A Research Of The Distribution Rule Of The Pathogenic Syndrome Elements Of Insomnia And The Role Of Phlegm-heat In Insomnia

Objective:(1)To Explore the method of standardizing TCM syndromes of insomnia and make a diagnostic scale with high reliability of pathogenic syndrome elements.(2)To apply the diagnostic scale of pathogenic syndrome element,standardize and analyze the diagnoses of pathogenic syndrome element of insomnia patients and to find its distribution rules,reveling the importance of phlegm-heat in insomnia.(3)To analyze the correlation between having difficulty falling asleep,being easy to awake,waking up too early and pathogenic syndrome elements.Methods:(1)To make a diagnostic scale of insomnia pathogenic syndrome elements through literature review and Delphi method.(2)To calculate the diagnoses of pathogenic syndrome element of 333 insomnia cases by applying the scale,analyze its distribution rule through statistical methods.(3)To figure out the correlation between having difficulty falling asleep,being easy to awake,waking up too early and pathogenic syndrome elements through Pearson correlation coefficient.Results:(1)The diagnostic scale of pathogenic syndrome elements is of high reliability and practice,of which the 8 pathogenic syndrome elements and their diagnostic threshold value are phlegm-heat(7 scores),liver depression(8 scores),stagnated fire(11 scores),blood stasis(5 scores),insufficient of the gallbladder-qi(8 scores),blood-insufficiency(6 scores),deficiency of qi(6 scores),deficiency of yin(9 scores)respectively.(2)The distribution rule of insomnia pathogenic syndrome elements:ranked by the frequency:phlegm-heat>blood-insufficiency(heart)>deficiency of yin(heart and kidney)>insuf ficient of the gallbladder-qi>deficiency of qi(spleen)>stagnated fire>liver depression>blood stasis.Phlegm-heat(177 examples,53.15%)is the top of the list.The total examples of excess syndrome elements including phlegm-heat,stagnated fire,liver depression,blood stasis is 389,accounting for 40.02%,of which the phlegm-heat is the most popular;the total examples of deficiency syndrome elements including blood-insufficiency>deficiency of yin>insufficient of thegallbladder-qi>deficiency of qi is 583,accounting for 59.98%,which is more common than excess syndrome elements and of which the deficiency of qi(117 examples)is the most.(3)The correlation between major clinical syndromes of insomnia and pathogenic syndrome elements:having difficulty fa.lling asleep has nothing to do with each pathogenic syndrome element,being easy to awake is most closely related to deficiency of qi(spleen),followed by blood-insufficiency(heart),deficiency of yin(heart and kidney),blood stasis,waking up too early is closely related to liver depression and blood-insufficiency(heart).Conclusion:The diagnostic scale of insomnia pathogenic syndrome elements is of high science and practice and workable,being convenient for standardizing TCM syndromes of insomnia.Phlegm-heat is the top of all the pathogenic syndrome elements and often combined with deficiency of yin,suggesting that phlegm-heat has an important role in insomnia.Major clinical syndromes of insomnia is closely related to pathogenic syndrome elements,being easy to awake most closely related to deficiency of qi(spleen),waking up too early closely related to liver depression,which provide new ways of syndrome-differentiation and treatment of insomnia.