| Objective:Based on differentiation of theoretical research on obstructive sleep apnea hypopnea syndrom (OSAHS) in TCM syndrome distribution characteristics, and analysis of traditional Chinese medicine syndrome and BMI. AHI, lowest oxygen saturation (LSaO2), the correlation between ESS score, trying to seek more objective reference for TCM syndrome differentiation of OSAHS indicators, to provide evidence for the selection of clinical individualized treatment of OSAHS, to further improve the clinical curative effect and patients’compliance.Methods:Choose between December 2013 and December 2013 in the Chinese academy of sciences wangjing hospital of traditional Chinese medicine of sleep-disordered breathing ZhuanBing outpatient clinic patients with snoring, use the portable sleep apnea monitoring of sleep apnea monitoring (PM), incorporated in the cases of 240 cases of OSAHS diagnosis criteria.Measure and record the patient’s height, weight, neck circumference, sleep monitoring results, calculation of body mass index, fill in the patients with snoring sleep basic information table and the Epworth sleepiness scale, by two more than attending physician of TCM four diagnostic data collection (including symptoms, tongue and pulse condition, face, etc.), and according to the standard to determine the final TCM differentiation of traditional Chinese medicine syndrome.The collected data and input information into the computer, using EpiData to establish database, and generate the Excel file, all data are applied statistical software SPSS 20.0 statistical analysis.Result:1.240 cases of OSAHS patients were 182 male cases (75.8%) and 58 female cases (24.2%), the male incidence of a disease is significantly higher than female;2.The average age of 240 patients was 52.4±14 years old, including 108 cases (45%) aged between 45 to 60 years old, in the majority with middle-aged disease group;3.The average body mass index (BMI) of 240 patients was 29.13±4.1 Kg/m2, of which the obese (BMI>28) for a total of 142 cases, accounting for 59.2%;4.TCM syndrome distribution proportion is:phlegm hot indicates pulmonary syndrome in 74 cases (30.8%), cold dampness trapped spleen syndrome in 70 cases (29.2%), lung spleen deficiency syndrome in 52 cases (21.7%), blood stasis resistance 22 cases (9.2%,),20 patients with kidney Yang deficiency syndrome (,8.3%), liver depression and qi stagnation syndrome in 2 cases (0.8%); OSAHS patients are not all single syndrome, mixed syndrome (29.2%), common syndromes phase and combination is:cold dampness trapped spleen card+lung and spleen deficiency syndrome, cold dampness trapped spleen syndrome+blood stasis resistance syndrome, lung and spleen deficiency syndrome+blood stasis resistance syndrome;5.Four diagnostic data distribution:frequency in more than 40% of symptoms in the order:snoring, sleepiness, thirst, forgetfulness, tiredness, bosom frowsty, often with heavy body trapped, spontaneous perspiration, mouth, tongue as light white tongue (63.3%), the main coating is white and greasy moss (40%), yellow greasy moss (31.2%), thin white moss (23.3%), the main pulse condition is, fine pulse and pulse number of arteries and veins, string;6. Most in 240 OSAHS patients combined with hypertension, a total of 156 cases, accounting for 65%; Followed by hyperlipidemia,70 cases (29.2%),59 cases of coronary heart disease (24.6%), diabetes,48 cases (20%),26 cases of cerebrovascular disease (10.8%), arrhythmia,17 cases (7.1%). With hypertension, see more at vagina trapped spleen syndrome (47 cases), phlegm heat indicates pulmonary syndrome (45 cases), lung spleen deficiency syndrome (27 cases), coronary heart disease found in blood stasis resistance syndrome (17 cases), cold dampness trapped spleen syndrome (14 cases), hyperlipidemia in most cold dampness trapped in the spleen syndrome (33 cases), followed by phlegm heat indicates pulmonary syndrome (17 cases); Most diabetes in phlegm heat indicates pulmonary (16 cases), followed by cold dampness trapped spleen syndrome (10 cases), cerebrovascular disease develops in kidney Yang deficiency syndrome.7. AHI between different syndromes, the differences between the lowest oxygen saturation has no statistical significance (P> 0.05); Phlegm heat of lung card indicates BMI level higher than that of lung and spleen deficiency syndrome, blood stasis syndrome and kidney Yang deficiency syndrome (P< 0.05), kidney Yang deficiency syndrome neck circumference less than phlegm heat indicates pulmonary syndrome, cold dampness trapped spleen, lung and spleen deficiency syndrome and blood stasis resistance syndrome (P< 0.05), phlegm heat of lung card indicates the longest pause times higher than that of cold dampness trapped spleen syndrome, blood stasis resistance and kidney Yang deficiency syndrome (P< 0.05). phlegm heat of lung card indicates the average pause times higher than that of lung and spleen deficiency syndrome and kidney Yang deficiency syndrome (P< 0.05);8. In OSAHS TCM syndrome and PM monitoring indexes and BMI, ESS score of correlation study, using Logistic regression analysis, summed up the regression equation is as follows: Phlegm heat indicates pulmonary syndrome:Logit(p)=0.728X1+1.88X4-5.198 Cold dampness trapped spleen syndrome:Logit(p)=1.82X1+0.528X2-3.39 Lung deficiency syndrome:temper:Logit(p)=0.799X2-0.846X3-1.474 Blood stasis resistance:Logit(p)=1.65X2-3.344X3+2.077X4-4.276 The kidney Yang deficiency syndrome:Logit(p)=1.65X2--2.311X3-2.69 Among them, the X1,X2, X3, X4 represent the BMI, AHI, LSaO2, ESS scoreConclusions:OSAHS in TCM syndrome distribution characteristics as follows:phlegm hot indicates pulmonary syndrome> cold dampness trapped spleen> lung and spleen deficiency syndrome> blood stasis resistance syndrome> kidney Yang deficiency syndrome> liver depression and qi stagnation syndrome, the disease is associated with the disorder of the five zang-organs. OSAHS in general there are many complications and complications and has a certain relationship between TCM syndrome, such as high blood pressure, see more at phlegm heat indicates pulmonary syndrome, cold dampness trapped spleen, hyperlipidemia, see more at vagina trapped spleen syndrome, coronary heart disease found in blood stasis resistance, cerebrovascular disease found in kidney Yang deficiency syndrome.Phlegm heat indicates pulmonary degree of body mass index, sleepiness, pause time were significantly higher than that of other syndrome, phlegm heat is an important pathological factor of OSAHS. Different syndrome types and PM monitoring indicators and BMI, the relevance of ESS score, phlegm heat indicates pulmonary syndrome mainly associated with BMI, ESS score, cold dampness trapped spleen syndrome is mainly related to BMI, lung deficiency syndrome is mainly associated with AHI, LSaO2 temper, syndrome of blood stasis resistance mainly associated with LSaO2, kidney Yang deficiency syndrome is mainly associated with AHI, LSaO2, tips for phlegm heat indicates pulmonary or vagina trapped spleen syndrome in patients with the treatment can first consider to lose weight, weight control is given priority to, for lung and spleen deficiency syndrome, blood stasis syndrome and kidney Yang deficiency syndrome patient should first consideration is given priority to with CPAP therapy, in order to reduce apnea hypoventilation index, improve hypoxia state. |
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