慢性失眠患者中医证候分布调查研究

Investigation on the distribution of TCM syndromes in patients with chronic insomnia.

目的分析慢性失眠人群中医证候特点及分布规律,为失眠的辨证施治提出不同的方法。方法选取400例失眠患者参与研究,通过制定中医四诊信息表,收集患者的病例资料,判定其证候,计算量表评分,归纳分析之病性、病位、证型。结果不同年龄、婚姻状况、职业的失眠患者SPIEGEL评分比较差异均有统计学意义(P<0.01)。对中医四诊信息进行因子分析,选取大于1的公因子,证明失眠的病位证素在心、肾、脾、胃、肝、胆;病性证素包括虚、气滞、痰湿、火、热。聚类分析得出7类证型:肝郁气滞、心脾两虚、痰热内扰、痰湿中阻、肝阳上亢、心虚胆怯、心肾不交。结论失眠与五脏六腑的功能活动密切相关,但主要在心,其本质在于脏腑气机运动失常导致阴阳失交而不寐。

Objective To analyze the characteristics and distribution of TCM syndromes of chronic insomnia and propose different methods for the treatment of insomnia based on different syndromes.Methods A total of 400 insomniacs were selected and their case data were collected to judge their syndromes through TCM four diagnostic information table.All subjects’disease nature,disease location,and syndrome type were analyzed.Results There existed significant differences in the SPIEGEL scores of insomnia patients with different ages,different marital statuses and different occupations(P<0.01).The factor analysis of TCM four diagnostic information was carried out,and the common factor greater than 1 was selected to prove that the disease location of insomnia were in the heart,kidney,spleen,stomach,liver and gallbladder;the disease nature of insomnia were deficiency,Qi stagnation,phlegm-damp,fire,heat.Cluster analysis showed 7 kinds of syndrome types:liver Qi stagnation,heart-spleen deficiency,phlegm-heat attacking internally,phlegm-damp blocked,hyperaction of liver Yang,timidity due to heart-deficiency,heart-kidney imbalance.Conclusion Insomnia is closely related to the functional activities of internal organs of the body,but mainly in the heart.Its essence lies in the disorder of Zang-fu organs Qi movement,which leads to the Yin-Yang incompatibility and insomnia.