不同年龄人群中医体质对睡眠质量的影响分析研究

背景　现代社会人们普遍存在不同程度的睡眠问题。有研究显示睡眠与中医体质密切相关，不同年龄人群的睡眠质量由于体质状况的差异可能呈现不同特点，但中医体质对睡眠质量影响情况在不同年龄段人群中的具体差异研究较为缺乏。目的　探讨不同年龄人群中医体质对睡眠质量的影响。方法　2015年3月-2016年5月，利用横断面现场调查法，收集1 029 例北京市一般人群的中医体质量表和匹兹堡睡眠质量指数量表（PSQI）数据。由中医体质量表获得平和质、气虚质、阳虚质、阴虚质、痰湿质、湿热质、血瘀质、气郁质和特禀质9种体质类型得分，得分越高体质倾向越明显；由PSQI获得总体睡眠质量得分，得分越高睡眠质量越差。结果　不同年龄人群平和质、阳虚质、特禀质得分及总体睡眠质量得分比较，差异均无统计学意义（P>0.05）；不同年龄人群气虚质、阴虚质、痰湿质、湿热质、血瘀质、气郁质得分比较，差异均有统计学意义（P<0.05）。不同年龄人群的平和质得分与总体睡眠质量得分呈负相关（P<0.001）；8种偏颇体质得分与总体睡眠质量得分呈正相关（P<0.001）。多元线性回归分析结果显示，不同年龄人群平和质及其他8种偏颇体质对总体睡眠质量均有影响（P<0.001），而不同年龄人群中医体质对睡眠质量的影响顺位和程度不同：位于前三位的体质因素，18~30岁为平和质、血瘀质、气郁质，31~44岁为平和质、气虚质、气郁质，≥45岁为平和质、血瘀质、痰湿质；31~44岁人群的中医体质对总体睡眠质量的影响大于18~30岁和≥45岁人群。结论　平和质对总体睡眠质量的影响最大，偏颇体质对总体睡眠质量的影响在不同年龄人群中存在差异。对不同年龄人群采取针对性的干预，改善偏颇体质，提升平和质水平，可能是提高睡眠质量的有效方法。

Effect of TCM-based Body Constitution on Sleep Quality:an Age-specific Analysis

Background Nowadays,sleep problems are a common disease.Studies have shown that sleep quality is closely related to TCM-based body constitution.Sleep quality in people of different ages may vary by body constitution.But there is lack of studies about the influence of TCM-based body constitution on sleep quality in different age groups.Objective To investigate the influence of TCM-based body constitution on sleep quality in different ages.Methods The data were obtained from a cross-sectional survey conducted in a convenience sample of 1 029 Beijing’s residents during March 2015 to May 2016.The Constitution in the Chinese Medicine Questionnaire (CCMQ) and Pittsburgh Sleep Quality Index (PSQI) were adopted in the survey.Scores of nine constitutional types,including gentleness type,Qi-deficiency type,Yang-deficiency type,Yin-deficiency type,phlegm-wetness type,wet-heat type,blood-stasis type,Qi-depression type and special diathesis type,were obtained by CCMQ.High score is associated with a more obvious tendency of constitution.The PSQI score is negatively correlated with sleep quality.Results The scores of Qi-deficiency type,Yin-deficiency type,phlegm-wetness type,wet-heat type,blood-stasis type and Qi-depression type varied significantly among the respondents by age(P<0.05),but the scores of gentleness type,Yang-deficiency type and special diathesis type and total PSQI score did not (P>0.05).There was a negative correlation between the score of gentleness type and the total PSQI score (P<0.001),indicating that sleep quality increased with the growth in gentleness of constitution.The scores of 8 types of pathological constitutions were positively correlated with the total PSQI score (P<0.001),showing that if body constitution was more pathologic,the quality of sleep would be worse.The results of multiple linear regression analysis showed that all the types of constitution had effects on the overall sleep quality of different age groups but with differences(P<0.001).The top three types of constitutions influenced the sleep quality most were gentleness type,blood-stasis type and Qi-depression type in 18-30-year-old respondents,and gentleness type,Qi-deficiency type and Qi-depression type in 31-44-year-old respondents,and gentleness type,blood-stasis type and phlegm-wetness type in respondents aged ≥45.The sleep quality in 31-44-year-old respondents was affected more significantly by TCM-based body constitution compared with those aged 18-30 or those aged ≥45.Conclusion The effects of gentleness type constitution on the sleep quality among people of different ages are the biggest.The influences of pathological constitutions on the sleep quality are different among people of different ages.To improve the sleep quality of people of different ages,targeted interventions based on age for ameliorating the pathological constitutions or enhancing the level of gentleness of constitution,may be an effective method.