慢性失眠德国患者125例中医证候分布特征分析及其与PSQI评分相关性研究  

Analysis on the distribution of TCM syndromes in 125 cases of chronic insomnia in Germany and the correlation between TCM syndrome type and PSQI score

作　　者：熊航 马淑惠[2,3] 李媛媛[2,4] 戴京璋[2,3] XIONG Hang;MA Shu-hui;LI Yuan-yuan;DAI Jing-zhang(Tongzhou District of Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 101121,China;TCM-Klinik,Beijing University of Chinese Medicine,Bad Koetzting 93444,German;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学东直门医院通州院区,北京101121 [2]北京中医药大学德国魁茨汀医院,德国93444 [3]北京中医药大学东直门医院,北京100700 [4]北京中医药大学东方医院针灸科,北京100078

出　　处：《中华中医药杂志》2021年第9期5541-5545,共5页China Journal of Traditional Chinese Medicine and Pharmacy

摘　　要：目的:探讨德国人群中慢性失眠住院患者的中医证候分布、辨证分型规律、各证型失眠的特点及证型与匹兹堡睡眠质量指数(PSQI)评分相关性。方法:收集从2019年4月至10月在北京中医药大学德国魁茨汀医院住院治疗的慢性失眠患者病例125例。收集其年龄、性别、职业、病史、症状、舌脉象等基本信息,以频数分析、聚类分析、单样本卡方检验等方法分析其证候分布、证型规律及失眠特点,观察中医证型与PSQI评分的相关性。结果:患者性别、年龄、职业、病程、居住情况、文化程度及失眠构成情况对中医证型的分布均无显著性影响。慢性失眠患者的常见症状有20项,出现频率较高的前5项症状依次为易醒、疲乏、入睡困难、早醒、醒后难再眠;舌、脉象以舌质暗、胖、有瘀斑,舌苔薄白、薄黄、白腻,脉象弦细、细滑和弦滑多见;辨证分型按频数多少依次为:心脾两虚证(47例)、肝火扰心证(35例)、心肾不交证(34例)、心胆气虚(5例)和痰热扰心证(4例);其中心脾两虚和肝火扰心证以入睡困难最多见,心肾不交证以易醒最多见,心胆气虚早醒最常见,痰热扰心证则多见易醒和早醒。PSQI评分由大到小依次为痰热扰心、心脾两虚、肝火扰心、心肾不交和心胆气虚证,各组间有明显统计学差异(P<0.01);且虚证患者的PSQI评分显著高于实证和虚实夹杂患者(P<0.01)。结论:德国人群中慢性失眠患者最常见的中医证型为心脾两虚,睡眠质量最差的为虚证失眠,且不同中医证型的PSQI评分有明显差异。Objective: To explore the distribution of TCM syndromes, the rule of syndrome differentiation and classification, and the characteristics of insomnia of various syndromes in Germany patients with chronic insomnia and to study the correlation between TCM syndrome type and Pittsburgh Sleep Quality Index(PSQI) score. Methods: A total of 125 cases of chronic insomnia inpatients were collected from April 2019 to October 2019 in the hospital of TCM-Klinik, Bad Koetzting,Germany, Beijing University of traditional Chinese medicine. The basic information of age, gender, occupation, history,symptoms, tongue and pulse were collected. The distribution and characteristics of syndrome were analyzed by frequency analysis, cluster analysis and single sample chi square test. And the correlation between TCM syndrome type and PSQI score was observed. Results: Gender, age, occupation, course of disease, residence, education and insomnia had no significant effect on the distribution of TCM syndrome types. There were 20 common symptoms in patients with chronic insomnia. The first 5 symptoms with high frequency were easy to awake during sleep, fatigue, difficulty sleeping, early wake-up and hard to fall asleep again after awake. The common tongue is dark, fat, ecchymosis, and the common tongue coating is thin white, thin yellow and white greasy.The common pulse is string-like and thin, thin and slippery, string-like and slippery. There are five types of common syndrome differentiation: heart-spleen deficiency syndrome(47 cases), liver fire harassing heart syndrome(35 cases), cardionephric disharmony syndrome(34 cases), heart-cholecyst deficiency syndrome(5 cases) and type of phlegm-heat attacking the heart(4 cases). The most common insomnia symptom of heart-spleen deficiency syndrome and liver fire harassing heart syndrome is difficulty in falling asleep. Easy to wake up is the most common insomnia symptom in cardionephric disharmony syndrome. The most common insomnia symptom of heart-cholecyst deficiency syndrome is waking up early. A

关 键 词：慢性失眠德国患者 中医证候 匹兹堡睡眠质量指数 

分 类 号：R256.23[医药卫生—中医内科学]