不寐患者中医体质与中医证型相关性研究

目的 探讨不寐患者中医证型与体质的相关性,为临床防治不寐提供新的思路与方法 。方法 对来源于2018年12月至2019年11月杭州市中医院睡眠障碍门诊的584例不寐患者进行临床研究调查,采用中医临床调查表及中医体质调查表,对调查结果进行总结,并采用SPSS 19.0统计学软件进行分析。结果 不寐患者常见体质为痰湿质175例、气郁质141例、阴虚质83例。常见中医证型为痰热扰心证149例、心胆气虚证132例、气郁化火证106例、肝郁气滞证73例。Logistic回归分析显示,痰湿质与痰热扰心证(P0.001,OR=3.057)、心胆气虚证(P0.001,OR=3.140)有关;气郁质与气郁化火证(P=0.003,OR=6.638)、肝郁气滞证(P=0.004,OR=6.504)有关;阴虚质与阴虚火旺证(P0.001,OR=3.868)有关;湿热质与痰热扰心证(P=0.001,OR=3.480)、心肝火旺证(P=0.046,OR=4.837)有关。结论 不寐患者中医证型与中医体质有密切的关系,不同的中医体质易转化为某种中医证型,为临床辨证治疗不寐提供新的思路。

Study on the correlation between TCM constitution and TCM syndrome of insomniacs

Objective To explore the correlation between traditional Chinese medicine (TCM) syndrome and TCM constitution of insomniacs,so as to provide new ideas and methods for clinical prevention and treatment of insomnia.Methods A clinical study on 584 insomniacs from the Sleep Disorder Clinic of Hangzhou Hospital of Traditional Chinese Medicine from December 2018 to November 2019 was carried out.The clinical questionnaire of TCM and the TCM constitution questionnaire were used to summarize the survey results,and Statistical Product and Service Solution(SPSS) Statistics 19.0 was used for statistics.Results The common constitutions of insomniacs were phlegm-dampness(175 cases),Qi-stagnation (141 cases),and Yin-deficiency (83 cases).Common TCM syndromes were syndrome of phlegm heat disturbing the heart (149 cases),deficiency of heart-Qi and gallbladder-Qi (132 cases),syndrome of Qi depression transforming into fire (106 cases),and syndrome of liver depression and Qi stagnation (73 cases).Logistic regression analysis showed that the phlegm-dampness constitution was related to syndrome of phlegm heat disturbing the heart(P<0.001,OR=3.057) and deficiency of heart-Qi and gallbladder-Qi(P<0.001,OR=3.140).The Qi-stagnation constitution was related to syndrome of Qi depression transforming into fire (P=0.003,OR=6.638) and liver-Qi stagnation(P=0.004,OR=6.504).The Yin-deficiency constitution was related to syndrome of hyperactivity of fire due to Yin-deficiency (P<0.001,OR=3.868).The Damp-heat constitution was related to syndrome of phlegm heat disturbing the heart(P=0.001,OR=3.480) and hyperactivity of heart-fire and liver-fire (P=0.046,OR=4.837).Conclusion There is a close relationship between TCM syndrome and TCM constitution of insomniacs.Different TCM constitution can easily be transformed into certain TCM syndrome,which provides new ideas for syndrome differentiation and treatment of insomnia in clinical practice.