成人不寐患者中医证候临床流行病学预调查

Clinical epidemiology pre-investigation on traditional Chinese medicine syndromes of insomnia in adults

关键词:  不寐  中医证候  临床预调查

Key words:  insomnia in adults  TCM syndromes  clinical pre-investigation

摘要:

[目的] 初步了解临床中成人不寐患者的一般情况、睡眠情况及中医证候特征与规律。[方法] 利用研制的成人不寐中医证候临床流行病学调查问卷和匹兹堡睡眠质量指数（PSQI）对2017年8月-2018年2月以不寐为主诉的成人患者进行预调查，用Excel建立数据库，并运用SPSS及Modeler进行统计分析。[结果] 共回收有效问卷75份，其中被调查者66.67%为女性，平均（56.20±14.19）岁，以60~79岁年龄的人数最多，61.33%的患者是高中及以上学历，44%的患者是脑力劳动为主者；76%的患者有既往病史，涉及43个疾病。90.67%的患者为慢性不寐，81.33%为入睡困难，92%为混合型不寐，PSQI（15.12±3.22）分。73.33%患者的病因病机是情志失调，37个常见中医症状，30.67%属心脾两虚证。[结论] 本次预调查的成人不寐患者以女性、老年人、脑力劳动者为主，文化程度较高，常伴有多种内科疾病；以慢性病程为主，以入睡困难者最多，多为混合型不寐；最主要的病因病机是情志失调，常见中医症状除睡眠相关主症外，常伴随精神情绪及日间功能下降症状，证候类型以心脾两虚最多。

Abstract:

[Objective] To know preliminarily the general situation,sleep situation and the characteristics and laws of traditional Chinese medicine (TCM) of insomnia in adults. [Methods] To investigate the adult patients with insomnia from August 2017 to February 2018 with developed TCM syndromes clinical epidemiology investigation questionnaire of insomnia in adults and Pittsburgh sleep quality index (PSQI) and establish the database with Excel to do the statistical analysis with SPSS as well as Modeler. [Results] This pre-clinical investigation retracted 75 effective questionnaires. There were 66.67% of the patients were women. The average age was (56.20±14.19) years old,with the most people in the age group from 60 to 79. 61.33% of the patients were high school degree and above,and 44% were mental labors. 76% of the patients had medical history,involving 43 diseases. 90.67% of the surveyed patients were chronic insomnia,81.33% had difficulty falling asleep,and 92% were mixed insomnia types with (15.12±3.22) of the PSQI average score. 73.33% of the patients' etiology and pathogenesis of insomnia in TCM was emotional disorders with 37 common TCM symptoms,while 30.67% of the patients' TCM syndrome type was heart and spleen deficiency. [Conclusion] The insomnia adult patients surveyed this time mostly were women,older people and mental labor with high education degree often accompanying several internal medical diseases. With mixed types of insomnia,most patients surveyed had chronic insomnia and had difficulty falling asleep. The major etiology and pathogenesis of insomnia in TCM was emotional disorders. The common TCM symptoms were psychosomatic and decreased daytime function ones besides the main symptoms of insomnia and the major TCM syndrome type was heart and spleen deficiency.