| Objective:Through collect and statistic the clinical data,to explore the clinical features and characteristics of patients with insomnia.Through the features which are out of the biologic field,realize the importance of them,put up necessity of knowing the stories behind the disease and establish narrative medicine records of Traditional Chinese Medicine(TCM).Method:These 95 cases patients of insomnia come from the Neurology in the Dong Zhi Men hospital between October 2015 and February 2017.Collected and recorded the patients’information such as the name,sex,age,national origin,marital status,occupation,education,disease course,the situation of take drugs to improve the sleep,past-disease history,insomnia situation and TCM symptoms.Use the Pittsburgh Sleep Quality Index(PSQI)for sleep quality-evaluation,Hamilton Anxiety Scale(HAMA)assessment of anxiety level according to the collected data..According to the specific circum-stances of data collected to establish the relevant data-base,use the Statistical analysis software SPASS20.0 to statistical analysis of descriptive statistics,chisquare test,correlation analysis,non-parametric test,cluster analysis and t-test.From 2015 to 2017,we invited 5 professor which come from different medical offices to interview the patients and then set the self-examination.Through the method of sound recording,write them down,there has been 10 interview so far.Results:The 95 insomnia patients include 66.32%patients with anxiety,33.68%are not,the scale is 1.97:1.The appearance point out that anxiety-related insomnia is general.Through described statics of PSQI and HAMA score,obtained that the lowest score of PSQI is 7,the highest is 20 and the average score is 12.58±3.528.The lowest score of HAMA is 3,the highest is 44,the average is 19.14±9.122.The PSQI score of patients with anxiety-related insomnia is 13.33±3.943,without anxiety’s is 10.50(6),P<0.05,point the two ones are different.The rank mean is 37.83 and 53.17,point out the PSQI score of anxiety-related ones is higher.The statistical effect of HAMA grouping of components of PSQI showed that PSQI score,sleep quality(habitual sleep efficiency),sleep time(sleep latency),sleep disorders(subjective sleep quality),daytime dysfunction(daytime dysfunction)were affected by the HAMA group,and the 5 r value was over 0.The p value is less than 0.05,can be considered as anxiety group and PSQI of each component is related to the absolute value of the comparison shows that the most significant anxiety of sleep time and daytime function,followed by the PSQI score,and sleep disorders,in the end is the quality of sleep.Non anxiety and anxiety in patients with insomnia group the proportion of men and women were 1:2.2 and 1:2.94.Female patients with insomnia are more than male ones.The highest age for the elderly people at the age of 40-59(41.05%),followed by the young and middle-aged population aged 20-39(36.84%),the last for 60-80 years old people(22.11%).The ratio of patients with insomnia in the mental and manual labor is 4:1,ratio of 4.3:1 group simple insomnia patients with anxiety;group 3.85:1 ratio of each group can be found that the number of insomnia engaged in mental work was higher than that of manual labor,and the difference of simple insomnia crowd more obvious.The degree of manual labor,and the difference of simple insomnia crowd more obvious.The degree of culture,2 cases(2.11%primary school culture junior high school)a total of 17 cases(17.89%),high school of secondary school culture in 28 cases(29.47%),41 cases of university culture(43.16%),7cases of culture(7.37%)The general data of intermediate frequency number to describe visible gender,age,occupation,the degree of change had significant influence on insomnia,but the difference was not statistically significant(P>0.05).The main clinical features:the main features of insomnia were difficult to fall asleep in 84 cases(88.42%),dreaminess in 83 cases(87.37%),easy to wake up in 83 cases(87.37%),78 cases of fatigue after waking(82.11%)and 73 cases(76.84%)wake up early and found that non anxiety group can not sleep,wake up easily in 27 cases(84.38%),wake up early in 23 cases(71.88%).The anxiety group can not sleep,easy to wake up in 56 cases(88.89%),wake up early in 50 cases(79.37%).Insomnia patients with anxiety are more features prone to sleep,wake up easily.Secondary clinical features:the character and way of life and work of HAMA packets and the chi square test,according to a =0.05 standard,found only in love and worry about the character of HAMA packet is statistically significant,the rest of the p value,but according to the 0.05.frequency description results,worry about love in 70 cases(73.68%),a quick temper in 61 cases(64.21%),58(61.11%)cases of mad love,the pursuit of the perfect in 53 cases(55.79%),too much to bear in 41 cases(43.16%)and other personality traits and work pressure in 32 cases(33.68%),video work in 56 cases(58.95%),keep one position for a long time in 36 cases(37.89%)other ways of life are closely related to insomnia.Based on the clinical characteristics of patients with insomnia summary,reveal the secondary features closely related with insomnia,clear the importance of biological clinical features.Try to guide narrative medicine theory into clinic,invited 5 experts to the deputy high above the patients bedside interviews and write them down.To provide experience and reference for the construction of narrative parallel chart.Conclusion:1.Gender,age,occupation,educational level,duration of illness,personality traits,work life style are related to insomnia;2.Female,middle-aged,highly educated,white-collar workers,the long duration of time;a quick temper,easy to anger,easy to worry about;work pressure,life stress,non biological characteristics of life is not the law are the clinical features of secondary insomnia;3.Through the clinical interview and writing,the narrative medicine was introduced into the clinical practice of Chinese medicine,and the parallel medical records of TCM were constructed... |
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