肿瘤失眠患者中医证型与PSQI的相关性及用药分析  

Correlation between Chinese medicine patterns and PSQI scores in patients with insomnia in malignant tumours and analysis of medication patterns

作　　者：张澄 潘玉真[2] 朱颖[2] ZHANG Cheng;PAN Yuzhen;ZHU Ying(The First Clinical College,Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Department of Oncology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学第一临床学院,辽宁沈阳110847 [2]辽宁中医药大学附属医院肿瘤科,辽宁沈阳1100321

出　　处：《中国现代医生》2025年第12期25-29,共5页China Modern Doctor

摘　　要：目的探究恶性肿瘤失眠患者中医证型与匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分的相关性,总结中药治疗恶性肿瘤失眠患者的用药规律,为临床治疗提供参考。方法选取2023年9月至2024年3月于辽宁中医药大学附属医院肿瘤科住院的63例恶性肿瘤患者,收集患者的中医证型、PSQI评分及中药处方,运用Excel表格整理数据,统计药物频次、功效、归经及性味,采用IBM SPSS Modeler 18.0进行药物关联规则分析。结果心气不足型PSQI等级差的发生率最高(45.00%),痰热扰心、肝郁化火、肝气郁结、阴虚火旺型PSQI等级一般的发生率最高(分别占50.00%、45.45%、50.00%、60.00%),心阳不足型PSQI等级很好、好、一般的发生率最高(33.33%)。心气不足证患者与PSQI评分等级为一般、差呈显著性正相关(P<0.05)。痰热扰心证患者与PSQI评分等级为好、一般、差呈正相关(P<0.05)。肝郁化火证患者与PSQI评分等级为一般、差呈正相关(P<0.05)。肝气郁结证患者与PSQI评分等级一般呈正相关(P<0.05)。收集处方63张,含药物49味,使用频次最高的药物为远志;药物功效以补虚药为主;性味归经以甘味、平性、归肺经为主。关联规则中支持度最高的二阶、三阶组合药物分别为远志–黄芪,远志–黄芪+甘草。结论本研究纳入的恶性肿瘤失眠患者的中医证型与PSQI评分等级有相关性,心气不足、痰热扰心、肝郁化火、肝气郁结证患者PSQI评分高,睡眠情况更差。中药主要以补虚安神为主,配合清热化痰、利水渗湿之法,同时可根据患者不同中医证型个体化治疗。Objective To investigate the correlation between Chinese medicine patterns and Pittsburgh sleep quality index(PSQI)scores in patients with insomnia of malignant tumours,and to summarize the rules of Chinese medicine for treating patients with insomnia of malignant tumours,so as to provide reference for clinical treatment.Methods Sixty-three patients with malignant tumours who were hospitalised in the Department of Oncology,Affiliated Hospital of Liaoning University of traditional Chinese Medicine from September 2023 to March 2024 and met the criteria were studied and the patients’traditional Chinese medicine patterns,PSQI scores and traditional Chinese medicine prescriptions were collected,and the data were sorted out by Excel,and the frequency,efficacy,meridian,and flavour of the medicines were counted,and then analysed by IBM SPSS Modeler 18.0 for the analysis of medication correlation rules.Results The highest prevalence of poor PSQI grade was found in the heart-Qi deficiency type(45.00%),the highest prevalence of phlegm-heat disturbing the heart,liver-depressing fire,liver-Qi stagnation,and Yin-deficiency and fire-excessive types all had average PSQI grades(50.00%,45.45%,50.00%,and 60.00%,respectively),and the highest prevalence of heart-Yang deficiency type had PSQI score grades of very good,good,and average(33.33%).There was a significant positive correlation between patients with heart-Qi deficiency evidence and PSQI score grades of fair and poor(P<0.05).There was a positive correlation between patients with phlegm-heat disturbing the heart evidence and PSQI score grades of good,fair,and poor(P<0.05).There was a positive correlation between patients with liver-depressing fire syndrome and PSQI score grades of fair and poor(P<0.05).There was a positive correlation between patients with liver-Qi stagnation syndrome and PSQI score grade of fair(P<0.05).Sixty-three prescriptions were collected,containing 49 flavours of medicines,and the most frequently used medicine was Yuanzhi;The efficacy of the medicines

关 键 词：恶性肿瘤 失眠 匹兹堡睡眠质量指数 中医证型 中药 用药规律 

分 类 号：R273[医药卫生—中西医结合]