慢性肝胆病伴失眠多梦的证型分布特点分析  

The investigation of the clinical features and distribution of TCM syndrome in Chronic liver and gallbladder diseases patients with insomnia and dreaminess

作　　者：张压西[1] 石松[2] 王奕[2] 刘明波[2] 

机构地区：[1]武汉市中医医院消化内科,430014 [2]湖北中医药大学,武汉430065

出　　处：《世界睡眠医学杂志》2014年第2期102-106,共5页World Journal of Sleep Medicine

基　　金：国家自然科学基金资助(30973687)

摘　　要：目的观察慢性肝胆病失眠多梦的临床特征,分析多梦的发生频率和中医证型分布情况,试图发现慢性肝胆病患者中失眠与多梦的相关性,从中医经典理论"肝藏血,血舍魂"引发出对梦诊的进一步思考。方法采用睡眠基本情况调查表、PSQI、SRSS、SAS和SDS量表问卷方式,归纳慢性肝胆病失眠多梦患者临床特征,借助统计软件对数据分析总结,并探讨其机理。结果慢性肝胆病合并失眠的患者中出现多梦占54.4%(135/248)、出现恶梦占13.3%(18/135);从性别分布看,慢性肝胆病失眠中多梦的男性占45.9%(62/135)、女性占54.1%(73/135);从中医证型分布看,男性多发于肝郁气滞型29.0%(18/62)和肝郁血瘀证型21.0%(13/62),女性多发于心胆不宁型28.8%(21/73)、肝血亏虚型19.2%(14/73)、肝郁气滞证型16.4%(12/73);慢性肝胆病单纯失眠与失眠多梦者在PSQI和SRSS评分比较方面差异无统计学意义;在SAS评分比较,男性高于同组女性(P<0.05);SDS评分比较,女性高于同组男性(P<0.05);SDS评分比较,失眠多梦组女性高于单纯失眠组女性(P<0.05)。结论失眠多梦是慢性肝胆病常见伴随症状,中医证型蕴涵了不同性别患者特定的失眠特征。To explore the correlation between chronic liver and gallbladder diseases with insomnia and dreaminess by observing the clinical features of chronic liver and gallbladder diseases with insomnia and dreaminess, analysing the frequency of dreaminess and distribution of TCM syndrome. To reflect further on dream diagnosis based on the classical theory of traditional Chinese medicine ＂liver storing blood, blood storing soul＂. Methods To summarize the clinical features of patients with chronic liver and gallbladder diseases with insomnia and dreaminess by sleep basic questionnaire, PSQI, SRSS, SAS and SDS scale questionnaire, to analyze and summarize the data by using statistical software, and explore its mechanism. Results In total chronic liver and gallbladder diseases patients with insomnia and dreaminess, the dreaminess accounted for 54.4% （ 135/248）, the emergence of a nightmare accounted for 13.3% （ 18/135 ）. On the gender distribution of chronic liver and gallbladder diseases and insomnia and dreaminess, males accounts for 45.9% （62/135）, female accounts for 54.1% （73/135）. On the distribution of TCM syndrome,in the total dreaminess patients, male trends to liver-Qi stagnation type 32.1% （18/62）and stagnation of blood stasis 23.2% （ 13/62 ）, female trends to the heart and gallbladder restless type 28.8% （ 21/73 ）, the deficiency of hepatic blood type19.2% （ 14/73 ） and liver-Qi stagnation type 16.4% （ 12/73 ）. There is no significant difference between chronic liver and gallbladder diseases patients with insomnia and with both insomnia and dreaminess. In comparison of SAS score, male is higher than female from the same group （P 〈 0.05 ）. In comparison of SDS score, female is higher than male from the same group （P 〈 0.05 ） ,and female in the group of both insomnia and dreaminess is more than only insomnia（ P 〈 0.05 ）. Conclusion The insomnia and deaminess are the common associated symptoms of chronic liver and gallbladder diseases ,TCM syndrome implies in

关 键 词：肝藏血 失眠 多梦 中医证型 

分 类 号：R259.631[医药卫生—中西医结合]