阻塞性睡眠呼吸暂停患者中医证型分布规律及特征分析

Study on distribution and characteristics of TCM syndrome types in patients with obstructive sleep apnea

目的分析阻塞性睡眠呼吸暂停(OSA)患者中医证型分布规律及特征。方法选择2020年1月—2022年1月于首都医科大学附属北京中医医院综合科住院部治疗的OSA患者60例,收集患者的一般资料,包括性别、年龄、中医证候、睡眠呼吸暂停低通气指数(apnea-hypopnea index,AHI)、夜间最低血氧饱和度(SaO2)、合并基础病。结果60例OSA患者中,痰瘀互阻证33例(55.00%)、湿热中阻证13例(21.67%)、肺脾气虚证8例(13.33%)、肺肾阳虚证6例(10.00%);肺肾阳虚证轻度OSA占比较其他证型高(P<0.05),痰瘀互阻证较其他证型更易发生重度夜间低氧血症(P<0.05);65.00%的患者合并高血压,痰瘀互阻证合并高血压比例较其他证型高(P<0.05)。结论OSA患者中痰瘀互阻证、湿热中阻证最为常见,痰瘀互阻证患者多为中重度OSA、夜间低氧血症程度重、临床常合并高血压,肺肾阳虚证患者更易发为轻度OSA。

Objective To analyze the distribution and characteristics of TCM syndromes in patients with obstructive sleep apnea(OSA).Methods 60 patients,who were diagnosed with OSA during hospitalization from January 2020 to January 2022 in the General Department of Beijing Hospital of Traditional Chinese Medicine affiliated to the Capital Medical University,were collected.The gender,age,TCM syndromes,apnea-hypopnea index(AHI),minimum blood oxygen saturation at night(SaO2),and complicated underlying diseases were summarized.Results Among 60 OSA patients,33 cases(55.00%)were characterized by mutual obstruction of phlegm and stasis,13 cases(21.67%)were characterized by dampness and heat obstruction in the middle jiao,8 cases(13.33%)were characterized by lung and spleen qi deficiency,and 6 cases(10.00%)were characterized by lung and kidney Yang deficiency.Mild OSA was more likely to occur in lung and kidney Yang deficiency than other syndromes(P<0.05).Severe nocturnal hypoxemia was more likely to occur in the phlegm-stasis syndrome group than in the other syndrome groups(P<0.05).65.00%patients were complicated with hypertension,and the syndrome of mutual obstruction of phlegm and stasis together with hypertension was more than that of other syndromes(P<0.05).Conclusion Among the OSA patients,the syndrome of mutual obstruction of phlegm and blood stasis and dampness and heat obstruction in the middle jiao are the most common.Most patients with phlegm and blood stasis syndrome suffer from moderate to severe OSA,more severe hypoxemia at night,and higher risk of hypertension.Patients with lung and kidney Yang deficiency syndrome are more likely to develop mild OSA.