糖尿病肾病伴睡眠障碍患者的中医体质分布与睡眠质量的相关性研究

【目的】探讨糖尿病肾病(DN)伴睡眠障碍患者的中医体质分布特征,以及中医体质与睡眠质量之间的关系,为DN的防治提供客观依据。【方法】于2015年10月至2018年10月,采用横断面调查方法,对300例DN患者采用匹兹堡睡眠质量指数量表(PSQI)进行睡眠质量评估,根据PSQI评分结果分为DN睡眠障碍组143例和DN非睡眠障碍组157例,比较2组患者的中医体质分布、病情进展程度等情况,并对DN睡眠障碍组患者进一步分析中医体质与睡眠质量、睡眠障碍的自觉症状之间的内在联系。【结果】(1)随着DN病情的进展,睡眠障碍的发生率呈上升趋势,差异有统计学意义(P<0.01)。(2)DN睡眠障碍组的中医体质分布以气虚质、阴虚质为主,与DN非睡眠障碍组比较,差异有统计学意义(P<0.05)。(3)二分类Logistic回归分析结果显示,气虚质(OR=5.34)、阴虚质(OR=7.70)、气郁质(OR=6.00)和血瘀质(OR=14.00)是DN伴发睡眠障碍的高危体质,差异均有统计学意义(P<0.01)。(4)DN伴睡眠障碍组患者主要表现为入睡困难(占59.3%)、多梦(占36.0%)、易醒(占33.0%)和早醒(占32.3%)。【结论】随着DN病情进展,睡眠质量呈下降趋势;睡眠质量和中医体质有一定的相关性,气虚质、阴虚质、气郁质和血瘀质的DN患者更易发生睡眠障碍。

Correlation Between Traditional Chinese Medicine Constitution Types and Sleep Quality in Diabetic Nephropathy Patients Complicated with Sleep Disorder

Objective To investigate the traditional Chinese medicine(TCM)constitution distribution characteristics of diabetic nephropathy(DN)patients complicated with sleep disorders,and to explore the relationship between TCM constitution types and sleep quality,so as to supply evidence for the prevention and treatment of DN.Methods From October 2015 to October 2018,a cross-section survey was carried out in 300 DN patients,and their sleep quality was assessed by Pittsburgh Sleep Quality Index(PSQI).According to the PSQI scores,the patients were divided into DN sleep disorder group(143 cases)and DN non-sleep disorder group(157 cases).And then we investigated TCM constitution distribution and disease progression of DN in the two groups,and analyzed the correlation of TCM constitution with sleep quality and sleep disorder symptoms in DN patients complicated with sleep disorder.Results(1)With the progression of DN,the incidence of sleep disorder showed an upward trend with statistical significance(P<0.01).(2)The TCM constitution in DN sleep disorder group was predominated by qi deficiency and yin deficiency,which differed from that in DN non-sleep disorder group(P<0.05).(3)The binary Logistic regression analysis showed that the constitution of qi deficiency(OR=5.34),yin deficiency(OR=7.70),qi stagnation(OR=6.00)and blood stasis(OR=14.00)were the high-risk constitution types of DN complicated with sleep disorder,the difference being significant(P<0.01).(4)The main insomnia manifestations of DN patients with sleep disorders were difficulty in falling asleep(59.3%),dreamfulness(36.0%),easy to be awakened(33.0%),and being early awakened(32.3%).Conclusion With the progression of DN,the sleep quality of DN patients tends to decline;the sleep quality is correlated with TCM constitution,and DN patients with the constitution of qi deficiency,yin deficiency,qi stagnation and blood stasis are more likely to suffer from sleep disorder.