an important reference for the clinical TCM classification and treatment of OSAHS.