A Preliminary Study On The Abnormality Of Insomnia And Defecation

Aim:Investigating the cause, pathomechanism and related TCM syndromes of patients with insomnia and abnormal bowel movement to provide a scientific basis for the clinical treatment of insomnia.Methodology:Using cross-sectional study approach and a unified inclusion criteria, each participant’s personal information, TCM diagnostic information, Pittsburg Sleep Quality Index(PSQI), Hamilton Anxiety Scale (HAMA) and Sleep Dysfunction Rating Scale were collected, heart rate variability and neurological activity were measured. Participants were sepatrated into two main groups normal bowel movement and abnormal bowel movement, according to TCM diagnosis, and further dividing the group with abnormal bowel movement into 6 subgroups those with sticky stools, difficulty defecating, tenesmus, lack of strength to defecate, dry stools, diarrhea. Investigating how insomniacs’sociological causes, personality traits, other related symptoms, heart rate variability and neurological activity affect type and degree of abnormal bowel movement, simultaneously performing data analysis of clinical symptoms presented by the group with insomnia accompanied by abnormal bowel movement, concluding and analyzing related TCM syndromes. SPSS 17.0 statistical software was used for data analysis and descriptive statistics, normality test, chi-square test, non-parametric test, such as clustering.Results:1.Amongst insomniacs,59% had abnormal bowel movement, out of which the majority had tenesmus,accounting for 26% of the group with abnormal bowel movement,and subsequently patients with sticky stools,dry stools etc. Within the group of insomniacs with abnormal bowel movement,the majority, in terms of gender, were females, male:female ratio was 3:2;in terms of age, were middle-aged(50-60 years old) or elderly (60 years old and above);in terms of profession, were white-collared workers accounting for 80.85%; in terms of education, were university, high school graduates. The group with abnormal bowel movement had the following personality traits:easily agitated(76.60%), short-tempered(65.96%),excessively worried (78.72%),easily nervous (53.19%).The majority of insomniacs with abnormal bowel movement had lifestyle habits including prolonged video operations (74.47%),eating too quickly with lack of chewing (51.06%).Whether or not work was stressful for insomniacs with sticky stools,showed a more significant difference (P<0.01) than that of other types of abnormal bowel movement;the lifestyle habit of prolonged video operations and prolonged maintenance of the same posture for insomniacs with tenesmus, showed a more significant difference (P<0.01) compared to other types of abnormal bowel movements.Distribution of accompanying symptoms of insomniacs with abnormal bowel movement:overthinking,poor memory,anxiety and so on.The following groups showed significant difference (P<0.01) from other types of abnormal bowel movement:the presence of or lack thereof stiff neck,lower back and knee soreness, shoulder stiffness etc accompanying symptoms in insomniacs with dry stools;the presence of or lack thereof dizziness and stiff neck etc accompanying symptoms in insomniacs with sticky stools; the presence of or lack thereof overthinking, dizzy,short-temperedness etc accompanying symptoms in insomniacs with difficulty defecating;the presence of or lack tendency to sweat easily in insomniacs with lack of strength to defecate. According to PSQI scores, significant characteristics of the group with insomnia and abnormal bowel movements were sleep disorders and daytime dysfunction.2.Patients with insomnia often accompanied by abnormal defecation, among the group of TCM Syndrome Differentiation for syndrome of stagnation of liver qi and spleen deficiency and pathogenesis is stagnation of liver qi, spleen qi deficiency, liver spleen disharmony, gas lift disorders;3.Distribution of heart rate variability within the group of insomniacs with abnormal bowel movement:For the autonomic nervous system,it was mainly the activation of the sympathetic nervous system, accounting for 62.5% of all cases. Insomniacs with abnormal bowel movements had a more significant difference (P<0.05) in LF/HF. LFnorm、Hfhorm scores than those with normal bowel movement;heart energy index, M-HRT. SD-HRT、SDNN、 rMSSD、SD、SDSD、PNN50(%)、TP、VLF、LF、Hfscores showed no significant difference (P<0.05)4.Distribution of brain activity of insomniacs with abnormal bowel movements:The group of insomniacs with abnormal bowel movements displayed a significant difference (P<0.05) in the degree of brain activity compared to the group with normal bowel movements. Conclusion:1. Patients with insomnia often accompanied by abnormal defecation, among the group of TCM Syndrome Differentiation for syndrome of stagnation of liver qi and spleen deficiency and pathogenesis is stagnation of liver qi, spleen qi deficiency, liver spleen disharmony, gas lift disorders; therefore traditional Chinese medicine treatment of insomnia, promoting blood circulation to remove blood stasis, Anshen Dingzhi and should be pay attention to harmonizing liver and spleen, regulating the circulation of Qi, Ning Anshen.2.Insomnia with patients with abnormal defecation multi autonomic nervous system disorder, sympathetic nerve excitability enhancement, reduce the parasympathetic nerve excitability; and the usual easy over thinking, self into a higher degree; therefore, traditional Chinese medicine and Western medicine in the treatment of insomnia should focus on lower sympathetic nerve excitability, restoration of parasympathetic nerve tension, improve the dysfunction of the autonomic nervous system.