萧山地区帕金森病睡眠障碍患者中医证候要素、复合证候及其危险因素研究

TCM Syndrome Elements, Complex Syndromes, and Risk Factors of Parkinson’s Disease Patients with Sleep Disorders in Xiaoshan District

目的 分析萧山地区帕金森病睡眠障碍(PDSD)患者的中医证候及其危险因素,旨在为相关人员的研究工作提供参考。方法 择取2018年6月—2021年6月萧山地区某医院收治的160例帕金森病(PD)患者作为研究对象,结合《CCMD-3中国精神障碍分类与诊断标准(第三版)》中的相关标准,依照患者是否存在睡眠障碍(SD),分为睡眠障碍组(107例)和非睡眠障碍组(53例)。采用帕金森病证素量表比较两组PD患者中医证候要素(证素)及中医复合证候分布情况,并应用多因素Logistic回归分析法分析PDSD患者中医证素及中医复合证候针对PDSD发生的危险因素。结果 两组证素分布情况比较,睡眠障碍组阴虚证、髓减证比例高于非睡眠障碍组,差异具有统计学意义(P <0.01);其余各证素组间分布情况比较,差异无统计学意义(P> 0.05)。两组复合证候分布情况比较,睡眠障碍组肾虚证+髓减证、阴虚证+髓减证、阴虚证+阳亢证比例高于非睡眠障碍组,差异具有统计学意义(P <0.01);其余各复合证候组间分布情况比较,差异无统计学意义(P> 0.05)。阴虚证、髓减证针对PDSD发生有危险性(OR=2.511,P <0.01;OR=3.549,P <0.01),肾虚证+髓减证、阴虚证+髓减证、阴虚证+阳亢证为发生PDSD的危险因素(OR=3.179,P <0.01;OR=3.796,P <0.01;OR=2.162,P <0.01)。结论 萧山地区PDSD中医证素主要为阴虚证、髓减证,往往以肾虚髓减、阴虚髓减、阴虚阳亢的形式加以表现,并对PDSD的发生存在危险性。

Objective To analyze the traditional Chinese medicine(TCM)syndromes and risk factors of patients with sleep disorder in Parkinson’s disease(PDSD)in Xiaoshan district and provide inspiration for relevant researchers.Methods A total of 160 patients with Parkinson’s disease(PD)treated in a hospital in Xiaoshan district from June 2018 to June 2021 were enrolled and divided into a sleep disorder group(107 cases)and a non-sleep disorder group(53 cases)according to the relevant standards in the 3 rd edition of Chinese Classification of Mental Disorders(CCMD-3).A PD rating scale was used to compare the distribution of TCM syndrome elements and TCM complex syndromes between the two groups,and multivariate logistic regression analysis was used to analyze the risk factors of TCM syndrome elements and TCM complex syndromes in PDSD patients.Results As revealed by the comparison of the distribution of syndrome elements in the two groups,the proportions of yin deficiency syndrome and essence sufficiency syndrome in the sleep disorder group were higher than those in the non-sleep disorder group(P<0.01).There was no significant difference in the distribution of other syndrome elements between groups(P>0.05).The comparison of the distribution of complex syndromes in the two groups indicated that the proportions of kidney deficiency syndrome+essence sufficiency syndrome,yin deficiency syndrome+essence sufficiency syndrome,and yin deficiency syndrome+yang hyperactivity syndrome in the sleep disorder group were higher than those in the non-sleep disorder group(P<0.01).There was no significant difference in the distribution of other complex syndromes between groups(P>0.05).Risk factors existed in yin deficiency syndrome and essence sufficiency syndrome for PDSD(OR=2.511,P<0.01;OR=3.549,P<0.01).Kidney deficiency syndrome+essence sufficiency syndrome,yin deficiency syndrome+essence sufficiency syndrome,and yin deficiency syndrome+yang hyperactivity syndrome showed risk factors for PDSD(OR=3.179,P<0.01;OR=3.796,P<0.01;OR=2.162,P<0.01).Conclusion TCM syndrome elements of PDSD in Xiaoshan district were mainly yin deficiency syndrome and essence sufficiency syndrome which were often present in the patterns of kidney deficiency+essence sufficiency,yin deficiency+essence sufficiency,and yin deficiency+yang hyperactivity,possessing risk factors for the development of PDSD.