高原高山地区失眠中医证型证素分布及睡眠质量指数特点研究

目的探讨高原高山地区失眠中医证型证素分布及睡眠质量指数特点,弥补对高原高山地区失眠中医证型证素及睡眠质量指数研究数据的不足。为全国不同地域失眠病症的辨证论治提供更科学更全面的客观依据。方法按照《中医病症诊断标准》、PSQI自评量表对失眠患者进行证候分类及问卷调查。采用卡方检验和对应分析等多种统计学方法研究高原高山地区失眠中医证型证素分布及睡眠质量指数特点。结果共纳入312例失眠患者,归纳14种证型,其中排列前3的由多到少依次是痰火扰心、心脾两虚、肝火扰心。高原高山地区痰火扰心(102例,32.69%)远超过心脾两虚(58例,18.59%)排列第1,组间差异具有统计学意义(P<0.01)。心脾两虚PSQI位于第1(17.90±1.31),痰热扰心PSQI位于第2(16.97±1.84),组间差异具有统计学意义(P<0.05)。病位证素分布中"心"位于首位(232例,54.72%)。病性证素分布中"火"位于首位(157例,30.31%)。结论高原高山地区痰热扰心型失眠远高于全国整体地区位列首位的心脾两虚型失眠。失眠证型比率与睡眠质量指数之间无相关性。高原高山地区心脾两虚失眠症状更严重。无论男女,在30~69岁年龄段痰热扰心及心脾两虚失眠发病率高、PSQI指数高。失眠主要影响到心,火是最主要的病因。通过证型证素及PSQI研究能为失眠的中医辨证论治提供客观化证据。

Study on Distribution of TCM Syndrome Types and Sleep Quality Index of Insomnia in High Altitude Area

Objective To explore the distribution of TCM syndrome types and sleep quality index of insomnia in high altitude area.To make upthe lack of the research data of TCM syndrome type and sleep quality index of insomnia in high altitude areas.To provide a more scientific and comprehensive objective basis for the syndrome differentiation and treatment of insomnia in different regions of the country.Method According to the diagnosis standard of traditional Chinese medicine and PSQI Self-evaluation Scale,the syndrome classification and questionnaire survey were carried out for insomnia patients.Chi square test and correspondence analysis were used to study the distribution of syndrome type factors and sleep quality index of insomnia in high altitude areas.Results A total of 312 insomnia patients were included.There were 14 types of syndrome.Among them,the top three were phlegm-fire disturbing heart,deficiency of heart and spleen,liver fire disturbing heart.In the high mountain area of plateau,the phlegm-fire disturbing heart type(n=102,32.69%)was more than the deficiency of heart and spleen type(n=58,18.59%).The difference between groups was statistically significant(P<0.01).PSQI of deficiency of heart and spleen type was in the first place(17.90±1.31)and the second place was the phlegm-fire disturbing heart type(16.97±1.84).The difference between groups was statistically significant(P<0.05)."Heart"was the first in the distribution of disease location and syndrome element(n=232,54.72%).Fire was the most important factor in the distribution of disease syndrome elements(n=157,30.31%).Conclusion The insomnia of phlegm-heat disturbing heart type in high altitude area was much higher than that of heart spleen deficiency type in the whole country.There was no correlation between insomnia syndrome rate and sleep quality index.Regardless of men and women,at the age of 30-69 population,the incidence of phlegm-heat disturbing heart type and spleen deficiency type of insomnia was high and the PSQI index was high.Insomnia mainly affects the heart,and fire is the main cause.The study of syndrome types and PSQI can provide objective evidence for TCM syndrome differentiation and treatment of insomnia.