帕金森病睡眠障碍患者中医证候要素及其危险度分析  

Analysis on Traditional Chinese Medicine Syndrome Elements and Its Risk Degree of Parkinson’s Disease Patients with Sleep Disorder

作　　者：周沪方 秦斌[2] 樊东升[3] 李小刚[3] 刘娜[3] 李雨濛[1] 张天清[1] 田浩林 纪显玥 贾冬冬 李婷[1] 时晶[1] 田金洲[1] ZHOU Hufang;QIN Bin;FAN Dongsheng;LI Xiaogang;LIU Na;LI Yumeng;ZHANG Tianqing;TIAN Haolin;JI Xianyue;JIA Dongdong;LI Ting;SHI Jing;TIAN Jinzhou(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700;Beijing Hospital;Peking University Third Hospital)

机构地区：[1]北京中医药大学东直门医院,北京市100700 [2]北京医院 [3]北京大学第三医院

出　　处：《中医杂志》2019年第22期1946-1950,共5页Journal of Traditional Chinese Medicine

基　　金：首都卫生发展科研专项(首发2014-1-4191);北京市科技计划首都临床特色应用研究(Z141107002515019)

摘　　要：目的研究帕金森病睡眠障碍患者的中医证候特征。方法将156例帕金森病患者采用帕金森病睡眠障碍量表分为睡眠障碍组(105例)和非睡眠障碍组(51例),并采用课题组制定的帕金森病证候要素量表进行证候要素辨别,包括肾虚、脾虚、气虚、血虚、阴虚、阳虚、髓减、血瘀、阳亢、内热、痰浊、气滞和肝风13个中医证候要素。比较两组患者各证候要素积分和所占比例的差异及复合证候要素分布情况,用Logistic回归法分析各证候要素对帕金森病睡眠障碍发病的危险度。结果睡眠障碍组阴虚占85.7%,髓减占87.6%,非睡眠障碍组分别为70.6%、66.7%,差异有统计学意义(P=0.031,P=0.004);睡眠障碍组肾虚证候要素积分为(10.62±3.46)分,非睡眠障碍组为(9.04±3.43)分,差异有统计学意义(P=0.012)。睡眠障碍组阴虚+阳亢、肾虚+髓减、阴虚+髓减比例分别为63.8%、81.9%、77.1%,显著高于非睡眠障碍组的45.1%、58.8%、47.1%,差异具有统计学意义(P=0.038、P=0.003、P<0.001)。阴虚(P=0.027、OR=2.500)、髓减(P=0.003、OR=3.538)证候要素对帕金森病睡眠障碍发病具有危险性;阴虚+阳亢(P=0.028、OR=2.146)、肾虚+髓减(P=0.002、OR=3.168)、阴虚+髓减(P<0.001、OR=3.797)对帕金森病睡眠障碍发病具有危险性。结论帕金森病睡眠障碍的主要证候要素为阴虚、髓减,常以阴虚阳亢、肾虚髓减的复合证候形式出现,其对帕金森病睡眠障碍的发病具有危险性。Objective To study the characteristics of traditional Chinese medicine(TCM)syndromes in Parkinson’s disease patients with sleep disorders.Methods A total of 156 patients with Parkinson’s disease were divided into a sleep disorder group(105 cases)and a non-sleep disorder group(51 cases)by Parkinson’s Disease Sleep Disorder Scale,and the Parkinson’s disease syndrome element scale developed by the research group was used to identify syndrome elements,including 13 TCM syndrome elements such as kidney deficiency,spleen deficiency,qi deficiency,blood deficiency,yin deficiency,yang deficiency,marrow reduction,blood stasis,yang hyperactivity,internal heat,phlegm turbid,qi stagnation and liver wind.The differences between the scores of the syndrome elements and the proportion,and the composite syndrome elements were compared between groups.The logistic regression method was further used to analyze the risk of the syndrome elements in the pathogenesis of Parkinson’s disease.Results In the sleep disorder group,yin deficiency accounted for 85.7%,marrow reduction accounted for 87.6%,and those in the non-sleep disorder group was 70.6%and 66.7%,respectively.The difference was statistically significant(P=0.031,P=0.004);In the sleep deficiency group,the kidney deficiency syndrome elements score was(10.62±3.46)points,and that of the non-sleep disorder group was(9.04±3.43)points.The difference was statistically significant(P=0.012).The proportion of yin deficiency+yang hyperactivity,kidney deficiency+marrow reduction and yin deficiency+marrow reduction in the sleep disorder group was 63.8%,81.9%,and 77.1%,respectively,which was significantly higher than 45.1%,58.8%,47.1%in the non-sleep disorder group.The difference had statistical significance(P=0.038,P=0.003,P<0.001).Yin deficiency(P=0.027,OR=2.500)and marrow reduction(P=0.003,OR=3.538)syndrome elements had risks for the onset of sleep disorders in Parkinson’s disease;Yin deficiency+yang hyperactivity(P=0.028,OR=2.146),kidney deficiency+marrow reduction(P=0.002,OR=3

关 键 词：帕金森病 睡眠障碍 证候要素 阴虚 髓减 危险度 

分 类 号：R74[医药卫生—神经病学与精神病学]