肝血亏虚、心肝火旺证慢性失眠患者证候特征与睡眠质量、负性情绪及神经递质水平的相关性研究  

Study on the correlation between syndrome characteristics and sleep quality,negative emotion,and neurotransmitter level in patients with chronic insomnia of deficiency of liver blood,hyperactivity of heart-liver fire syndrome

作　　者：靳会会 李施新 段佳钰 王业飞 宋佳乐 李晓杉 廖俊雅 金香兰[2] JIN Huihui;LI Shixin;DUAN Jiayu;WANG Yefei;SONG Jiale;LI Xiaoshan;LIAO Junya;JIN Xianglan(The Second Clinical Medical College,Beijing University of Chinese Medicine,Beijing100078,China;the Second Department of Encephalopathy,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing100078,China)

机构地区：[1]北京中医药大学第二临床医学院,北京100078 [2]北京中医药大学东方医院脑病二科,北京100078

出　　处：《中国医药导报》2024年第32期110-114,共5页China Medical Herald

基　　金：中华中医药学会求实项目(2022-QNQSDEP-08)。

摘　　要：目的探讨肝血亏虚、心肝火旺证慢性失眠患者中医证候评分与匹兹堡睡眠质量指数(PSQI)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD-17)、5-羟色胺及多巴胺水平的相关性。方法选取2023年9月至2024年5月北京中医药大学东方医院门诊收治的71例肝血亏虚、心肝火旺证慢性失眠患者。采用中医证候评分量化中医证候,PSQI评估睡眠质量,失眠严重指数评估失眠严重程度,HAMA、HAMD-17评估焦虑和抑郁情绪。采用酶联免疫吸附试验法测定血清5-羟色胺、多巴胺水平。分析中医证候评分与PSQI、HAMA、HAMD-17评分,以及5-羟色胺、多巴胺水平的相关性。比较不同严重程度慢性失眠患者5-羟色胺、多巴胺水平。结果慢性失眠患者PSQI总分及其入眠时间、睡眠时间、睡眠效率、睡眠阻碍、催眠药物、白天功能障碍各维度评分与中医证候评分呈正相关(P<0.05);HAMA、HAMD-17评分与中医证候评分呈正相关(P<0.05);多巴胺水平与中医证候评分呈正相关(P<0.05)。慢性失眠患者HAMA评分与PSQI总分呈正相关(P<0.05);HAMD-17评分与PSQI总分呈正相关(P<0.05)。重度失眠患者5-羟色胺水平低于轻、中度失眠患者,多巴胺水平高于轻、中度失眠患者(P<0.05);中度失眠患者多巴胺水平高于轻度失眠患者(P<0.05)。慢性失眠患者5-羟色胺水平与病情严重程度呈负相关(P<0.05),多巴胺水平与病情严重程度呈正相关(P<0.05)。结论慢性失眠患者睡眠质量、负性情绪、神经递质水平与中医证候评分相关,血清5-羟色胺、多巴胺水平与病情严重程度有关。Objective To explore the correlation between traditional Chinese medicine syndrome score and Pittsburgh sleep quality index(PSQI),Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD-17)scores,5-hydroxytryptamin,and dopamine levels in patients with chronic insomnia of deficiency of liver blood,hyperactivity of heart-liver fire syndrome.Methods A total of 71 patients with chronic insomnia of deficiency of liver blood,hyperactivity of heart-liver fire syndrome admitted to Outpatient Service of Dongfang Hospital,Beijing University of Chinese Medicine from September 2023 to May 2024 were selected.Traditional Chinese medicine syndrome was quantified by using traditional Chinese medicine syndrome score,sleep quality was evaluated by using PSQI,insomnia severity was evaluated by using insomnia severity index,and anxiety and depression were evaluated by using HAMA and HAMD-17.Serum 5-hydroxytryptamin and dopamine levels were measured by using enzyme-linked immunosorbent assay.The correlation between traditional Chinese medicine syndrome scores and PSQI,HAMA,HAMD-17 scores,as well as 5-hydroxytryptamin and dopamine levels were analyzed.Levels of 5-hydroxytryptamin and dopamine in patients with chronic insomnia of different severity levels were compared.Results Total score of PSQI in patients with chronic insomnia,as well as the dimensions of sleep time,sleep duration,sleep efficiency,sleep obstruction,hypnotic drugs,and daytime dysfunction were positively correlated with traditional Chinese medicine syndrome score(P<0.05);HAMA and HAMD-17 scores were positively correlated with traditional Chinese medicine syndrome scores(P<0.05);dopamine level was positively correlated with traditional Chinese medicine syndrome scores(P<0.05).HAMA score of patients with chronic insomnia was positively correlated with total score of PSQI(P<0.05);HAMD-17 score was positively correlated with total score of PSQI(P<0.05).Levels of 5-hydroxytryptamin in patients with severe insomnia were lower than those in patients with mild to moderate

关 键 词：慢性失眠 中医证候 睡眠质量 负性情绪 神经递质 

分 类 号：R256.23[医药卫生—中医内科学]