深圳地区绝经前后不寐患者体质类型及失眠程度与情绪障碍的相关性研究

Correlation of Constitution Types with Insomnia Severity and Emotional Disorders in Perimenopausal Insomnia Patients from Shenzhen Area

【目的】对深圳地区围绝经期失眠(绝经前后不寐)患者进行中医体质辨识和失眠程度、抑郁及焦虑情绪评估,寻找本地区围绝经期失眠患者的体质分布规律,探寻主要中医体质类型患者的失眠程度与抑郁焦虑情绪的相关性。【方法】收集100例符合纳入标准的围绝经期失眠女性患者的临床资料,采用匹兹堡睡眠质量指数(PSQI)进行失眠程度评估,采用中医体质辨识量表进行中医体质辨识,采用抑郁自评量表(SDS)和焦虑自评量表(SAS)进行抑郁及焦虑情绪评估,分析不同中医体质患者的失眠程度与抑郁、焦虑程度的相关性。【结果】(1)中医体质分布:100例围绝经期失眠患者的中医体质类型分布居前3位的依次为气郁质(31.0%)、阴虚质(26.0%)、气虚质(15.0%),未见平和质和特禀质。(2)围绝经期失眠患者失眠程度与抑郁、焦虑程度的相关性:围绝经期失眠患者多伴有不同程度的抑郁、焦虑,其失眠程度与抑郁、焦虑程度呈显著正相关性(P<0.01),相关系数介于0.474~0.772之间。(3)主要体质类型患者的失眠程度与抑郁、焦虑程度的相关性:气郁质患者的失眠程度与抑郁、焦虑程度均存在正相关性(P<0.01),相关系数介于0.457~0.715之间;阴虚质患者的失眠程度与抑郁、焦虑程度均存在正相关性(P<0.05或P<0.01),相关系数分别为0.431和0.980;气虚质患者的失眠程度与抑郁程度之间存在正相关性(P<0.05),相关系数为0.533。【结论】深圳地区围绝经期失眠患者多具有情绪障碍,其中医体质类型主要为气郁质、阴虚质、气虚质,且这3种体质类型患者的失眠程度与抑郁、焦虑程度均具有一定程度相关性;对围绝经期失眠患者进行中医体质辨识和调理,并配合情志疏导,将有助于提高临床疗效,改善睡眠质量。

Objective To identify the traditional Chinese medicine(TCM)constitution types and to assess the severity of insomnia,depression and anxiety in patients with perimenopausal insomnia(menopausal sleeplessness)from Shenzhen area,so as to find out the distribution pattern of perimenopausal insomnia patients from Shenzhen and to investigate the correlation between insomnia severity and depression-anxiety status in patients with major TCM constitution types. Methods The clinical data of 100 female patients with perimenopausal insomnia who met the inclusion criteria were collected. The severity of insomnia was assessed using the Pittsburgh Sleep Quality Index(PSQI),the TCM constitution identification scale was used to identify the TCM constitution,and the self-rating depression scale(SDS) and the self-rating anxiety scale(SAS) were used to assess depression and anxiety respectively. The correlation of the severity of insomnia with the severity of depression and anxiety in patients with various TCM constitution types was analyzed. Results (1)The top 3 TCM constitution types in the 100 perimenopausal insomnia patients were qi stagnation constitution(31.0%),yin deficiency constitution(26.0%)and qi deficiency constitution(15.0%),while balanced constitution and inherited special constitution were not seen.(2)Patients with perimenopausal insomnia were mostly accompanied by different severity of depression and anxiety,and the severity of insomnia showed a significant positive correlation with the severity of depression and anxiety(P<0.01),with the correlation coefficient ranging from 0.474 to 0.772.(3)Analyis of correlation of the severity of insomnia with depression and anxiety in patients with the primary constitution types showed that postive correlation was presented in qi stagnation constitution(P<0.01)with the correlation coefficient ranging from 0.457 to 0.715,in yin deficiency constitution(P<0.05 or P<0.01)with the correlation coefficient ranging from 0.431 to 0.980,and in qi deficiency constitution(P<0.05) with the correlation coefficient being 0.533. Conclusion Most perimenopausal insomnia patients from Shenzhen have emotional disorders,and their TCM constitution types are mainly identified as qi stagnation,yin deficiency and qi deficiency,and the severity of insomnia in these three constitution types is correlated with the severity of depression and anxiety to a certain extent. Differentiating and regulating the TCM constitution of perimenopausal insomnia patients, together with emotional and spiritual guidance,will help enhance clinical efficacy and improve sleep quality.