基于中医阴阳寤寐学说的原发性失眠阴证/阳证临床辨识系统初探  

Primary Study on Clinical Identification System of Primary Insomnia Yin or Yang Syndrome Based on YinYang Waking and Sleeping Theory of Chinese Medicine

作　　者：张娅[1] 黄俊山[1] 吴松鹰[2] 张敏[1] 张一帆[1] 赵欢欢[1] 黄真花 沈银河[1] 廖淑珍[1] 

机构地区：[1]福建省中医药研究院,福建省福州市五四路282号350003 [2]福建省第二人民医院

出　　处：《中医杂志》2016年第20期1754-1758,共5页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81173149);福建省卫生厅青年科研课题(2012-1-33);福建省公益类科研院所基本科研专项(2015R1035-10)

摘　　要：目的初步探讨原发性失眠阴证/阳证临床辨识系统。方法采用临床流行病学调查方法对704例原发性失眠患者的社会人口学特征、社会及躯体疾病等因素进行调查,运用神经心理学量表进行评估,同时观察各项睡眠参数。采用单因素及多因素二分类Logistic回归方法分析原发性失眠阴阳属性的主要影响因素。结果 704例原发性失眠患者中,阳证525例,阴证179例。与阴证患者比较,阳证患者年龄较大,男性、独身、A型性格、吸烟居多,而体育锻炼的强度、优质蛋白及胆固醇的摄入量、总体主观自评、宗教信仰、社会支持与联系、兴趣爱好方面较低,匹兹堡睡眠质量指数(PSQI)量表评分高(P<0.05或P<0.01);表现出明显的抑郁和焦虑状态,Logistic分析结果显示,原发性失眠阴阳属性的主要影响因素有年龄、性别、婚烟状况、体育锻炼、胆固醇摄入量、社会支持与联系、兴趣爱好、PSQI量表评分、睡眠时间、觉醒次数和睡眠效率。结论原发性失眠患者阳证居多,以肝郁化火证和阴虚火旺证多见。阳证患者年龄较大,男性、独身比例较高,体育锻炼强度较小,胆固醇摄入量低,缺乏社会支持与联系以及兴趣爱好,总体睡眠质量差,主要表现为睡眠时间短、觉醒次数多以及睡眠效率低下。Objective To preliminarily discuss the clinical identification system of primary insomnia Yin or Yang syndrome. Methods Clinical epidemiological methods were adopted to investigate the social demographic characteristics,social factors and healthy factors,and other factors of 704 patients with primary insomnia. Neuropsychological scales were used to evaluate patients＇ quality of sleep and psychological conditions. At the same time the sleep parameters were observed. Single factor and multi-factor binary Logistic regression analysis were used to analyze the main influencing factors of Yin or Yang primary insomnia. Results Among the 704 patients with primary insomnia,there were 525 cases of Yang Syndrome,and 179 cases of Yin syndrome. Compared with the patients with Yin Syndrome,patients with Yang syndrome were older,predominantly male,single,with type A personality,and smoking.Among the patients with Yang syndrome,scores of physical exercise intensity,high-quality protein and cholesterol intake,subjective self-assessment,religious beliefs,social support and contact,interest and hobbies were lower,and PSQI score was higher（P〈0. 05 orP〈0. 01）; and they were showing obvious depression and anxiety state. Logistic analysis showed that the main influencing factors of Yin or Yang primary insomnia are age,gender,marital status,physical exercise,cholesterol intake,social support and contact,interests and hobbies,PSQI scale score,sleep time,arousal frequency,and sleep efficiency. Conclusion The majority of patients with primary insomnia are with Yang syndrome,among which liver depression transforming into fire syndrome and Yin-deficiency and fire-hyperactivity syndrome are more common. Patients with Yang syndrome are older,more single and male,and the intensity of physical exercise is lower. These patients also have low cholesterol intake,lack of social support and relations and interests,poor overall sleep quality,which is mainly manifested as short sleep time,higher arousal frequency and low sleep efficiency.

关 键 词：原发性失眠 中医阴阳寤寐学说 阴证 阳证 临床辨识系统 

分 类 号：R256.23[医药卫生—中医内科学]