基于因子分析探讨失眠症苯二氮䓬类药物依赖中医证候特征  

Exploration on the traditional Chinese medicine syndrome characteristics of insomnia with benzodiazepines dependence based on factor analysis

作　　者：高毅东 黄俊山 尹鹭峰 张瑜 张娅 曾雪爱 梁琛 易泳鑫 GAO Yi-dong;HUANG Jun-shan;YIN Lu-feng;ZHANG Yu;ZHANG Ya;ZENG Xue-ai;LIANG Chen;YI Yong-xin(Third People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou 350122,China;The Inheritance Studio of Fujian Famous Traditional Chinese Medicine Expert HUANG Jun-shan,Fuzhou 350003,China;Fujian Academy of Chinese Medical Sciences,Fuzhou 350003,China;Fujian Key Laboratory of Sleep Medicine of Traditional Chinese Medicine,Fuzhou 350003,China)

机构地区：[1]福建中医药大学附属第三人民医院,福州350122 [2]黄俊山福建省名老中医药专家传承工作室,福州350003 [3]福建省中医药科学院,福州350003 [4]福建省中医睡眠医学重点实验室,福州350003

出　　处：《中华中医药杂志》2021年第8期4863-4867,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家科技部重点研发计划项目(No.2018YFC1705600);国家自然科学基金项目(No.81774285);福建省教育厅中青年教师教育科研项目(No.JAT190271)。

摘　　要：目的:探讨失眠症苯二氮䓬类药物(BZD)依赖中医证候特征。方法:采用回顾性调查方法和横断面研究方案,收集失眠症BZD依赖和失眠症无BZD依赖患者的四诊资料,应用因子分析挖掘证候特征。结果:收集观察组477例,对照组477例。两组以中青年、慢性失眠为多,因子分析显示,观察组证型主要为肝郁脾虚证、肝郁肾虚证、心肾不交证、肝胃不和证、肝郁胆虚证、肝郁血瘀证;PSQI评分、SDS评分、药物对证型无影响,肝郁胆虚证SAS评分与其他证比较,差异有统计学意义(P<0.05);早醒、时睡时醒、通宵难眠、多梦、恶梦惊醒在6个证型间差异有统计学意义(P<0.05)。结论:失眠症BZD依赖证候以肝郁为主,兼有脾虚、肾虚等表现,病性虚实兼夹。Objective:To explore the TCM syndromes characteristics of insomnia with benzodiazepines(BZD)dependence.Methods:Retrospective survey and cross-sectional survey were included into this study.The detailed TCM syndrome information from insomnia patients with BZD dependence and insomnia patients without BZD dependence were collected,in which the four diagnostic information were analyzed using the factor analysis and cluster analysis.Results:A total of 477 cases in the observation group and 477 cases in the control group were collected.The two groups mainly consisted of middle-aged and young people with chronic insomnia.Factor analysis showed that the observation group had syndromes of liver depression and spleen deficiency,liver depression and kidney deficiency,heart and kidney failure,liver and stomach discordance,liver depression and gallbladder deficiency,liver depression and blood stasis syndrome;PSQI score,SDS score,drug had no effect on the syndrome type,liver stagnation and gallbladder deficiency syndrome was different from other syndromes in SAS score(P<0.05);Among 6 syndromes,wake up early,wake up when sleeping,overnight sleepless,dreamy and nightmare wake up,there were differences between the syndrome types(P<0.05).Conclusion:Insomnia BZD dependence syndrome is mainly liver stagnation,with both spleen and kidney deficiency manifestations,and both disease and deficiency.

关 键 词：失眠 苯二氮䓬类药物依赖 因子分析 中医证候 肝郁 因素 

分 类 号：R256.23[医药卫生—中医内科学] R277.7[医药卫生—中医学]