失眠患者637例证型与体质类型的相关性研究

Study on correlation between syndrome types and physique types of 637 cases of insomnia

目的:研究失眠患者中医证型与体质类型的相关性。方法:采用横断面研究方法,收集637例失眠患者一般资料、中医四诊信息,进行证型、体质类型的判定,运用典型相关分析方法计算证型与体质类型的相关程度。结果:637例失眠患者主要证型为心脾两虚证216例(25.3%)、心肾不交证197例(23.1%)、心胆气虚证129例(15.1%),主要体质类型为阴虚质159例(25.0%)、气郁质153例(24.0%)、气虚质138例(21.7%)。典型相关分析结果表明,心脾两虚证与气虚质、阳虚质呈显著正相关(P<0.01),心肾不交证与阴虚质呈显著性正相关(P<0.01),心胆气虚证与气虚质、痰湿质呈显著正相关(P<0.05,P<0.01),胃气不和证与气郁质、痰湿质呈显著正相关(P<0.01),肝郁化火证与气郁质、湿热质呈显著正相关(P<0.01),痰热内扰证与湿热质呈显著正相关(P<0.01),瘀血内阻证与瘀血质呈显著正相关(P<0.01)。结论:失眠证型与患者体质类型关系密切,能较好地为辨体-辨病-辨证提供客观依据,对临床做出针对性、个体化诊疗方案具有指导意义。

Objective:To study the correlation between traditional Chinese medicine(TCM)syndrome types and physique types in patients with insomnia.Methods:The cross-sectional research method was used to collect the general information of 637 patients with insomnia and the TCM four-diagnosis information to determine the syndrome type and physique type.The canonical correlation analysis method was used to calculate the degree of correlation between the syndrome type and the physique type.Results:The main syndrome types of 637 patients with insomnia were 216 cases(25.3%)of the deficiency of both heart and spleen,197 cases(23.1%)of the incompatibility of the heart and kidney,129 cases(15.1%)of the deficiency of heart,gallbladder qi.The main physique types were yin deficiency 159 cases(25.0%),153 cases(24.0%)with stagnation of qi,and 138 cases(21.7%)with deficiency of qi.The results of canonical correlation analysis showed that the deficiency of heart and spleen syndrome was significantly positively correlated with the quality of qi deficiency and yang deficiency(P<0.01),the syndrome of heart-kidney failure was significantly positively correlated with the quality of yin deficiency(P<0.01),and the deficiency of heart and gallbladder qi was significantly positively correlated with the quality of qi deficiency and phlegm-dampness(P<0.05,P<0.01).Disharmony of stomach-qi syndrome was significantly positively correlated with qi stagnation quality and phlegm-damp quality(P<0.01).Liver stagnation transforming fire syndrome was significantly positively correlated with qi stagnation and damp-heat quality(P<0.01).There was a significant positive correlation between phlegm-heat internal disturbance syndrome and damp-heat quality(P<0.01),and there was a significant positive correlation between the blood stasis internal resistance syndrome and the blood stasis quality(P<0.01).Conclusion:The type of insomnia has a close relationship with the physique type of the patient,which can provide an objective basis for body differentiation,disease differentiation,and syndrome differentiation,and has guiding significance for clinically targeted and individualized diagnosis and treatment programs.