原发性失眠的证素调查分析

发布时间：2018-04-05 16:08

本文选题：原发性失眠　切入点：失眠　出处：《南京中医药大学》2017年硕士论文

【摘要】：目的:原发性失眠是最常见的睡眠障碍,目前专门针对原发性失眠进行证素调查的较少,本研究通过对原发性失眠患者的症状进行调查,探讨原发性失眠主要的病性、病位证素及其分布组合规律。方法:对在我院脑病中心收集100例原发性失眠患者进行流行病学调查,建立Excel表,运用探索性因子分析的方法对所收集患者的症状、舌脉等信息进行分析,得出原发性失眠的证候要素及证素组合规律,运用卡方检验探讨各病性证素与性别、年龄、病程的相关性。结果:100例原发性失眠患者的平均年龄为(45.66±15.16)岁,18-45岁占51%,45-60占31%,60-79岁占18%。男性占28%,女性患者占72%,男女比例为1:2.57。病程最短的1月,最长37年,平均病程为(62.98±71.10)月。根据因子分析得出的病性证素是:心、肝、胆、脾、胃、肾;病性证素是:火热、气滞、气虚、痰浊、气滞、阴虚、血虚。原发性失眠患者病性证素分布、组合规律:(1)100例患者的病性证素按频数由高到低排列依次是:火热气虚气滞痰浊血虚阴虚。(2)原发性失眠证素组合规律:最为常见的是两证素组合,占59%;其次为三证组合、单一证素,分别占26%、15%,未见四证素以上组合。单一证素分别是气虚和火热(10%);两证素组合有8种证型,主要有肝郁化火证、痰热扰心证、心脾两虚证和阴虚火旺证("g10%)。三证素组合有3种证型,主要为痰热内扰,心肝不宁证(10%)。(3)原发性失眠病性证素与性别、年龄的相关性:无论性别、年龄,火热最为常见;男性多见痰浊(P0.01),女性多见气虚(P0.05)。在年龄方面,各病性证素与各年龄组比较P0.05,无明显统计学意义。(4)原发性失眠与病程的相关性:亚急性失眠组19例,气虚证素最多(57.8%),慢性失眠组81例,火热证素最多(64.2%)。结论:(1)原发性失眠涉及的主要病位证素是:心、肝、胆、脾、胃、肾;主要病性证素是:火热、气滞、气虚、痰浊、血虚、阴虚。(2)无论年龄、性别,火热是原发性失眠的主要病性证素。(3)原发性失眠的病性证素存在性别差异,男性以痰浊为多,女性气虚为多。(4)原发性失眠的证素存在多种组合形式,其中以两证组合最为多见。(5)原发性失眠在发病年龄方面,以青年居多,各年龄组病性证素均以火热为多。(6)原发性失眠病性证素与病程有关,亚急性失眠组以气虚为多,慢性失眠组火热多见。
[Abstract]:Objective: primary insomnia is the most common sleep disorder. At present, there are few investigation on syndrome factors for primary insomnia. This study investigated the symptoms of patients with primary insomnia, and discussed the main disease of primary insomnia.Syndrome factors and their distribution and combination law.Methods: an epidemiological survey of 100 patients with primary insomnia was carried out in the brain center of our hospital. Excel tables were established and the symptoms, tongue veins and other information of the patients were analyzed by exploratory factor analysis.The syndromes and syndromes combination rules of primary insomnia were obtained, and the correlation between syndromes and sex, age and course of disease was discussed by chi-square test.Results the average age of 100 patients with primary insomnia was 45.66 卤15.16 years old.Men accounted for 28 and women for 72, with a ratio of 1: 2. 57.The shortest one month, the longest 37 years, the average course of disease is 62.98 卤71.10 months.According to factor analysis, the factors of disease syndrome are heart, liver, gallbladder, spleen, stomach and kidney, and the factors of disease syndrome are fire and heat, qi stagnation, qi deficiency, phlegm turbidity, qi stagnation, yin deficiency and blood deficiency.The distribution of syndrome factors in patients with primary insomnia, the combination rule of the disease syndrome factors of 100 patients with primary insomnia were in order of frequency from high to low: heat, deficiency of qi, stagnation of qi, stagnation of phlegm, blood deficiency, yin deficiency and yin deficiency.) the rule of combination of factors of primary insomnia syndrome: the most common was the combination of two syndromes, and the most common was the combination of two syndromes.The second is the combination of three syndromes and the single syndromes, accounting for 2615 points respectively, no more than four syndromes.There are 8 syndromes in the combination of the two syndromes: liver depression, phlegm and heat disturbing the heart, heart and spleen deficiency and yin deficiency and fire.The combination of three syndromes has three syndromes, mainly phlegm heat and internal disturbance, and heart and liver restlessness syndrome (10 / 10) and sex, age correlation: regardless of sex, age, fire heat is the most common; phlegm turbid phlegm is more common in male than phlegm in P0.01, and female in Qi deficiency P0.05.Conclusion the main syndromes related to primary insomnia are heart, liver, gallbladder, spleen, stomach and kidney, and the main syndromes are heat, qi stagnation, deficiency of qi, phlegm turbidity, blood deficiency, yin deficiency, etc.)Fire fever is the main symptom factor of primary insomnia. (3) there are sex differences in the factors of disease syndrome of primary insomnia. In men, phlegm turbidity is more, and in women qi deficiency is more. 4) there are many combinations of syndromes of primary insomnia.Among them, the combination of two syndromes is the most common. (5) the age of onset of primary insomnia is more than that of young people, and the most of all age groups is fire fever. 6) the factors of primary insomnia syndrome are related to the course of disease, and the subacute insomnia group is mainly caused by deficiency of qi.Fire fever was more common in chronic insomnia group.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R256.23

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