综合医院门诊患者失眠的影响因素及与中医体质的相关性

Influencing factors of insomnia in outpatients of general hospitals and their correlation with Traditional Chinese Medicine constitution

目的探讨失眠在综合医院门诊就诊患者中的发生率、影响因素及其与中医体质的关系。方法对1550例在广州市4家综合医院门诊就诊的患者进行测评,使用《睡眠问卷》判断是否存在失眠症状,情绪症状通过抑郁自评量表(PHQ-9)、广泛性焦虑症量表(GAD)自评,中医体质使用中医体质分类与判定表自评。结果在综合医院就诊的患者中,失眠的发生率是15.2%。失眠组比无失眠组的年龄更大、受教育年限更少、GAD和PHQ-9的得分更高,体质方面得分除平和质较低外其余8种体质均较高(P<0.05)。logistics回归示年龄、PHQ-9以及阴虚质与失眠呈正相关,平和质、气虚质、阳虚质以及高血压史与失眠呈负相关(P<0.05)。结论综合医院门诊患者失眠与年龄、抑郁情绪均有相关性;与中医体质密切相关,其中阴虚质患者失眠的发生率更高。

Objective To investigate the incidence of insomnia in outpatients of general hospitals,influencing factors and their correlations with the constitution of Traditional Chinese Medicine.Methods A total of 1550 patients in the outpatient clinics of 4 general hospitals in Guangzhou were evaluated.The Sleep Questionnaire was used to determine whether there were symptoms of insomnia.Emotional symptoms were assessed by the Self-Rating Depression Scale(PHQ-9)and self-evaluated Generalized Anxiety Disorder Scale(GAD).TCM physique self-evaluation was applied using TCM constitution classification and judgment table.Results Among patients treated in general hospitals,the incidence of insomnia was 15.2%.Compared with the insomnia-free group,the patients in insomnia group were significantly older,with fewer years of education,higher GAD and PHQ-9 scores,and higher scores in the other eight constitution except for the lower neutral constitution(P<0.05).Logistics regression showed that age,PHQ-9 and Yin-deficiency quality were positively correlated with insomnia;while calm quality,Qi-deficiency quality,Yang-deficiency quality,and history of hypertension were negatively correlated with insomnia(P<0.05).Conclusion Insomnia in outpatients of general hospitals is correlated to age and depression.It is closely correlated to the constitution of Traditional Chinese Medicine,and the incidence of insomnia is higher in patients with Yin-deficiency constitution.