老年脑梗死患者睡眠、情绪障碍及中医证候特征研究

目的探讨老年脑梗死患者亚急性期睡眠障碍、情绪障碍及中医证候特征。方法将符合研究标准的急性期脑梗死病例按照年龄分为老年组和非老年组,经常规西药治疗2周后,运用"中风病辨证诊断标准"进行中医证候评定,运用匹兹堡睡眠质量指数量表(PSQI)评价患者的睡眠状况,运用Zung抑郁自评量表(SDS)和Zung焦虑自评量表(SAS)进行情绪状态评估。结果老年组患者睡眠潜伏期、睡眠持续性、使用睡眠药物及PSQI总分分值明显高于非老年组(P0.05,P0.01)。老年组患者焦虑总分明显高于非老年组(P0.05)。老年组患者阴虚阳亢证候评分明显高于非老年组,痰证评分明显低于非老年组(P0.05)。结论老年脑梗死患者亚急性期睡眠质量较差,焦虑情绪明显,阴虚阳亢证候突出,可能与老年患者生理、心理特点密切相关。

Characteristics of Sleep Disturbance, Emotional Disorder and Syndrome Types of Elder Cerebral Infarction Patients

Objective To determine the characteristics of sleep disturbance, emotional disorder and syndrome types of elder cerebral infarction patients in sub-acute seizure phase. Method All the patients enrolled were divided into the older-age group and non-older-age group. After routine treatment of westem medicine for 2 weeks, the sleep quality of patients were evaluated with Pittsburgh Sleep Quality Index （PSQI） during the sub-acute seizure phase. Emotional disorder was assessed with the Self-rating Depression Scale （SDS） and Self-rating Anxiety Scale （SAS）. The syndrome types were determined by the Diagnostic Criteria of Syndrome Differentiation of Stroke. Result The scores of sleep latency, sleep duration, use of sleep medication and overall PSQI score in the older-age group were obviously higher than that in non-older-age group （P 〈0.05, P〈0.01）. The anxiety score in the older-age group was obviously higher than that in non-older-age group （P〈0.05）. The score of yin-deficiency and yang-predominance syndrome was higher and the phlegm syndrome score was lower in the older-age group （P〈0.05）. Conclusion The older patients with cerebral infarction in sub-acute seizure phase have lower sleep quality and more obvious emotional disorder. The yin-deficiency and yang-predominance syndrome is more significant than that of the non-older-age group, which may be closely related to the physiological and psychological characteristics of elder people.