围绝经期失眠中医证型分布与证型间睡眠状况差异的初步研究

发布时间：2018-01-12 11:17

本文关键词：围绝经期失眠中医证型分布与证型间睡眠状况差异的初步研究　出处：《成都中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：探索围绝经期失眠患者中医证型的分布规律,初步探讨围绝经期失眠患者不同中医证型之间睡眠状况(包括失眠中医主症、PSQI各个测评因子)的差异,及与睡眠有关的焦虑、抑郁情绪评分的差异。以提出较为客观、相对规范的围绝经期失眠中医证侯分型,为进一步开展大样本、多中心的围绝经期失眠的中医药系统研究打下基础。方法：通过临床观察及文献调查,参照导师经验及专家意见设计围绝经期失眠问卷调查表,2015年03月至2016年3月共收集符合纳入标准的205份病例,在EpiData 3.1数据控制功能下进行数据录入、核对,借助SPSS 21.0统计软件包,对数据进行统计分析：聚类分析、频数分析、确切概率法等,最后得出结论。结果：1.本次研究共纳入205例围绝经期失眠的患者,证型分布最常见为肝郁气滞证,其次依次为肝肾阴虚证、心脾两虚证及心胆气虚证。围绝经期失眠患者的症状频次排列,由多到少依次可见：入睡困难,苔白,多梦,舌淡,大便干,时睡时醒,月经提前,情绪焦虑抑郁,脉细弦,月经量多,心悸健忘,耳鸣等：2.经过确切概率法比较,不同证型之间失眠状况存在差异,肝郁气滞证以入睡困难为主,心胆气虚以时睡时醒、恶梦惊醒、多梦、早醒为主,心脾两虚以晨起思睡,晨起乏力为主3.经统计学处理.4个证型在PSQI总得分及7个因子得分上均有差异。4.在焦虑SAS量表上肝郁气滞证、肝肾阴虚证得分最高,在SDS抑郁得分上肝郁气滞证与心胆气虚证得分偏高。结论：围绝经期失眠患者证型分布以肝郁气滞最多见,其次依次为肝肾阴虚、心脾两虚、心胆气虚,不同证型之间的睡眠状况(包括睡眠障碍的主症及PSQI测评因子)、焦虑SAS及抑郁SDS量表评分均有差异。
[Abstract]:Objective: to explore the distribution of TCM syndromes in patients with insomnia in peri-menopausal period and to explore the sleep status among different TCM syndromes (including main symptoms of insomnia) in patients with insomnia in peri-menopausal period. In order to put forward a more objective and relatively standard TCM classification of insomnia during menopause, the differences of the scores of anxiety and depression related to sleep were also found. In order to further develop the large sample, multi-center peri-menopausal insomnia of traditional Chinese medicine system research lay a foundation. Methods: through clinical observation and literature survey. According to the experience of mentors and expert opinions, we designed the questionnaire of insomnia in menopausal period. From March 2015 to March 2016, we collected 205 cases that met the inclusion criteria. Data input and check were carried out under the function of EpiData 3.1 data control. With the help of SPSS 21.0 statistical software package, the data were statistically analyzed: cluster analysis, frequency analysis. Results 1. This study included 205 patients with peri-menopausal insomnia. The most common type of syndrome distribution was liver stagnation of qi, followed by liver and kidney yin deficiency syndrome. Syndrome of deficiency of heart and spleen and deficiency of heart and gallbladder qi. The frequency of symptoms of patients with insomnia in peri-menopausal period can be seen from more to less: difficulty in falling asleep, white moss, more dreams, light tongue, dry stool, waking up when sleeping and menstruation ahead of time. Emotional anxiety depression pulse fine string menstrual volume more palpitations amnesia tinnitus and so on 2. Through the exact probability method comparison between different types of insomnia there are differences liver stagnation of qi mainly difficult to fall asleep. Heart, gallbladder Qi deficiency to sleep when awake, nightmares wake up, more dreams, wake up early, heart and spleen deficiency in the morning to think of sleep. The four syndromes were different in the total score of PSQI and the scores of seven factors. 4. On the anxiety SAS scale, the syndrome of stagnation of liver and qi was the highest, and the syndrome of deficiency of liver and kidney yin was the highest. On the score of SDS depression, the scores of liver depression qi stagnation syndrome and heart and gallbladder qi deficiency syndrome were higher. Conclusion: liver depression qi stagnation is the most common type in peri-menopausal insomnia patients, followed by liver and kidney yin deficiency, heart and spleen deficiency, heart and gallbladder qi deficiency. There were significant differences in sleep status among different syndromes (including the main symptoms of sleep disorder and PSQI evaluation factors, anxiety SAS and depression SDS scale).
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R256.23

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