强直性脊柱炎睡眠质量与中医证型分析  

Analysis of Sleep Quality and TCM Syndrome Types in Ankylosing Spondylitis LI Xue-

作　　者：李雪婷 邱明山[3] LI Xue-ting;QIU Ming-shan

机构地区：[1]厦门市翔安区马巷街道社区卫生服务中心,福建厦门361000 [2]福建中医药大学,福建福州350122 [3]厦门市中医院(北京中医药大学东直门医院厦门医院),福建厦门361009

出　　处：《风湿病与关节炎》2024年第2期17-22,共6页Rheumatism and Arthritis

基　　金：第五批全国中医临床优秀人才研修项目(国中医药人教函[2022]1号)。

摘　　要：目的:探讨睡眠质量与强直性脊柱炎(ankylosing spondylitis,AS)患者中医证型的关系,为伴睡眠质量问题AS患者的辨证论治提供参考。方法:选取AS患者110例,进行中医证型辨证,记录患者的一般资料、Bath强直性脊柱炎疾病活动指数(BASDAI)、Bath强直性脊柱炎功能指数(BASFI)、C反应蛋白(CRP)、红细胞沉降率(ESR)。运用睡眠状况自评量表(SRSS)评估睡眠质量。采用SPSS 20.0软件进行统计分析。结果:不同证型伴睡眠质量问题程度的分布差异有统计学意义(P <0.05),AS患者肾虚督寒证较肾虚湿热证更易发生睡眠质量问题(P <0.05)。AS患者肾虚督寒证伴睡眠质量问题多表现为轻度睡眠质量问题,在早醒、恶梦夜惊、失眠后反应方面分值均高于肾虚湿热证(P <0.05),其失眠后反应主要为乏力、疲倦、做事效率低下;AS患者肾虚督寒证伴睡眠质量问题较无睡眠质量问题者ESR及CRP水平高、BASDAI及BASFI分值高(P <0.05)。AS患者肾虚湿热证伴睡眠质量问题多表现为中度睡眠质量问题,在入睡困难方面分值明显高于肾虚督寒证(P <0.05);且CRP、ESR、BASDAI、BASFI均高于肾虚督寒证(P <0.05);AS患者肾虚湿热证伴睡眠质量问题较无睡眠质量问题者病程长、年龄大、ESR及CRP水平高、BASDAI及BASFI分值高(P <0.05)。结论:(1) AS患者不同证型的睡眠质量问题分布存在差异,肾虚督寒证伴睡眠质量问题发生率较高,但程度较轻,在早醒、恶梦夜惊、失眠后反应等方面困扰较大;肾虚湿热证伴睡眠质量问题时程度较重,以入睡困难为主要表现。(2) AS患者2种证型伴睡眠质量问题时ESR、CRP、BASDAI、BASFI均较高,肾虚湿热证上述指标均高于肾虚督寒证。Objective:To explore the relationship between sleep quality and traditional Chinese medicine(TCM)syndrome types in patients with ankylosing spondylitis(AS),and provide reference for the diagnosis and treatment of AS patients with sleep quality problems.Methods:One hundred and ten patients with AS were selected for TCM syndrome differentiation,and their general information,Bath Ankylosing Spondylitis Disease Activity Index(BASDAI),Bath Ankylosing Spondylitis Functional Index(BASFI),C-reactive Protein(CRP),and Erythrocyte Sedimentation Rate(ESR)were recorded.Self Rating Sleep Scale(SRSS)was used to evaluate sleep quality.Statistical analysis was conducted using software SPSS 20.0.Results:There was a statistically significant differ-ence in the distribution of sleep quality problems among different syndrome types(P<0.05),and AS patients with kidney deficiency and Du cold syndrome were more prone to sleep quality problems than those with kidney deficiency and damp heat syndrome(P<0.05).AS patients with kidney deficiency and Du cold syndrome often exhibited mild sleep quality problems,with scores higher than those with kidney deficiency and damp heat syndrome(P<0.05)in early awakening,nightmares and night terrors,and post insomnia reactions.The main post insomnia reactions were fatigue and low work efficiency.The ESR and CRP levels,as well as the BASDAI and BASFI scores,were higher in AS patients with kidney deficiency and Du cold syndrome accompanied by sleep quality problems compared to those without sleep quality problems(P<0.05).AS patients with kidney deficiency and damp heat syndrome accompanied by sleep quality problems often exhibited moderate sleep quality problems,and their scores in difficulty falling asleep were significantly higher than those of kidney deficiency and Du cold syndrome(P<0.05);and CRP,ESR,BASDAI,and BASFI were all higher than those of Kidney Deficiency and Du Cold Syndrome(P<0.05).AS patients with kidney deficiency and damp heat syndrome accompanied by sleep quality problems had a longer co

关 键 词：强直性脊柱炎 睡眠质量 中医证型 睡眠状况自评量表 临床分析 

分 类 号：R259[医药卫生—中西医结合]